HE4联合CA125及彩色多普勒超声在上皮性卵巢癌诊断中的价值

Value of HE4 combined with CA125 and color Doppler ultrasound in diagnosis of epithelial ovarian cancer

目的探讨新型血清肿瘤标记物人附睾蛋白(HE4)联合CA125及彩色多普勒超声在诊断上皮性卵巢癌中的临床价值。方法选取在2013年1月-2016年1月在该院妇科接受手术治疗并根据术后常规病理检查结果确诊为卵巢上皮性肿瘤的患者为研究对象,其中恶性肿瘤组73例,良性肿瘤组93例,另收集上皮性交界性肿瘤为交界性组41例。对术前常规检测的肿瘤标记物及彩色多普勒超声检查结果进行回顾性分析,探讨各项检查在卵巢上皮性癌诊断中的价值。结果 HE4、CA125及彩色多普勒超声阳性率在观察组与对照组间比较,差异有统计学意义(χ~2_(HE4)=80.38,P<0.005;χ~2_(CA125)=93.02,P<0.005;χ~2_(超声)=31.48,P<0.005);HE4、CA125及彩色多普勒超声检查单独诊断上皮性卵巢癌的灵敏度、特异度、准确度、阳性预测值、阴性预测值分别是75.34%、92.47%、84.94%、88.71%、82.69%;90.41%、84.95%、87.35%、82.50%、91.86%及73.97%、69.89%、71.69%、65.85%、77.38%。3者联合诊断上皮性卵巢癌的灵敏度、特异度、准确度、阳性预测值、阴性预测值分别是98.63%、54.84%、74.10%、63.16%、98.08%。结论 HE4联合CA125及彩色多普勒超声检查可显著提高卵巢上皮性癌诊断的灵敏度及阴性预测值,减少漏误诊率,对早期诊断和治疗卵巢癌、改善预后有着重要的临床价值。

Objective To explore the clinical value of human epididymis protein-4（HE4） combined with CA125 and color Doppler ultrasound in diagnosis of epithelial ovarian cancer.Methods The patients diagnosed as epithelial ovarian cancer definitely by postoperative pathological examination in Department of Gynecology in the hopsital from January 2013 to January 2016 were selected as research object,then they were divided into maliagnant tumor group（73 patients） and benign tumor group（93 patients）.Forty-one patients with borderline ovarian tumor were collected as borderline tumor group.The levels of tumor indexes and results of color Doppler ultrasonography before surgery were analyzed retrospectively,the value of various examinations in diagnosis of epithelial ovarian cancer was analyzed.Results There were statistically significant differences in the positive rates of HE4,CA125 and color Doppler ultrasonography between observation group and control group（χ^2HE4= 80.38,P〈0.005;χ^2CA125= 93.02,P〈0.005;χ^2ultrasound= 31.48,P〈0.005）.The sensitivities,specificities,accuracies,positive prediction values,and negative prediction values of HE4,CA125,and color Doppler ultrasonography in diagnosis of epithelial ovarian cancer were 75.34%,92.47%,84.94%,88.71%,82.69%;90.41%,84.95%,87.35%,82.50%,91.86% and73.97%,69.89%,71.69%,65.85%,77.38%,respectively.The sensitivity,specificity,accuracy,positive prediction value,and negative prediction value of joint detection of the three indexes were 98.63%,54.84%,74.10%,63.16%,and 98.08%,respectively.Conclusion HE4 combined with CA125 and color Doppler ultrasound can improve the sensitivity and negative prediction value of diagnosing epithelial ovarian cancer,reduce the misdiagnosis rate,which has great cilinical value in eraly diagnosis and treatment of epithelial ovarian cancer and improvement of prognosis.