血清HE4浓度测定对卵巢恶性肿瘤的诊断价值

Diagnostic Value of Serum HE4 in Ovarian Tumor

目的探讨血清HE4(human epididymis gene product 4,HE4)水平测定对卵巢恶性肿瘤的诊断价值。方法通过酶联免疫法(ELISA法)分别测定64例卵巢上皮性恶性肿瘤患者、40例卵巢良性肿瘤患者以及40例健康妇女血清HE4水平,同时检测CA125的测定值。结果卵巢上皮性恶性肿瘤患者血清HE4测定值为395.2±231.29 pmol/L,卵巢良性肿瘤患者血清HE4测定值为43.86±20.87pmol/L,健康妇女血清HE4测定值为30.22±9.64 pmol/L。卵巢上皮性恶性肿瘤患者血清HE4水平与其他两组比较,差异有统计学意义(P<0.01),卵巢上皮性恶性肿瘤患者血清HE4水平明显高于其他两组。而卵巢良性肿瘤病变组和健康妇女组血清HE4水平比较,差异无统计学意义(P>0.05)。血清HE4测定值在148.8 pmol/L时诊断值最大,其特异性为97.5%,敏感度为86.4%,ROC曲线下的面积为0.975(95%CI0.970～1.000,P<0.001),FIGO分期、是否有远处转移及术后残余灶大小为卵巢恶性肿瘤患者生存的独立影响因素,HE4及CA125阳性或阴性、是否有淋巴结转移、腹水是否阳性、大网膜是否有转移不是卵巢恶性肿瘤患者生存的独立影响因素。结论血清HE4水平检测有助于卵巢恶性肿瘤诊断。

Objective To investigate the variation of HE4 concentration in human ovarian carcinoma and its clinicopathologic significance.Methods The serum concentration of HE4 and CA125 in 64 human ovarian carcinoma,40 ovarian benign tumor carried patients and 40 healthy control were detected by ELISA and electrochemistry irradiance methods respectively.Results The mean concentration of HE4 in 64 human ovarian carcinoma,benign tumor and healthy control was（395.2±231.29） pmol/L,（43.86±20.87） pmol/L,and（30.22±9.64） pmol/L respectively.The serum levels of HE4 were significantly higher（P0.01）in ovarian cancer than those in benign tumor group and healthy control.But there was no significantly difference between ovarian benign tumors and healthy control（P0.05）.It would be best for diagnosis when serum concentration of HE4 was 148.8 pmol/L on ovarian carcinoma.The sensitivity and specificity of diagnosing were 86.4 %and 97.5% respectively.The HE4 assay in receiver operating characteristic-area under the curve（ROC-AUC）was 0.975（95%CI 0.970~1.0000,P0.001）.There was not significant difference on serum concentration of HE4 in patients with or without lymph node metastasis,ascites and omentum metastasis.The independent factors of ovarian cancer survival was associated with the stage of FIGO,distant metastasis and post-operative residual lesion,but the serous HE4 contain was not independent factors for the prognosis of ovarian cancer.Conclusion It would be helpful to diagnose ovarian cancer on testing of serum HE4 contain.