血清HE4,CA125联合经阴道超声对卵巢癌的诊断价值

The Diagnostic Value of Serum HE4, CA125 and Transvaginal Sonography Combined Detection for Ovarian Cancer

目的：探讨血清人附睾蛋白4（humanepididymisprotein4,HE4）、糖类抗原125（Carbohydrateantigen125,CA125）联合经阴道超声（transvaginalsonography,TVS）对卵巢癌的诊断价值。方法：选择2013年1月～2014年12月本院确诊的卵巢病变患者500例,同期体检中心健康女性200例作为对照组,应用酶联免疫法和化学发光分析系统检测方法分别检测其血清HE4、CA125水平,并进行阴道超声检查。结果：500例卵巢病变患者经活检检查发现卵巢癌患者70例,良性卵巢疾病患者430例。卵巢癌组HE4和CA125水平均显著高于良性卵巢疾病组和健康对照组,良性卵巢疾病组HE4和CA125水平显著高于健康对照组,差异有统计学意义（P〈0.01）。血清HE4＋CA125检测卵巢癌的敏感度为80.00%,特异度为95.11%;血清HE4＋CA125＋TVS联合检测卵巢癌的敏感度为94.29%,特异度为97.91%。HE4＋CA125＋TVS联合检测卵巢癌的敏感度和特异度均显著高于单项检测HE4、CA125或TVS（P〈0.05）。结论：HE4、CA125、TVS三者联合检测卵巢癌可以提高诊断的特异度和敏感度,对卵巢癌的诊断、治疗及监测具有重要意义。

Objective： To investigate the value of serum Human Epididymis protein 4（HE4）, Carbohydrate antigen 125（CA125）combined transvaginal sonography（TVS） in the diagnosis of ovarian cancer. Methods： From January 2013 to December 2014 in our hospital 500 patients with ovarian disease were diagnosed as objects,, and over the same period 200 cases of healthy women were selected as a control group. Enzyme-linked immunosorbent assay and chemiluminescence detection system was used to test the serum HE4 and CA125 level respectively and TVS were checked. Results： 500 cases of ovarian disease were included 70 cases of ovarian cancer and 430 cases of patients with benign ovarian disease diagnosed by biopsy. The levels of HE4 and CA125 of ovarian cancer group were significantly higher than those of benign ovarian disease group and the healthy control group, and the HE4 and CA125 levels of benign ovarian disease group were significantly higher than those of the healthy control group, and the difference was statistically significant（P〈0.01）.The sensitivity of serum HE4 combined with CA125 in ovarian cancer detection was 80.00 % and and the specificity was 95.11 %; while the sensitivity of serum HE4＋CA125＋TVS combined detection for ovarian cancer was 94.29 % sensitivity and the specificity was 97.91%. The sensitivity and specificity of HE4＋CA125＋TVS combined detection for ovarian cancer, was significantly higher than that of single detection of HE4, CA125 or TVS. Conclusions： HE4, CA125, TVS combined detection can improve the diagnostic specificity and sensitivity, which is of great importance for the diagnosis, treatment and monitoring of ovarian cancer.