人附睾分泌蛋白4在卵巢成熟畸胎瘤诊断中的临床应用价值

Clinical Values of Serum Human Epididymis Secretory Protein 4 in the Diagnosis of Mature Ovarian Teratoma

目的:探讨人附睾分泌蛋白4(HE4)在卵巢成熟畸胎瘤诊断中的临床应用价值。方法:选取88例卵巢成熟畸胎瘤患者(实验组)、80例健康女性(对照组),术前、术后采用酶联免疫法(ELISA)检测血清HE4水平;电化学发光免疫分析法检测血清CA199水平。通过制作受试者工作特征曲线(ROC),以曲线下面积(AUC)反映诊断的准确性,比较HE4及CA199对卵巢成熟畸胎瘤诊断的敏感度、特异度和阳性率。结果:实验组术前血清HE4和CA199水平分别为94.56pmol/L和54.72kU/L,对照组为29.13pmol/L和15.47kU/L,实验组均明显高于对照组,分别比较,差异有统计学意义(P<0.01,P<0.05)。实验组术后血清HE4和CA199水平分别为29.21pmol/L和18.23kU/L,术后血清HE4和CA199水平下降幅度比较,差异有统计学意义(P<0.01)。实验组检测HE4阳性率54.5%,CA199阳性率26.1%(P<0.05)。血清HE4和CA199单项检测的AUC分别为0.921和0.628;特异度为95%时的敏感度分别为64.3%和21.6%;特异度分别为96.2%和88.9%。结论:HE4在卵巢成熟畸胎瘤诊断中有意义,其检测阳性率高于CA199,诊断准确性、敏感度和特异度均优于CA199。

Objective：To explore the clinical values of human epididymis secretory protein 4 in diagnosis of mature ovarian teratoma. Methods ：88 patients with mature ovarian teratoma and 80 cases of healthy con- trol were enrolled at the first affiliated hospital of Harbin medical university between January 2011 and April 2012,whose serum HE4 and CA199 levels were respectively detected by ELISA and ECLIA before and after operation. The sensitivity, specificity, and positive rate of HE4 and CA199 in the diagnosis of mature ovarian teratoma were compared through ROC-AUC. Results：The serum HE4 and CA I~ levels of patients with ma- ture ovarian teratoma before operation were respectively 94. 56 pmol/L and 54.72 kU/L,which were signifi- cantly higher than the control group whose results were 29, 13 pmoVL and 15.47 kU/L（ P 〈 0.01 ; P 〈 0.05）. The serum levels of two indexes in mature ovariat~ teratoma patients after operation were 29.21 pmol/L and 18, 23 kU/L,which were significantly lower than the levels before operation（ P 〈 0, 01 ）. With the control group as the reference,the single detection AUC of HE4 and CA^99 in patients with mature ovarian teratoma were 0. 921 and 0. 628 respectively. Tumor marker sensitivity were 64. 3% and 21.6% respectively at the specificity was 95%, meanwhile the specificity of both were 96.2% and 88. 9% respectively. The posi- tive rate of HE4（54.5% ）were significantly higher than CA199 （26. 1% ） （ P 〈 0.05）. Conclusions：The HE4 has potential value in the diagnosis of ovarian teratoma,whose sensitivity,specificity and positive rate are bet- ter than CA199.