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目的研究血清中E-cad、TK1水平及HPV-DNA分型检测对宫颈癌诊断和预后的评价意义。方法选取2014年11月-2016年11月在该院就诊的宫颈病变患者280例作为研究对象、根据患者是否确诊为宫颈癌分为观察组和对照组。所有患者均检测血清中E-cad、TK1水平和HPV-DNA分型,对比两组患者中E-cad、TK1水平和HPV-DNA分型情况。探讨E-cad、TK1水平、HPV-DNA分型对宫颈癌的诊断价值,采用logistics回归分析各因素对宫颈癌预后的评价意义。结果观察组患者Ecad、TK1水平分别为41.5±12.36 ng/ml、3.36±0.69 pmol/L,HPV-DNA阳性率为78.6%,明显高于对照组(P<0.05);E-cad、TK1、HPV-DNA高危阳性三者联合诊断的敏感性、特异性、阳性预测值、阴性预测值分别为81.6%、97.7%、78.5%、98.2%,明显高于单用E-cad、TK1水平、HPV-DNA组患者,血清中E-cad、TK1、HPV-DNA阳性水平引入Cox回归模型,多因素分析提示:E-cad(P=0.07)、TK1评分(P=0.07)、HPV-DNA阳性是宫颈癌患者预后不良的独立危险因素。结论血清中E-cad、TK1、HPV-DNA与宫颈癌发生密切相关,是患者预后不良的风险因素。
Objective To study the significance of E-cad and TK1 levels in serum and the detection of HPV-DNA typing in the diagnosis and prognosis of cervical cancer. Methods A total of 280 cases of cervical lesions treated in our hospital from November 2014 to November 2016 were selected as the study subjects. According to whether the patients were diagnosed as cervical cancer, the patients were divided into observation group and control group. All patients were detected E-cad, TK1 levels and HPV-DNA typing, E-cad, TK1 levels and HPV-DNA typing were compared between the two groups. To investigate the diagnostic value of E-cad and TK1 levels and HPV-DNA typing in cervical cancer. Logistics regression was used to evaluate the significance of each factor in predicting the prognosis of cervical cancer. Results The levels of Ecad and TK1 in the observation group were 41.5 ± 12.36 ng / ml and 3.36 ± 0.69 pmol / L respectively, the positive rate of HPV-DNA was 78.6%, significantly higher than that in the control group (P <0.05) The sensitivity, specificity, positive predictive value and negative predictive value of combined HPV-DNA diagnosis were 81.6%, 97.7%, 78.5% and 98.2%, respectively, which were significantly higher than those of E-cad and TK1 (P = 0.07), TK1 score (P = 0.07), HPV-DNA positive was (P = 0.07), the positive rate of HPV- The independent prognosis of cervical cancer patients with independent risk factors. Conclusion Serum E-cad, TK1, HPV-DNA and cervical cancer are closely related to the prognosis of patients with poor risk factors.