HE4与CA125联合检测对卵巢肿瘤鉴别诊断的价值

Value of combined detection of CA125 and HE4 in differentiation diagnosis of ovarian tumor

目的评价HE4与CA125联合检测对卵巢肿瘤诊断的价值。方法将61例健康体检妇女、20例卵巢良性疾病患者及70例卵巢癌患者作为研究对象,按照经期情况,将151例研究对象分为绝经组和未绝经组,采用ELISA法与化学发光法分别对151例研究对象进行血清人附睾上皮分泌蛋白4(HE4)和糖类抗原125(CA125)检测,评价其诊断价值。结果绝经组和未绝经组中,卵巢癌患者血清HE4水平均显著高于卵巢良性疾病患者与健康体检者,差异均有统计学意义(P<0.05)。受试者工作特征(ROC)曲线分析表明,绝经组中HE4曲线下面积(AUC)为0.978,CA125AUC为0.877,HE4的敏感度和特异度分别为97.8%和94.3%,CA125的敏感度和特异度分别为91.1%和81.1%;未绝经组中HE4AUC为0.989,CA125AUC为0.877,HE4的敏感度和特异度分别为92.0%和88.6%,CA125的敏感度和特异度分别为84.0%和74.3%,二者的差异有统计学意义(P<0.05)。对于卵巢疾病患者,未绝经者和绝经者卵巢癌发病风险计算值(ROMA)分别大于14.4%和12.5%时,可能存在卵巢癌发病的高风险。结论 HE4与CA125的联合检测并计算ROMA,有助于卵巢癌的诊断及风险评估。

Objective To evaluate the value of the combined detection of carbohydrate antigen 125（CA125） and human epididymis secretory protein 4 （HE4） in the diagnosis of ovarian tumor .Methods 70 cases of ovarian cancer ,20 cases of benign ovarian diseases and 61 healthy women of healthy physical examination were collected as the research subjects and divided into the menopause group and the non‐menopause group according to the menstrual situation .The concentrations of serum CA125 and HE4 were detected by using the enzyme linked immunosorbent as‐say（ELISA） and chemiluminescence method .Results In the menopause group and the non‐menopause group ,the se‐rum HE4 level in the ovarian cancer group was significantly higher than that in the benign ovarian diseases group and the healthy control group ,the difference was statistically significant（P〈 0 .05） .The receiver operating characteristic （ROC） curve analysis indicated that the area under curve（AUC） of HE4 in the menopause group was 0 .978 ,AUC of CA125 was 0 .877 ,the sensitivity and specificity of HE4 were 97 .8% and 94 .3% respectively ,which of CA125 were 91 .1% and 81 .1% respectively ;in the non‐menopause group ,AUC of HE4 was 0 .989 and which of CA125 was 0 .877 ,the sensitivity and specificity of HE4 were 92 .0% and 88 .6% respectively ,which of CA125 were 84 .0% and 74 .3% respectively ,the differences were statistically significant（P〈 0 .05） .For the patients with ovarian diseases ,if the calculated value of ovarian cancer risk（ROMA） in the menopause patients and the non‐menopause patients was more than 14 .4% and 12 .5% respectively ,the high risk of ovarian cancer onset could exist .Conclusion The com‐bined detection of HE4 and CA125 and ROMA calculation conduce to the diagnosis of ovarian cancer and the risk e‐valuation .