摘要
目的了解血清癌抗原125(CA125)、癌抗原199(CA199)、甲胎蛋白(AFP)及癌胚抗原(CEA)在子痫前期(PE)高风险患者不同时期表达特征,评价其对子PE的诊断及预测价值。方法以2016年1月至2018年10月阜阳市第二人民医院收治的224例PE高危患者为研究对象,进行前瞻性随访与血清学监测,最终86例患者被诊断为PE,作为PE组;138例患者正常妊娠,作为对照组。比较两组患者妊娠18~20周、26~28周、32~34周血清CA125、CA199、AFP及CEA表达水平。采用诊断试验评价上述指标对PE的预测价值。结果PE组与对照组血清CA125、CA199及AFP随孕周延长呈显著上升趋势(P<0.05)。PE组妊娠18~20周、妊娠32~34周CA125、CA199及AFP均显著高于对照组,差异有统计学意义(P<0.05),而妊娠26~28周上述4种标志物均显著高于对照组,差异有统计学意义(P<0.05)。条件logistic回归显示,妊娠18~20周CA125、CA199及AFP,妊娠26~28周CA125与AFP是PE发生的独立影响因素(OR=1.416、1.031、1.069、1.513、1.077,P<0.05)。受试者工作特征曲线评价结果显示妊娠18~20周CA125+CA199+AFP联合诊断AUC=0.828(95%CI:0.754~0.884,P<0.001),妊娠26~28周CA125+AFP联合诊断AUC=0.845(95%CI:0.776~0.915,P<0.001),妊娠18~20周与26~28周联合指标预测效能差异无统计学意义(P>0.05)。结论CA125、CA199、AFP可在PE患者妊娠20周前即出现显著上升,具有较高的诊断及预测价值。
Objective To understand the expression characteristics of CA125,CA199,AFP and CEA in pre-eclampsia(PE)high-risk patients at different stages,and to evaluate the diagnostic and predictive value for PE.Methods 224 patients high-risk PE patients who admitted to Fuyang Second People's Hospital from January 2016 to October 2018 were enrolled in the study.Prospective follow-up and serological monitoring were performed.86 patients were diagnosed with PE(PE group);138 patients without PE were included as control group.The serum levels of CA125,CA199,AFP and CEA were compared between the two groups at 18-20 weeks of pregnancy,26-28 weeks,and 32-34 weeks of pregnancy were compared.The predictive value of the above indicators for PE was evaluated by diagnostic tests.Results The serum levels of CA125,CA199 and AFP in PE group and control group increased significantly with gestational age(P<0.05).The levels of CA125,CA199 and AFP in PE group were significantly higher than those in the control group at 18-20 weeks and 32-34 weeks after pregnancy(P<0.05).In the 26th to 28th week,four biomarkers were all significantly higher than in the control group(P<0.05).Conditional logistic regression showed that CA125,CA199 and AFP in 18-20 weeks of gestation,CA125 and AFP in 26-28 weeks were independent factors for PE(OR=1.416,1.031,1.069,1.513,1.077,P<0.05).The receiver operating characteristic curve showed that AUC of CA125+CA199+AFP was 0.828(95%CI:0.754-0.884,P<0.001)for 18-20 weeks of gestation,and AUC of CA125+AFP in 26-28 weeks was 0.845(95%CI:0.776-0.915,P<0.001).There was no statistical difference in the predictive efficacy between the 18-20 weeks and 26-28 weeks of gestation(P>0.05).Conclusion CA125,CA199 and AFP of PE patients can be significantly increased before 20th week,which has a high diagnostic and predictive value.
作者
刘芳林
朱红梅
路影
LIU Fang-lin;ZHU Hong-mei;LU Ying(Department of Obstetrics and Gynecology,Fuyang Second People's Hospital,Fuyang Anhui 236015,China)
出处
《临床和实验医学杂志》
2020年第20期2175-2178,共4页
Journal of Clinical and Experimental Medicine
基金
安徽高校自然科学研究项目(编号:KJ2016A371)。
关键词
子痫前期
血清标志物
诊断
预测
Pre-eclampsia
Serum markers
Diagnosis
Prediction
