| Objective: This study through the detection of second serum protein activator of mitochondrial caspase(Smac),human epididymis protein 4(HE4),carcinoembryonic antigen(CA125),to investigate the clinical significance of serum Smac,HE4 and CA125 alone or combined detection in epithelial ovarian carcinoma.Methods:1.Collected in December 2015 to 2017 January in Tianjin Central obstetrics and gynecology hospital examination qualified 40 healthy controls(I group),40 cases of benign ovarian tumor(II group)and Surgical treatment and the pathologic diagnosis of 60 cases of epithelial ovarian cancer(III group).Fasting serum were collected before and after surgery and chemotherapy.The level of serum Smac was detected by ELISA,the level of serum HE4 and CA125 was detected by Electrochemical immune method.2.The serum levels of Smac,HE4 and CA125 were compared between the three groups,and the relationship with clinical pathological factors.3.I group +II group as the control group,draw ROC curve to determine the optimal threshold value of serum Smac,analysis of the value of the three diagnosis of ovarian cancer.4.To compare the sensitivity and specificity of serum Smac,HE4 and CA125 in single and combined detection of EOC,and to explore the best method for the diagnosis of EOC.5.To compare the positive rates of serum Smac,HE4 and CA125 in different FIGO stages of EOC,and to screen the best index for the diagnosis of early ovarian cancer.6.The changes of serum Smac,HE4 and CA125 expression were detected before and after operation and chemotherapy,To explore the clinical value of the three in EOC postoperative monitoring.7.All the results using SPSS22.0 software for statistical analysis.Result: 1.Serum Smac expression level in epithelial ovarian cancer was significantly lower than that of healthy controls and benign ovarian tumor group(P < 0.05),while HE4 and CA125 expression level in EOC group was significantly higher than the other two groups.2.Youden index maximum value of Smac is 117pg/ml;the critical value of HE4 and CA125 were 140pmol/l and 35U/L respectively.3.Serum Smac is closely associated with FIGO stage and lymph node metastasis;and HE4 is associated with age,FIGO stage,pathologic type;CA125 is associated with FIGO stage,pathological type and NLR.4.The Sensitivity of Smac single detection up to 91.67%;The of specificity HE4 is the highest,up to 98.75%;Two joint among three,the specificity were lower than the highest single index;The Sensitivity of Smac+HE4+CA125 combined is the highest,up to 98.33%,but the specificity is low.5.The positive rates of Smac in early and late stage were higher than that in HE4 and CA125.The positive rate of CA125 in the late stage was significantly higher than that in the early stage,and the positive rate was only about 75% at the early stage.6.The expression level of Smac is obviously higher than that of preoperative,while HE4 and CA125 in contrast.Smac increased to normal at the end of the 2 period of treatment,HE4 and CA125 in 2,3 period of treatment respectively decreased to normal.Conclusions: 1.Serum Smac,HE4 and CA125 in EOC compared with other two groups have statistical significance(P < 0.05),and healthy controls and ovarian benign group have no differences.The three to differentiate benign and malignant ovarian tumors have certain clinical value.2.Serum Smac,HE4 and CA125 can be used for preoperative evaluation of epithelial ovarian cancer.3.Serum Smac has some guiding value in preoperative diagnosis of non-serous ovarian cancer.4.Patients with epithelial ovarian cancer in the process before and after surgery and chemotherapy,the serum Smac increased with the number of chemotherapy and the level gradually increased,and expression of CA125 and HE4 can be used in a reverse trend.The thress is used to monitoring the prognosis of postoperative ovarian cancer.5.Serum Smac can be used to detect early ovarian cancer,and the combination of HE4 is of greater value for the diagnosis of ovarian cancer in EOC. |
PDF Full Text Request