人附睾分泌蛋白4和CA125在卵巢癌早期诊断中的价值

Human Epididymis Secretory Protein 4 and CA125 in Early Diagnosis of Ovarian Cancer

目的探讨人附睾分泌蛋白4(HE4)和糖类抗原125(CA125)检测对卵巢癌早期诊断的价值。方法选择2012年1月至2014年1月南方医科大学附属深圳市妇幼保健院收治的45例卵巢癌患者(卵巢癌组)、50卵巢良性肿瘤患者(良性组)作为研究对象,并选择同期40例健康体检者作为对照组,比较三组血清HE4、CA125水平,并比较不同病理分期、有无淋巴转移卵巢癌患者之间血清HE4、CA125水平,比较血清HE4、CA125单项或联合检测对卵巢癌诊断的诊断效能。结果卵巢癌组、良性组、对照组血清HE4水平分别为(264±96)、(62±13)、(50±13)pmol/L,CA125水平分别为(306±121)、(58±19)、(19±9)k U/L,组间比较差异有统计学意义(P<0.01);Ⅰ、Ⅱ期卵巢癌患者血清HE4、CA125水平低于Ⅲ、Ⅳ期患者[(196±91)pmol/L比(357±137)pmol/L,(108±34)k U/L比(412±168)k U/L,P<0.01],有淋巴转移的卵巢癌患者血清HE4、CA125水平高于无淋巴转移患者[(374±143)pmol/L比(201±98)pmol/L,(418±163)k U/L比(122±47)k U/L,P<0.01];血清HE4CA125联合检测诊断卵巢癌的灵敏度、特异度、阳性预测值、阴性预测值、准确度分别为93.3%、95.6%、89.7%、96.6%、94.8%,均高于两者单项检测。结论血清HE4、CA125联合检测可弥补单项检测的不足,提高早期卵巢癌的诊断率。

Objective To explore the value of the human epididymis protein 4 （HE4） and carbohydrate antigen 125 （CA125） detection in early diagnosis of ovarian cancer. Methods A total of 45 patients with ovarian cancer（ the ovarian cancer group）, 50 patients with benign ovarian tumors （the benign group） were included as the study objects, and 40 healthy controls during the same period were selected as the control group, the serum HE4 and CA125 levels of the patients were compared, and serum HE4 and CA125 levels of the patients with or without lymph node metastasis at different pathological stage were compared, the diagnos- tic efficiency of serum HE4 and CA125 alone or combined detection for ovarian cancer was compared. Results Serum levels of HE4 of the patients in the three groups were （264 ± 96 ）, （ 62 ± 13 ）, （50 ± 13 ） pmol/L,levels of CA125 were （306 ± 121 ）, （58 ± 19）, （ 19 ± 9 ） kU/L, there were statistically significant differences between the groups（P 〈0. 05） ;the serum HE4 levels of the patients with ovarian cancer at stage I, II were lower than that of the patients at stage IF[, 1V [ （ 196 ± 91 ） pmol/L vs （357 ± 137 ） pmol/L, （108 ±34） kU/L vs （412 ± 168） kU/L,P 〈0. 05] ,serum HE4 and CA125 levels of the patients with lymph node metastasis were higher than that of the patients without lymph node metastasis [ （ 374 ± 143 ） pmol/L vs（201 ±98） pmol/L, （418 ± 163） kU/L vs（121 ±47） kU/L,P 〈0. 05] ;the sensitivity,specific- ity, positive predictive value and the negative predictive value of the serum HFA and CA125 combined detec- tion in diagnosis of ovarian cancer were 93.3% ,95.6% ,89.7% ,96.6% ,94. 8% and higher than that of HE4 and CA125 detection alone. Conclusion The combined detection of serum HE4 and CA125 can make up for the shortages of single detection, and it can improve the early diagnosis rate of ovarian cancer.