HE4、CA125、CA72-4、CA153、CA19-9、CYFRA21-1、TSH在妇科肿瘤诊断中的评价

The evaluation of HE4,CA125,CA72-4,CA153,CA19-9,CYFRA21-1,TSH in diagnosis of gynecological tumor

目的探讨人附睾蛋白4(HE4)、癌症抗原125(CA125)、糖类抗原72-4(CA72-4)、糖类抗原153(CA153)、糖类抗原19-9(CA19-9)、细胞角蛋白21-1(CYFRA21-1)、促甲状腺激素(TSH)及联合检测在妇科肿瘤临床诊断中的价值。方法收集114例妇科肿瘤患者及40例正常对照者,ELISA法检测血清中HE4的表达,罗氏电化学发光方法检测血清中CA125、CA72-4、CA153、CA19-9、CYFRA21-1及TSH水平。结果腺癌中的HE4、CA125、CYFRA21-1、鳞癌中的HE4以及炎症反应中CA125的阳性率均显著高于正常对照(P<0.05);腺癌中CA125的阳性率显著高于平滑肌瘤、其他肿瘤和鳞癌(P<0.05);良、恶性肿瘤中HE4和CA125的阳性率显著高于正常对照(P<0.05);恶性肿瘤中CYFRA21-1的阳性率显著高于良性疾病和正常对照,CY-FRA21-1在腺癌和炎症反应之间差异有统计学意义(P<0.05)。结论 CA125、CYFRA21-1有助于妇科肿瘤诊断和鉴别诊断,联合检测有助于妇科肿瘤的诊断。

Objective To evaluate the value of human epididymis protein 4 （HE4）, cancer antigen 125 （CA125）, cancer antigen 72-4 （ CA724）, cancer antigen 153 （ CA153 ）, cancer antigen 19-9 （ CA19-9 ）, CY- FRA21-1, thyroid-stimulating hormone （TSH） in clinical diagnosis of gynecologic tumor. Methods 114 cases of gynecological neoplasms and 40 cases of normal controls were gathered. Adopting enzyme linked immnosorbent as- say （ELISA） to detect serum HE4 while electrochemilumineseenee assay of Roche was employed to detect serum CA125, CA72-4, CA153, CA19-9, CYFRA21-1 and TSH. Results Positive rates of HE4, CA125, CYFRA21-1 in patients with adenoeareinoma, HE4 in patient with squamous cell carcinoma, CA125 in patient with inflammato- ry reaction were significant higher than those in health control （P 〈 0. 05）. Meanwhile, positive rates of CA125 in patients with adenocarcinoma were significant higher than those in patients with leiomyoma, other tumor and squamous cell carcinoma （P 〈 0.05） ,and positive rates of both HE4 and CA125 in patient with malignant tumor were significant higher than those in benign disease patients and health control（P 〈 0.05）. Moreover, positive rates of CYFRA21-1 in patients with malignancy were significant higher than those in benign disease patients and health control, and there was significant difference between patients with adenocarcinoma and inflammatory reaction （P 〈 O. 05 ）. Conclusion Both CA125 and CYFRA21-1 are useful in the diagnosis and differential diagnosis of gyneco- logical tumor, and the combined detection is useful in the diagnosis of gynecological tumor.