人附睾蛋白4在卵巢恶性肿瘤早期诊断中的作用

Application value of human epididymis protein 4 in early diagnosis of the ovary cancer

目的探讨人附睾蛋白4(HE4)检测在卵巢肿瘤鉴别诊断及疾病转归中的价值。方法用病例-对照研究方法,分别检测病例组术前以及健康对照组血清人附睾蛋白4和糖类抗原-125(CA125)的水平;用免疫组化方法比较各组的组织上HE4的表达情况,分析HE4分布特点,探讨HE4水平与卵巢癌病理分型的关系以及与肿瘤分期的关系。结果血清HE4水平在56.37 pmol·L-1时,HE4诊断卵巢恶性肿瘤的敏感度为80%,特异度为96%;HE4水平与病理分化呈负相关,而与临床分期呈正相关;HE4在恶性肿瘤组及交界性组表达阳性率明显高于卵巢良性肿瘤组、卵巢非赘生性病变组及其他妇科恶性肿瘤组。血清HE4水平与组织中的HE4表达情况呈正相关。结论 HE4诊断卵巢恶性肿瘤的敏感性和特异性均高于CA125,与CA125联合检测的敏感性最高,血清HE4及组织HE4水平均与卵巢恶性肿瘤病理分型及临床转归均密切关联。

Objective To determine the value of human epididymis pro-tein 4 （ HE4） in the diagnosis and prognosis of ovarian cancer.Methods We use the clinical case -control method, in which the level of HE4 and carbohydrate antigen -125 （ CA125 ） before operation in clinical case and normal women were detected.An immunohistochemistry meth-od was used to measure the expression of HE4 in different tissues.Statis-tical analysis was performed to determine the relationship between the level of HE4, the pathologic type of ovarian cancer, and the stage of the ovarian tumor.Results If the level of HE4 in the serum was 56.37 pmol·L^-1 , the sensitivity of HE4 in diagnosing the malignant ovary tumor was 80%and the specificity was 96%.The level of HE4 and the pathological differentiation are negatively related and positively related to the clinical staging .HE4 in the malignant tumor group and borderline tumor group was higher than in other 3 groups, which contained bening ovary tumors, non-neoplastic lesions of ovary and other malignant gyne-cologic tumors.The HE4 level in the serum and HE4 in the tissue were relatively linked.Conclusion HE4 sensitivity and specificity in diagno-sing the ovary malignant tumor is higher than the sensitivity of CA125.The combined detection of HE4 and C125 is more effective.The level of HE4 in serum and HE4 in tissue was respectively closely related to the pathological type and clinical sequelae of the ovary malignant tumor.