联合检测HE4和CA125对卵巢癌早期评估的价值

Value of Combined Detection of HE4 and CA125 in Early Diagnosis of Ovarian Cancer

为探讨联合检测人附睾蛋白4（HE4）和糖类抗原125（CA125）在卵巢癌早期诊断、治疗中的价值,测定134例女性血清HE4、CA125水平,其中体检健康女性58名,作为正常对照组,盆腔肿物住院患者76例,按术后病理结果分为良性病变组15例,交界性病变组19例和卵巢癌组42例。应用ELISA法检测血清HE4水平,应用全自动化学发光分析系统检测血清CA125水平。全部随访2~62个月。卵巢癌组HE4、CA125水平明显高于其他3组,差异有统计学意义（P〈0.01）,其他3组CA125水平比较差异均无统计学意义（P〉0.05）,交界性病变组HE4水平与良性病变组、正常对照组比较,差异也有统计学意义（P〈0.05）;二者水平在I期与Ⅲ、Ⅳ期之间差异有统计学意义（P〈0.05）;且有淋巴结转移者明显高于无淋巴结转移者（P〈0.05）;随访结果表明,随HE4和CA125水平的差异（P〈0.05）,患者的5年生存率也有显著差异。对临床指标肿瘤长径〉6 cm的HE4水平明显高于肿瘤长径≤6 cm者（P〈0.05）,而两者间CA125水平无显著差异（P〉0.05）。卵巢癌患者HE4和CA125水平呈正相关（r=0.48）。联合检测HE4和CA125对卵巢癌早期诊断,判断恶性程度,评价治疗效果及评估预后均有重要意义。

To explore the clinical value of combined detection of human epididymis gene product 4（HE4）and cancer antigen 125（CA125）in the early diagnosis of ovarian cancer,the serum HE4 and CA125 levels in 76 patients and 58 health controls were measured by enzyme-linked immunosorbent assay（ELISA）and automated chemiluminescence analysis system respectively.The 76 patients were divided into benign lesion group（15 cases）,borderline lesion group（19 cases）and ovarian cancer group（42 cases）according to surgery pathological findings.The results showed that the serum HE4 and CA125 levels in ovarian cancer group were significantly higher than that of controls and other two patient groups（P0.01）;The CA125 levels in other 3 groups had no statistically difference（P 0.05）.There were statistically difference in serum HE4 levels between borderline lesion group and benign lesions,normal control group（P0.05）.The serum HE4 levels in phase I were statistically different with that in phase Ⅲ and phase Ⅳ（P0.05）.The serum HE4 levels in lymph node metastasis was significantly higher than those without lymph node metastasis（P0.05）.Follow-up results showed that there was a significant difference in 5-year survival rate of patients as the difference of serum HE4 and CA125 levels（P0.05）.The serum HE4 levels in those patients whose tumor size larger than 6cm were significantly higher than in those tumor size smaller than 6cm（P0.05）,while their serum CA125 levels were no significant difference（P 0.05）.There was a positive correlation between serum HE4 and CA125 levels in ovarian cancer patients（r=0.48）.The combined detection of serum HE4 and CA125 have significant importance in the early diagnosis,determining the degree of malignancy and evaluating the effect of treatment and prognosis of ovarian cancer.