人附睾蛋白4检测对卵巢恶性肿瘤鉴别及与病理特征的关系

Detection of human epididymis protein 4 for differential diagnosis of malignant ovarian tumors and its relationship with pathological features

目的检测盆腔肿物患者人附睾蛋白4(HE4),分析HE4对卵巢恶性肿瘤鉴别及与病理特征的关系。方法选取拟手术治疗的卵巢肿瘤患者124例,根据术后病例检查结果将患者分为恶性肿瘤组51例及良性肿瘤组73例,选取同期健康体检女性80例为对照组,分别以化学电发光免疫法和酶联免疫吸附法检测CA125和HE4水平,采用免疫组化法检测恶性肿瘤组患者HE4组织表达情况。结果恶性肿瘤组HE4及CA125水平高于良性肿瘤组及对照组,差异均有统计学意义(P<0.05),良性肿瘤组CA125水平高于对照组,差异均有统计学意义(P<0.05),但HE4水平与对照组比较差异无统计学意义(P>0.05)。HE4、CA125联合检查较HE4单一检测敏感度高,且均高于CA125单独检测的敏感度、特异度、准确度、阳性预测值及阴性预测值,差异有统计学意义(P<0.05)。低分化等级HE4组织表达阳性率高于中高分化等级阳性率,晚期卵巢癌阳性率高于早期卵巢癌,脏器转移者阳性率高于无脏器转移者,差异均有统计学意义(P<0.05)。结论 HE4是卵巢癌鉴别诊断的重要血清指标,HE4与CA125联合检查能够有效提高诊断准确性,对HE4的持续检测对卵巢癌患者病情进展监测有一定的指导价值。

Objective To detect the expression of human epididymis protein 4（HE4） in pelvic mass and analyze itsrelationship with differential diagnosis of malignant ovarian tumors and with pathological features. Methods A total of 124 patients undergoing elective surgery for ovarian tumors in our department from January to September 2015 were enrolled in thisstudy. According to the results of postoperative pathological tests, they were divided into malignant tumor group（n=51） andbenign tumor group（n=73）. Another 80 healthy women who taking physical examination at the same period were enrolled forcontrol group. The serum levels of carbohydrate antigen- 125（CA125） and HE4 were detected by chemiluminescenceimmunoassay and ELISA. The expression of HE4 in groups with malignant tumor was observed by immunohistochemical assay.Results The serum levels of HE4 and CA125 were significantly higher in the malignant tumor group than the benign tumorgroup and control group（P〈0.05）, and that of CA125 was obviously higher in the benign tumor group than the control（P〈0.05）,but there was no significant difference in the HE4 level between the 2 groups（P〉0.05）. The sensitivity of HE4 and CA125 combined examination were obviously higher than that of HE4, and the sensitivity, specificity, accuracy, positive predictivevalue and negative predictive value of the combination were higher than those of CA125 alone, with statistically significances（P〈0.05）. The expression level of HE4 was remarkably higher in the poorly differentiated than high-grade ovarian cancer, inadvanced than early ovarian cancer, and those with organ metastasis than those without（P〈0.05）. Conclusion HE4 is animportant serum indicator in the differential diagnosis of ovarian cancer. Combined examination of HE4 and CA125 caneffectively improve the diagnostic accuracy. It is of certain guiding value for continuous detection of HE4 in the progression ofovarian cancer.