血清人附睾分泌蛋白4(HE4)和CA125在卵巢癌患者围手术期的变化及临床意义

The changes and clinical significance of human epididymis secretory protein 4(HE4 )and CA125 during perioperative ovarian cancer

目的:监测卵巢癌手术前后血清人附睾分泌蛋白4(human epididymis secretory protein 4,HE4)、CA125(即糖类抗原125)的变化,分析HE4和CA125在卵巢癌诊治中的价值。方法:选取180例卵巢癌患者,根据临床分期分为早期组90例和中晚期组90例,选取90例卵巢良性疾病者作为良性组、90例健康成年女性作为对照组,在手术前后分别监测各组血清HE4和CA125表达水平,统计分析不同检测方法的诊断价值,同时随访卵巢癌患者12个月,对卵巢癌复发患者与未复发患者在手术前后的血清HE4和CA125进行统计分析。结果:血清HE4联合CA125特异度(98.89%)、阳性预测价值(99.27%)显著高于HE4单独检测及CA125单独检测,P<0.05,组间有统计差异;手术后,卵巢癌患者血清HE4、CA125显著下降(P<0.05),但是,在相同监测点,卵巢癌者血清HE4和CA125显著高于对照组和良性组(P<0.05),且中晚期组血清HE4显著高于早期组(P<0.05),良性组血清HE4、CA125略高于对照组,组间无显著差异(P>0.05);卵巢癌复发者血清HE4、CA125显著高于未复发组者,P<0.05,有统计学差异。结论:卵巢癌患者血清CA125和HE4显著异常升高,联合检测血清HE4和CA125不仅对于提高卵巢癌诊断特异性、阳性准确率具有重要价值,而且能够为预后评估提供可靠信息。

Objective：To monitor the changes of human epididymis secretory protein 4 （HE4） ,and CA125 （car- bohydrate antigen 125 ） of ovarian cancer patients before and after surgery, to analyze the value of HE4 and CA125 in the diagnosis and treatment of ovarian cancer. Methods：The data of 180 patients with ovarian cancer were selected, according to clinical stage, they were divided into early group （90 cases） and middle -late group （90 cases） ,90 ca- ses with benign ovarian disease as benign group and 90 cases of healthy adult women were selected as control group. The serum HE4 and CA125 expression level were monitored respectively before and after the surgery, to count and an- alyze the value of different testing methods for diagnosing, and the ovarian cancer patients were followed up for 12 months,the serum HE4 and CA125 of recurrence patients and patients without recurrence before and after surgery were analyzed. Results：The serum HE4 and CA125 specific degree were 98. 89%, positive predictive value （99.27%） was significantly higher than that of HE4 separate detection and CA125 separate detection,P 〈 0.05, there was statistical difference between groups. After the surgery, serum HE4 and CA125 of ovarian cancer patients were significantly decreased （P 〈0.05 ） , but,in the same spot, ovarian cancer serum HFA and CA125 were signifi- cantly higher than the control group and benign group （ P 〈 0.05 ） , and serum HFA in middle - late group was signifi- cantly higher than early group （P 〈 0.05 ） ,and the serum HFA and CA125 in benign group were slightly higher than the control group, there were no significant differences between groups （ P 〉 0.05 ）. For the ovarian cancer relapses patients, serum HE4 and CA125 were significantly higher than the group without recurrence, P 〈 0.05, there was sta- tistically significant. Conclusion：The serum CA125 and HFA abnormally elevate significantly in ovarian cancer pa- tients, combined detection of serum HE4 and CA125 can promote the early diagnosis of ovarian cancer specificity and positive accuracy and can also provide reliable information for prognostic assessment.