血清人附睾蛋白4对卵巢上皮性癌的诊断价值

The diagnostic values of serum HE4 levels in epithelial ovarian carcinoma

目的探讨血清人附睾蛋白4(HE4)对卵巢上皮性癌的诊断价值。方法 2007年12月至2008年12月在河北医科大学第二医院采用酶联免疫吸附试验,检测血清HE4在健康妇女、卵巢良性上皮性肿瘤、卵巢交界性肿瘤及卵巢癌患者血清中的水平。分析血清HE4诊断卵巢上皮性癌的价值。结果在健康妇女、卵巢良性上皮性肿瘤、卵巢交界性肿瘤及卵巢癌患者术前血清中,HE4的中位数分别为41.10、43.98、65.21、260.90pmol/L;HE4在术前卵巢癌组表达水平均高于前3组,差异均有统计学意义(P<0.05),前3组比较差异均无统计学意义;卵巢癌患者术后血清中HE4的中位数为124.32pmol/L,术前血清水平明显高于术后血清水平(P<0.05)。卵巢癌患者术前血清HE4质量浓度与病理类型、血清CA125质量浓度相关。以健康妇女组+良性肿瘤组为参照人群,HE4检测卵巢癌的ROC-AUC为0.960,HE4质量浓度在107.15pmol/L时,其ROC曲线(敏感性+特异性)-1的差值最大,即为最佳界值点。HE4的界值点为107.15pmol/L或150pmol/L时,HE4、CA125单项检测卵巢癌的敏感性差异无统计学意义;CA125单项检测的敏感性低于HE4+CA125联合检测的敏感性,差异有统计学意义(P<0.05);HE4单项检测的敏感性不低于上述联合检测的敏感性(P>0.05)。结论血清HE4水平可能成为卵巢癌的肿瘤标志物,其与CA125联合检测可提高卵巢癌的诊断率。

Objective To explore the diagnostic values of serum Human Epididymis Protein 4 （HE4）levels in epithelial ovarian carcinoma. Methods Enzyme-linked hnmunosorbent Assay （ELISA） technique was applied to detect serum HFA levels in healthy women and patients of benign ovarian tumor, borderline ovarian tumor,ovarian carcinoma between December 2007 and December 2008 in Second Affiliated Hospital of Hebei Medical University. The diagnostic values of serum HFA levels were analyzed. Results In healthy womeo, benign ovarian tumor, borderline Ovarian tumor and preoperative ovalian carcinoma, the sermn HE4 median levels were 41. 10, 43.98, 65.21, 260. 90 pmol/L respectively. The HFA levels in the preoperative ovarian carcinoma group were significantly higher than others （P 〈 0. 05）. However, there is no significant difference among the healthy women, benign ovarian tumor and borderline ovarian tumor group （P 〉 0.05 ）. In ovarian carcinoma group, the median postoperative HFA level was 124. 32 pmol/L, which was significantly lower than preoperative （P 〈0. 05）. In ovarian carcinoma group, the preoperative serum HFA levels was related to pathological types and the concentration of CA125. When ovarian carcinoma group was compared with healthy women and benign tumor groups, the HE4 assay in receiver operating characteristic-area under the curve （ROC-AUC） was 0. 960 and the diagnostic specificity was the best when the HE4 assay at the level of 107. 15pmol/L. When HFA set point of 107. 15pmol/L or 15015mol/L,the diagnostic sensitivity was no statistically difference compared with HFA and CA125 test alone. The combined assay of HFA ＋ CA125 was better than CA125 test alone, while HFA single test sensitivity is no less than the combined assay. Conclusion Serum HFA levels could be regarded as a biomarker of the ovarian carcinomas, which could improve the diagnostic rates of ovarian carcinomas when combined with CA125.