联合检测血清HE4和CA125对卵巢恶性肿瘤的诊断价值

Diagnostic value of serum HE4 combined with CA125 detected for ovarian malignant tumor

目的探讨血清中人附睾蛋白4(human epididymis protein 4,HE4)和糖链抗原-125(carbohydrate antigen 125,CA125)对卵巢恶性肿瘤的诊断价值。方法测定123例女性血清标本,其中卵巢恶性肿瘤34例,卵巢良性疾病39例,健康体检女性50例,用酶联免疫分析法(enzyme-linked immunosorbentassay,ELISA)和电化学发光法(electrochemiluminescence immunoassay,ECLIA)分别检测血清HE4和CA125水平。结果卵巢恶性肿瘤组血清HE4和CA125水平明显高于其他两组,差异有统计学意义(P<0.05);卵巢良性疾病组和健康对照组HE4比较差异无统计学意义(P>0.05)。以卵巢良性疾病作参照,单独检测血清HE4水平对卵巢恶性肿瘤诊断的敏感性为61.8%,低于单独检测CA125的73.5%;但特异性96.6%,高于CA125的80.9%。以二者其中之一高于参考值即视为阳性,联合检测血清HE4和CA125水平对卵巢恶性肿瘤诊断的敏感性94.1%,特异性80.9%,阴性预测值97.3%。结论检测血清HE4和CA125水平可明显提高卵巢恶性肿瘤诊断的准确率,并有助于卵巢良、恶性疾病的鉴别诊断。

Objective To study the diagnostic value of serum human epididymis protein 4（HE4） combined with carbohydrate antigen 125（CA125） detected for ovarian malignant tumors.Methods Serum samples of HE4 and CA125 levels from 123 cases including 34 cases with ovarian malignant tumors（in ovarian malignant tumors group）,39 cases with benign ovarian diseases（in ovarian benign diseases group） and 50 healthy women（in control group） were detected by enzyme-linked immunosorbent assay（ELISA） and electrochemiluminescence immunoassay（ECLIA）.Results Serum HE4 and CA125 levels in ovarian malignant tumors group were significantly higher than that in the other two groups and the difference was statistically significant（P0.05）.Serum HE4 between benign disease group and control group was no significant difference（P0.05）.Reference to benign ovarian diseases,diagnostic sensitivity of HE4 levels（61.8%） single detected for ovarian malignant tumors was lower than that of CA125（73.5%） alone detected.But the specificity of HE4 levels（96.6%） in ovarian malignant tumors was higher than that of CA125（80.9%） alone detected.Whichever one higher than the reference value was as positive.Diagnostic sensitivity,the specificity and negative predictive value of HE4 and CA125 combined detection was 94.1%,80.9%,of 97.3% respectively.Conclusion HE4 and CA125 combined detection can improve the diagnostic accuracy for ovarian malignant tumors and conduce to differential diagnosis for ovarian benign and malignant diseases.