Epidemiologic and biologic correlates of serum HE4 and CA125 in women from the National Health and Nutritional Survey (NHANES).
Epidemiologic and biologic correlates of serum HE4 and CA125 in women from the National Health and Nutritional Survey (NHANES).
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DOI：
10.1016/j.ygyno.2021.01.011
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发表时间：
2021-04
影响因子：
4.7
通讯作者：
Fichorova RN
中科院分区：
文献类型：
--
作者：
Cramer DW;Vitonis AF;Sasamoto N;Yamamoto H;Fichorova RN
在卵巢癌患者中，肿瘤特征在很大程度上决定了血清HE4和CA125水平；但非肿瘤因素也可能影响水平，通过研究非癌症女性样本中的决定因素可以更好地理解。对2001-2002年国家健康与营养调查（NHANES）队列中2302名妇女的血清HE4和CA125进行了测定。该队列的公开数据包括人口统计学/生殖变量、血细胞计数、c反应蛋白（CRP）、总同型半胱氨酸（tHcy）、可替宁和肌酐的测量，这些数据使用多变量模型和相关分析作为HE4和CA125的预测因子。HE4随年龄呈非线性增加，当前吸烟者的HE4较高。CA125在绝经后妇女和非白人中较低，并随着BMI的增加呈下降趋势。目前口服避孕药（OCs）使用者HE4和CA125较低；CA125随OC用量的增加呈下降趋势。孕妇CA125较高，哺乳期妇女HE4较高。HE4、CA125与中性粒细胞、单核细胞、中性粒细胞与淋巴细胞比值呈正相关，与淋巴细胞、淋巴细胞与单核细胞比值呈负相关。CRP与绝经后妇女HE4和CA125呈正相关。HE4与tHcy和肌酐均呈正相关。血清HE4和CA125水平受几种激素或环境刺激的影响，这些刺激会影响正常表达HE4或CA125的非癌组织。细胞因子在这些组织中的共表达可能反过来影响白细胞计数，并解释它们与HE4或CA125水平的相关性。
In women with ovarian cancer, tumor features largely determine serum HE4 and CA125 levels; but non-tumor factors may also influence levels and be better understood by studying determinants in a well-characterized sample of women without cancer. Serum HE4 and CA125 were measured in 2302 women from the 2001–2002 cohort of the National Heath and Nutritional Survey (NHANES). Publicly-available data on this cohort included demographic/reproductive variables, blood counts, and measurements of C-reactive protein (CRP), total homocysteine (tHcy), cotinine, and creatinine which were examined as predictors of HE4 and CA125 using multivariate models and correlational analyses. HE4 increased non-linearly by age and current smokers had higher HE4. CA125 was lower in postmenopausal women and non-whites and trended downward with increasing BMI. Current-users of oral contraceptives (OCs) had lower HE4 and CA125; and a downward trend for CA125 was seen with increasing OC use. Pregnant women had higher CA125 and nursing women higher HE4. HE4 and CA125 were positively correlated with neutrophils, monocytes, and the neutrophil-to-lymphocyte ratio and inversely correlated with lymphocytes and the lymphocyte-to-monocyte ratio. CRP was positively correlated with both HE4 and CA125 in postmenopausal women. Strong positive correlations existed for HE4 with both tHcy and creatinine. Serum levels of HE4 and CA125 are influenced by several hormonal or environmental stimuli which affect non-cancerous tissues which normally express HE4 or CA125. Cytokine co-expression in those tissues may, in turn, affect white cell counts and account for their correlation with HE4 or CA125 levels.
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