HE4和CA125联合检测在女性上皮性癌诊断中的应用研究

Combined detection of HE4 and CA125 in diagnosis of women epithelial carcinoma

目的探讨人附睾蛋白4(HE4)和糖链抗原125(CA125)联合检测在女性上皮性癌诊断和鉴别诊断中的应用价值。方法于2011年3月至2012年4月,对58例上皮性癌和64例良性病变女性患者进行血清CA125和HE4检测,分析CA125和HE4在良、恶性病变患者中的表达水平及二者联合检测的诊断效能。结果上皮性卵巢癌和其他上皮性癌患者血清HE4、CA125水平均高于良性病变患者(P<0.05),上皮性卵巢癌和其他上皮性癌患者血清HE4水平比较差异无统计学意义(P>0.05)。HE4、CA125单项检测的诊断灵敏度分别为46.6%和60.3%,联合检测诊断灵敏度为70.7%,较单项检测明显提高(P<0.05)。以良性疾病患者为参照人群,HE4、CA125单项检测及二者联合检测的受试者工作特征曲线下面积分别为0.783、0.679和0.791。血清HE4临界值设为107.145pmol/L时,诊断指数最大,灵敏度和特异度分别为69.0%和78.1%。结论 HE4是灵敏度较高的上皮性癌血清标志物,与CA125联合检测有助于提高肿瘤的检出率和诊断效能,有良好的应用前景。

Objective To study the value of combined detection of carbohydrate antigen 125（CA125）and human epididymis protein 4（HE4）in the diagnosis of women epithelial carcinoma.Methods From Mar.2011 to Feb.2012,serum levels of CA125 and HE4were detected in 58 patients with women epithelial carcinoma and 64 patients with gynecological benign diseases.All results were statistically analyzed.Results Serum levels of CA125 and HE4were significantly higher in patients with ovarian cancer or women epithelial carcinoma than patients with gynecological benign diseases（P〈0.05）.There was no significant difference between patients with ovarian cancer and patients with women epithelial carcinoma（P〉0.05）.The sensitivity of HE4 and CA125were 46.6%and 60.3%,respectively,and that of combined detection was 70.7%,which was higher than single test（P〈0.05）.Taking patients with gynecological benign diseases as reference group,the area under receiver operating characteristic curve of single detection of HE4,CA125 and combined detected were 0.783,0.679 and 0.791.When the cutoff value of serum HE4 was set at 107.145pmol/L,the Youden index was the biggest,and the sensitivity and specificity was 69.0%and 78.1%respectively.Conclusion Combined detection of CA125 and HE4could increase the detection rate and improve the diagnostic performance.