人附睾分泌蛋白4和糖类抗原125对卵巢癌诊断意义

Significance of serum human HE4 and CA125 for diagnosis of epithelial ovarian cancer

目的探讨血清中人附睾分泌蛋白4(HE4)和糖类抗原125(CA125)在盆腔肿瘤中的临床诊断价值。方法选取56例卵巢癌、64例盆腔良性肿瘤、60例健康女性的血清标本,采用电化学发光免疫方法检测所有研究对象的血清HE4和CA125水平。结果卵巢癌组血清HE4(189.94pmol/L)与CA125(89.39U/L)表达水平明显高于盆腔良性肿瘤组(HE4=56.74pmol/L,CA125=45.11U/L)和健康对照组(HE4=46.36pmol/L,CA125=34.24U/L),差异有统计学意义(P<0.01)。卵巢癌不同病理分期的Ⅲ、Ⅳ期表达水平(HE4=236.25pmol/L,CA125=206.35 U/L)明显高于Ⅰ、Ⅱ期(HE4=96.36pmol/L,CA125=67.8U/L),差异有统计学意义(P<0.01)。以盆腔良性肿瘤组作为参照,HE4对卵巢癌的特异性、敏感性和阴性预测值、阳性预测值分别为85.71%、71.67%和73.84%、84.31%。HE4的特异性明显高于CA125(P<0.01);CA125对卵巢癌的敏感性(86.67%)高于HE4(71.67%),差异有统计学意义(P<0.01)。HE4曲线下面积(0.87)高于CA125(0.81)(P<0.01)。HE4与CA125联合检测明显提高特异性和阴性预测值,分别为95.15%和92.13%(P<0.01)。结论血清HE4对卵巢癌具有重要的临床诊断价值,其鉴别诊断效能优于CA125,且与CA125联合检测有助于提高卵巢癌的临床意义。

Objective To evaluate the value of HE4,CA125 in the diagnosis of epithelial ovarian cancer（EOC）.Methods A total of 54 samples with epithelial ovarian cancer,64 suspicious benign pelvic mass,and 60 health controls were consecutively enrolled in this study.Results Good diagnostic performance in discriminating benign from EOC patients was obtained for CA125 and HE4.Serum level of HE4 of the patients in the three group were 189.94pmol/L,56.74pmol/L and 46.36pmol/L.Levels of CA125 were 89.39U/L,45.11U/L and 34.24U/L.There were stastically significant differences between the groups（P〈0.05）.The serum HE4 and CA125levels of the patients with ovarian cancer at stageⅢ,Ⅳ（HE4=236.25pmol/L,CA125=206.35U/L）were significantly higher than the cases at stageⅠ,Ⅱ（HE4=96.36pmol/L,CA125=67.8U/L P〈0.05）.Benign pelvic mass as control,the specificity（SP）was 86.6%,sensitivity（SN）was 82.6%,positive predictive value and negative predictive value of the serum HE4 were 85.71%,71.67%,73.84%,and 84.31% respectively.SN of CA125 was 86.67%,higher than that of HE4（71.67%,P〈0.01）.The area under curves（AUC）of HE4 was 0.87 higher than that of CA125（0.81）,（P〈0.01）.Combing detection of ovarian cancer was higher than that of HE4 and CA125alone.SP was 95.15%,negative predictive value was 92.13%（P〈0.01）.Conclusion Overall,the level of serum CA125 and HE4increase significantly,which showes well diagnostic performance to EOC from benign diseases.The combined detection of CA125 and HE4could improve the diagnostic power in cervical cancer prominently,so it has great reference value in the diagnosis of epithelial ovarian cancer.