HE4 CA125和sB7-H4联合检测在卵巢癌早期诊断的临床价值

The Clinical Value of HE4 and CA125 Combined with sB7-H4 in Early Diagnosis of Ovarian Cancer

目的:通过检测卵巢癌患者血清中人附睾蛋白4(human epid idym is protein 4,HE4)、CA125和可溶性B7同源体4(soluble B7 homologous body 4,sB7-H4)的水平,探讨这三项标志物联合检测在卵巢癌早期诊断与预后的临床价值。方法:采用酶联免疫法(ELISA)检测58例不同分期卵巢癌患者及35例健康对照组血清HE4、CA125和sB7-H4的水平以及观察卵巢癌患者手术前后三项指标的水平变化。结果:各期卵巢癌患者血清HE4、CA125和sB7-H4水平均显著高于健康对照组(P<0.01),且三项指标的水平随癌症分期的增高而升高(P<0.01),卵巢癌患者手术后血清三项指标的水平显著低于手术前水平(P<0.001);卵巢癌患者血清HE4、CA125和sB7-H4检测的灵敏度分别为89.66%、77.59%和82.79%,特异性分别为97.37%、84.21%和81.59%,三项指标联合检测的灵敏度和特异性为94.83%和94.74%。三项指标联合检测的灵敏度高于单项检测(P<0.05),特异性高于CA125和sB7-H4单独检测,但低于HE4单独检测。结论:HE4在卵巢癌诊断中有重要意义,尤其在早期卵巢癌的诊断中其灵敏度及特异性均优于CA125和sB7-H4,三项指标联合检测可提高卵巢癌的早期诊断率。

Objective： To explore the clinical value of three markers in early diagnosis and prognosis of ovarian cancer by detecting the serum level of HE4, CA125 combined with sB7-H4 in ovarian cancer patients. Method：HE4, CA125 and sB7-H4 serum levels were detected in 58 cases of different stage ovarian cancer patients and 35 healthy women as controls by ELISA. And observed three indexes level changes before and after operation. Result：The serum HE4, CA125 and sB7-H4 levels before operation of patients with ovarian cancer were significantly higher than the control group（ P〈0.01 ）. The serum level of three indexes were increased with cancer staging （ P〈0.01 ）. The serum level of three indexes in ovarian cancer patients after operation significantly below before operation level （ P〈0.001 ）. The detection sensitivity of HFA, CA125 and sB7-H4 was respectively 89.66% , 77.59% and 82.79%. The specificity was respectively 97. 37%, 84.21% and 81.59%. The sensitivity and specificity of three indexes joint test were 94.83% and 94.74%. The sensitivity of three indexes joint test was higher than single detection （ P〈0.05 ） , and the specificity was higher than those of CA125 and sB7-1-14, but belower than that HE4 detection. Conclusion：The HE4 has important significance in the diagnosis of ovarian cancer, especially, its sensitivity and specificity are all better than CA125 and sB7-H4 in the diagnosis of early ovarian cancer, the detection of HFA, CA125 combined with sB7-H4 can elevate the early diagnosis rate of ovarian cancer.