血清HE4浓度在妇科盆腔恶性肿瘤诊断中的应用

The Significance of HE4 Levels in the Diagnosis of Gynecological Pelvic Malignant Tumor

目的：探讨人附睾蛋白4（HE4）＆清含量在妇科盆腔肿物鉴别诊断中的价值。方法：检测132例妇女血清HE4水平，其中46例体检健康妇女作为正常对照组（n=46），86例盆腔肿物住院患者按术后病理结果分为良性病变组（n=56）和恶性病变组（n=30）。结果：正常对照组血清HE4范围是23．5～46．0pmol／L，均值为34．1±5．6pmol／L；艮性病变组血清HE4范围是30．1～58．9pmol／L，均值为39．1±7．2pmol／L；恶性病变组血清HF4范围是31．2—1430．0pmol／L，均值为248．7±364．5pmol／L，恶性病变组HE4水平明显高于其他两组，差异有统计学意义（P〈0．001）。HE4在51．6pmol／L时诊断指数最大（0．847），灵敏性和特异性分别为86．7％和98．0％，ROC曲线下面积0．935（95％CI：0．832-1．037，P=0．000）。HE4诊断盆腔恶性肿瘤的一致性检验Kappa值为0．867，／9=0．000。结论：血清HE4浓度测定是卵巢良、恶性肿瘤的鉴别诊断的良好指标。

Objective： To investigate the advantages of assessing the expression of human epididymis gene product 4 （HE4） in the differential diagnosis of gynecological pelvic tumor. Methods： We detected the level of serum HE4 in 132 women who were divided into the following three groups according to their postoperative pathology results： the normal control group （n=46）, the benign group （n=56） and the malignant group （n=30）. Results： The range of serum HE4 levels in the normal control group was 23.5-46.0 pmol/L with an average of 34.1±5.6 pmol/ L The range of serum HE4 levels in the benign group was 30.1-58.9pmo1/L with an average of 39.1±7.2 pmol/L. The range of serum HE4 levels in the malignant group was 31.2-1430.0 pmol/L, with an average of 248.7±364.5 pmol/L. The level of HE4 in the malignant group was significantly higher than that in the other two groups, with a significant difference （p=〈0.001）. A serum HE4 level of 51.6 pmol/L had the most significant diagnostic index （0.847）, with a sensitivity of 86.7% and a specificity of 98.0%. The ROC area under the curve was 0.935 （95% CI 0.832-1.037, P=0.000）. Checking the Kappa value of HE4 in diagnosing pelvic cancer gave a consistency of 0.867 （P=-0.000）. Conclusion： Serum level of HE4 protein is a good indicator for use in the differential diagnosis of benign and malignant ovarian tumors.