血清HE4和CA125在卵巢上皮癌中的诊断价值

The value of serum HE4 and CA125 tests in the diagnosis of epithelial ovarian cancer

目的通过盆腔包块患者血清HE4和CA125的检测来评估盆腔包块患者患卵巢上皮癌风险,以探讨血清HE4和CA125在卵巢上皮癌中的诊断价值。方法用CMIA法检测2013年5月-2015年7月在我院妇科住院并手术的244例盆腔包块患者的血清HE4水平及CA125水平,进行统计比较。同时根据患者绝经情况通过公式计算出患卵巢癌的风险度（ROMA）。结果 HE4在33例卵巢上皮癌中29例高度表达;而其他177例盆腔包块患者中只有3例高度表达;在其他妇科恶性肿瘤中34例只有一例高表达。CA125除在33例卵巢上皮癌中31例高度表达外,在卵巢子宫内膜异位囊肿,盆腔炎性包块（尤其急性炎性包块）中均有约60%以上高度表达。在33例卵巢上皮癌中通过ROMA值将30例分到了高危组,检出率为90.91%。良性肿瘤177例,分到高危组9例,假阳性率为5.08%;其他妇科恶性肿瘤34例中只有一例分到高危组。结论血清HE4和CA125在卵巢上皮癌的诊断中具有重要价值。

Objective To explore the value of serum HE4 and CA125 tests in the diagnosis of epithelial ovarian cancer through the risk evaluation of epithelial ovarian cancer based on serum HE4 and CA125 tests in the patients with pelvic masses. Methods By the CMIA tests, the serum HE4 and CA125 levels of 244 patients with pelvic masses who received surgeries in our hospital from May 2013 to July 2015 were recorded and compared. The ovarian cancer risk of the patients was calculated by formula（ROMA） according to their menopausal status. Results There were 29 cases with positive expressions of HE4 among 33 patients with epithelial ovarian cancers. There were 3 cases with positive expressions of HE4 among 177 patients with pelvic masses. And there were only 1 case with positive expression of HE4 among 34 cases with other gynecological malignant tumors. There were 31 cases with positive expressions of CA125 among 33 patients with epithelial ovarian cancers, while in the patients with ovarian endometrial implantation cysts or pelvic inflammatory masses（especially acute inflammatory masses）, the cases with positive expressions of CA125 account for more than 60% of total. According to the ROMA values, 30 cases of the patients with epithelial ovarian cancer were assigned to the high risk group, the positive rate was 90.91%, 9 cases of the patients with benign tumors were assigned to the high risk group, the false positive rate was 5.08%. Only 1 case of the 34 patients with other gynecological malignant tumors was assigned to the high risk group. Conclusion The serum HE4 and CA125 tests are very important in the diagnosis of epithelial ovarian cancer.