人附睾蛋白4在妇科疾病伴肾功能损害患者诊疗中的应用

Clinical application of human epididymis protein 4 in gynecological diseases with renal damage patients

目的探讨利用人附睾蛋白4(human epididymis protein 4,HE4)诊断妇科疾病和监测疗效时,如何减少肾功能损害对HE4水平的影响。方法比较各疾病组和对照组血清HE4、CA125水平。分析血清HE4与尿素、肌酐、尿酸和胱抑素C水平的相关性。结果良性+肾功能损害组血清HE4明显高于对照组、良性组和内膜癌组,差异有统计学意义(P<0.01),与卵巢癌组比较,差异无统计学意义(P>0.05)。良性+肾功能损害组、良性组、内膜癌组血清CA125比较差异无统计学意义(P>0.05)。血清HE4与尿素、肌酐、胱抑素C水平呈正相关(P<0.05),与尿酸水平无相关性(P>0.05)。卵巢癌+肾功能损害组、内膜癌+肾功能损害组血清HE4水平明显高于卵巢癌组、内膜癌组,差异有统计学意义(P<0.05)。结论血清尿素、肌酐和胱抑素C结果有助于排除肾功能损害导致的血清HE4水平增高。应注意高HE4伴肾功能损害患者的肿瘤性质分析,避免对妇科恶性肿瘤伴肾功能损害患者病情估计过重。

Objective To explore how to decrease renal damage effects on serum HE4 values when diagnosing gynaecological diseases and monitoring curative effect. Methods Serum HE4 and cancer antigen 125 concentrations of all disease groups and control group were compared. The correlation between serum HE4 and Urea,CRE,Cys C values was analyzed. Results Serum HE4 values in gynecological benign diseases with renal damage group significantly increased compared with the benign gynecological diseases,endometrial adenocarcinoma and normal control groups,with the differences statistically significant（ P〈0. 01）. And the differences were not statistically significant,compared with ovarian carcinoma group（ P〈0. 05）. Serum CA125 values in the gynecological benign diseases with renal damage group,benign gynecological diseases group and endometrial adenocarcinoma group were different,and the differences were not statistically significant,（ P〈0. 05）. The serum HE4 values were positively correlated to the serum values of Urea,CRE and Cys C（ P〈0. 05）,but not correlated to the UA（ P〈0. 05）. Serum HE4 values in ovarian carcinoma with renal damage and endometrial adenocarcinoma with renal damage groups significantly increased compared with the ovarian carcinoma and endometrial adenocarcinoma groups,and the differences were not statistically significant,（ P〈0. 05）. Conclusion Serum Urea,CRE and Cys C values help to eliminate high serum HE4 caused by renal damage. Tumor nature in renal damaged patients with high serum HE4 should be paid attention to avoid overestimating the illness of gynecology malignant tumor patients with renal damage.