人附睾蛋白4和糖链抗原125对卵巢癌的诊断价值

Diagnostic Value of Serum Human Epididymis Protein 4 and Carbohydrate Antigen 125 in Ovarian Cancer

目的评价人附睾蛋白4(human epididymis protein 4,HE4)和糖链抗原125(carbohydrate antigen 125,CA125)对卵巢癌的诊断价值。方法前瞻性收集175名(卵巢癌104名,妇科良性疾病患者71名)在过去3年里因盆腔肿块而来医院就诊的妇科患者,采用酶联免疫吸附剂测定(enzyme-linked immunosorbent assay,ELISA)法检测其血清HE4水平,采用受试者工作特征(receiver operating characteristic curve,ROC)曲线法评价HE4和CA125对卵巢癌的诊断价值,采用logistic回归分析HE4与卵巢癌的关系。结果不论是在绝经还是在未绝经女性中,HE4诊断卵巢癌的ROC曲线下面积(area under the curve,AUC)均高于CA125。在校正CA125之后,HE4>168.5 pmol/L仍然与卵巢癌独立相关(OR=24.54,P<0.01)。结论 HE4对卵巢癌的诊断价值高于CA125,二者的诊断价值并不完全重叠,联合使用有助于提高卵巢癌诊断的准确性。

Objective To evaluate the diagnostic accuracy of serum human epididymis protein 4（HE4） and carbohydrate antigen（CA125） in ovarian cancer. Methods One hundred and seventy five patients with pelvic mass（104 with ovarian cancer and 71 with gynecological benign disease） in our hospital were prospectively enrolled in this study.The serum HE4 concentration was determined by enzyme-linked immunosorbent assay（ELISA）.The diagnostic performance of HE4 and CA125 was estimated by receiver operating characteristic（ROC） curve analysis.The association between HE4 and ovarian cancer was evaluated by multivariable logistic regression model. Results The area under curve（AUC） of HE4 was higher than that of CA125,both for pre-and post-menopausal patients.After CA125 correction,serum HE4168.5 pmol/L was associated with ovarian cancer with the odds ration of 24.54（P0.01）. Conclusion HE4 has superior diagnostic value to CA125 and the combined utilization of CA125 and HE4 can improve the diagnostic accuracy.