血清癌抗原125和人附睾蛋白4在子宫腺肌症中的表达及临床意义

Expression and clinical significance of serum cancer antigen 125 and human epididymis protein 4 in adenomyosis

目的观察血清CA125及HE4在子宫腺肌症患者中的表达状况,探讨CA125和HE4联合检测对子宫腺肌症的临床鉴别诊断价值。方法选取114例子宫腺肌症(研究组)、129例子宫肌瘤(对照组1)及53例子宫内膜癌(对照组2),采用化学发光法检测血清CA125,酶联免疫吸附试验(ELISA)法检测血清HE4,比较CA125和HE4在3组间的表达差异并计算各组的表达阳性率。结果子宫腺肌症组的血清CA125水平显著高于子宫肌瘤组和子宫内膜癌组,差异均有统计学意义(Z=-3.739,P=0.000<0.05;Z=-3.591,P=0.000<0.05)。子宫腺肌症组和子宫肌瘤组的血清HE4水平均显著低于子宫内膜癌组,差异也有统计学意义(Z=-5.196,P=0.000<0.05;Z=-8.366,P=0.000<0.05)。3组患者中血清CA125的阳性率以子宫腺肌症组为最高,为71.93%(82/114),χ2检验表明,各组间的差异均有统计学意义(χ2=97.236,P=0.000<0.05;χ2=30.667,P=0.000<0.05;χ2=7.936,P=0.005<0.05)。血清HE4在子宫腺肌症组和子宫肌瘤组中的阳性率分别为9.65%(11/114)、7.57%(10/129),2组间差异不存在统计学意义(χ2=0.276,P=0.599>0.05),但2组均显著低于子宫内膜癌组的58.49%(31/53),差异有统计学意义(χ2=45.847,P=0.000<0.05;χ2=55.413,P=0.000<0.05)。结论血清CA125在子宫腺肌症中高表达且阳性率较高,而HE4在子宫腺肌症中低表达,两者联合检测对子宫腺肌症具有重要的辅助诊断价值。

Objective To observe the expression of serum CA125 and HE4 in adenomyosis,and to explore their diagnostic applications of combined detection. Methods Serum specimens from 114 adenomyosis patients（ research group）,129 women with uterine leiomyoma（control group 1） and 53 cases of endometrial cancer（ control group 2） were detected for CA125 by electrochemiluminescence immunoassay and for HE4 by enzyme linked immunosorbent assay. The expression levels of serum CA125 and HE4 in three groups were compared,and the positive rates were also analyzed. Results The levels of serum CA125 in adenomyosis patients were significantly elevated compared to other two control groups（all P〈0. 05）,while serum HE4 concentrations in adenomyosis or uterine leiomyoma patients were significantly lower than those of endometrial cancer group（ P〈0. 05）. The positive rates of serum CA125 in three groups were 71. 93%（82 /114）,10. 08%（13 /129）,26. 41%（14 /53）,respectively,and there were statistical significance between each two groups（ all P〈0. 05）. Similarly,the positive rates of serum HE4 in three groups were individually 9. 65%（11 /114）,7. 57%（10 /129）,58. 49%（31 /53）. There was no statistical meaning for serum HE4 between research group and control group 1（P〈0.05）,whereas there were statistical differences between endometrial cancer group and other two control groups（all P〈0. 05）. Conclusion As serum CA125 was overexpressed in adenomyosis patients with high positive rate,it will provide more diagnostic value for adenomyosis in combination with detection of serum HE4.