HE4与CA125联合检测在卵巢癌与卵巢子宫内膜异位囊肿鉴别诊断中的临床应用

Clinical application of combined detection HE4 and CA125 differentiate malignant ovarian tumours from ovarian endometriotic cysts

目的:探讨HE4、CA125单项及联合检测在卵巢癌及卵巢子宫内膜异位囊肿鉴别诊断中的应用价值。方法:分别用ELISA法和化学发光免疫分析法检测38例卵巢癌患者、91例卵巢子宫内膜异位囊肿患者(内异症组)和60例健康者(对照组)的血清中HE4、CA125水平,比较分析两标志物单项及联合检测对卵巢癌、卵巢内异囊肿鉴别诊断的准确性。结果:卵巢癌组血清HE4、CA125水平均明显高于内异症组和健康对照组,差异有统计学意义(P<0.01);内异症组与对照组相比,血清CA125差异有统计学意义(P<0.05),HE4差异无统计学意义(P>0.05)。卵巢癌组以内异症组为参照人群时,HE4、CA1 2 5单项及联合检测的诊断敏感性、特异性、准确性分别为78.95%、90.11%、86.82%;81.58%、69.23%、72.87%和86.84%、80.22%、82.17%;以健康对照组为参考人群时,HE4、CA125单项及联合检测的诊断敏感性、特异性、准确性分别为78.95%、93.33%、87.76%;81.58%、91.67%、87.76%和94.74%、96.67%、95.92%。无论以内异症组或健康对照组为参照,HE4、CA125联合检测的诊断敏感性、准确性明显高于两标志物单项检测。结论:单项检测,HE4诊断卵巢癌特异性优于CA125;HE4+CA125联合检测可进一步提高卵巢癌诊断的准确性,也是卵巢恶性肿瘤与卵巢内异囊肿鉴别诊断的良好指标。

Objective ：To explore the value of HFA, CA125 alone or combined assay in differential diagnosis of ovatian malignant tumor and ovarian endometriotic cysts. Methods：The serum HE4 and CA125 were measured by enzyme - linked immunosorbent assay （ELISA） and electro - chemiluminescence immunoassay （ECLIA） respectively in the serum samples of malignant ovarian turnout group （ 38 cases） , ovarian endometriotic cyst group （ 91 cases ） and healthy women group（60 cases）. The differential diagnosis accuracy of HFA or CA125 alone and combination assay was analyzed. Results ： Serum HE4 and CA125 concentrations in ovarian malignant tumor group were significantly higher than those in ovarian endometriotic cyst groups and healthy controls （ P 〈 0.01 ）. Ovarian endometriotic cyst group compared with the control,serum CA125 difference was statistically significant（ P 〈 0.05 ） , HE4 had opposite result. When ovarian malignant tumor compared to ovarian endometriotic cyst group, the diagnosis sensitivity, specificity and accuracy of HE4 or CA125 alone and addition assay were 78.95% ,90.11% ,86.82% ;81.58% ,69.23%, 72.87 % and 86.84% , 80.22%, 82.17 % , respectively ; In comparison with healthy group, the diagnosis sensitivity, specificity and accuracy of HE4 or CA125 alone and addition assay were 78.95% ,93.33% ,87.76% ;81.58%, 91.67% ,87.76% and 94.74% ,96.67% ,95.92% ,respectively. No matter different disease within ovarian endometriotic cyst group or the healthy control for comparison, combination of HE4 and CA125 increased the sensitivity and accuracy of the diagnosis when compared to either marker alone. Conclusion：As a single tumor marker, HE4 was su- perior to CA125 for detecting ovarian cancer. Combined serum HFA and CA125 is a more accurate predictor of ovarian cancer and discriminate ovarian malignant tumors from ovarian endometriotie cysts effectively.