血清肿瘤标记物与卵巢良恶性肿瘤的相关性分析

Analysis of correlations between serum tumor marker and benign or malignant tumor

目的分析血清肿瘤标记物糖类抗原CA125、癌胚抗原(CEA)、人附睾蛋白4(HE4)与卵巢肿瘤性质、卵巢癌临床分期、组织学分型及预后的相关性。方法 CA125、CEA采用电化学发光法检测,HE4采用酶联免疫(ELISA)法检测。选取178例卵巢肿瘤患者为研究对象,均经住院手术治疗,术后病理组织学确诊。其中,卵巢恶性肿瘤92例(卵巢癌组),卵巢良性肿瘤86例(卵巢良性病变组),所有病例术前、术后随访均有血清肿瘤标记物CA125、CEA、HE4检查资料,采用回顾性统计方法分析其与卵巢良恶性肿瘤的相关性。结果卵巢癌组患者血清CA125、CEA、HE4水平与卵巢良性病变组比较差异有统计学意义(P<0.01);卵巢癌高分期组(Ⅲ、Ⅳ期)血清CA125、CEA、HE4水平分别为(423.42±117.35)U/ml、(59.23±19.97)ng/ml、(513.11±221.13)pmol/L,卵巢癌低分期组(Ⅰ、Ⅱ期)分别为(207.19±61.23)U/ml、(36.78±9.41)ng/ml、(263.82±102.43)pmol/L,两组比较差异有统计学意义(P均<0.01);卵巢癌组手术后3个月血清CA125、CEA、HE4水平与术前比较差异有统计学意义(P<0.01);卵巢癌低分期组(Ⅰ、Ⅱ期)手术后3个月血清CA125、CEA、HE4水平与卵巢良性病变组比较差异无统计学意义(P>0.05);卵巢癌高分期组(Ⅲ、Ⅳ期)手术后3个月血清CA125、CEA、HE4水平与卵巢良性病变组比较差异仍有统计学意义(P<0.05)。CA125、CEA、HE4诊断卵巢癌的敏感性分别为64.1%、30.4%、42.4%,三项联合检测诊断卵巢癌的敏感性高达92.4%,联合检测与各单项检测敏感性比较差异有统计学意义(P<0.01)。结论血清肿瘤标记物CA125、CEA、HE4联合动态检测是鉴别卵巢良恶性肿瘤的有效方法,对卵巢癌的早期诊断、临床分期、组织学分型及预后观察具有重要的临床应用价值。

Objective To analyze the correlations between the serum tumor markers of CA125,CEA,HE4 and ovarian tumor character,clinical stage,histological classification and prognosis.Methods The CA125 and CEA were detected by electrochemical luminescence method,and HE4 was detected by enzyme-linked immunosorbent assay （ELISA）.178 cases of ovarian cancer patients were selected to study,of which,92 cases were ovarian malignant tumor patients（ovarian cancer group）,and 86 cases were ovarian benign tumor patients（control group）.All the patients were confirmed with postoperative histology diagnosis after hospitalization and surgical treatment,and the preoperative as well as the postoperative levels of serum tumor markers of CA125,CEA,HE4 were detected.The correlations between serum tumor marker and benign or malignant tumor were analyzed via retrospective analysis statistical method.Results The levels of the tumor makers CA125,CEA and HE4 of ovarian cancer group were apparently higher than those of benign ovarian group（P ＜ 0.01）.The levels of tumor makers CA125,CEA and HE4 of low stage（Ⅰ,Ⅱ）were（423.42 ± 117.35）U/ml,（59.23 ± 19.97） ng/ml,（513.11±221.13） pmoL/L.The levels of tumor makers CA125,CEA and HE4 of high stage（Ⅲ,Ⅳ） were （207.19 ± 61.23） U/ml,（36.78 ± 9.41） ng/ml,（263.82 ± 102.43） pmol/L,and the high stage（Ⅲ,Ⅳ）of ovarian cancer group was significantly higher than that of the low stage （Ⅰ,Ⅱ） （P ＜ 0.01）.The difference of tumor makers level of preoperative group comparing with postoperative group were statistical significant（P ＜ 0.01）.The diagnosis of ovarian cancer sensitivity of CA125,CEA and HE4 were 64.1％,30.4％ and 42.4％.The sensitivity of combined dynamic detection can reach up to 92.4％,which was statistical significant comparing with each individual indicator（P ＜ 0.01）.Conclusions The combined dynamic detection of CA125,CEA and HE4 is a good indicator of early diagnosis,clinical stage,histological classification and prognosis of ovarian cancer,which is favorable for clinical early detection and early intervention.