肿瘤标志物HE4、CA125、CA199、CA153、AFP在卵巢癌早期诊断中的应用价值

The clinical value of tumor markers HE4,CA125,CA199,CA153 and AFP in the early diagnosis of ovarian cancer

目的探讨肿瘤标志物血清人附睾蛋白4(HE4)、糖类抗原125(CA125)、糖类抗原199(CA199)、糖类抗原153(CA153)、甲胎蛋白(AFP)在早期卵巢癌诊断中的价值。方法选取2014年2月至2016年10月在该院治疗的卵巢肿瘤患者117例,其中卵巢癌组69例,卵巢良性病变组48例,同时选取健康自愿者70例为对照组,检测各受试者血清HE4、CA125、CA199、CA153、AFP水平。结果卵巢癌组HE4、CA125、CA199、CA153、AFP阳性率为59.42%、68.12%、33.33%、46.38%、39.13%,明显高于卵巢良性病变组和对照组(P<0.05)。CA125诊断卵巢癌的灵敏度为68.11%,特异度为88.98%,阴性预测值为78.33%,阳性预测值为82.68%,约登指数为0.571,诊断效能优于其他肿瘤标志物指标。经病理检查,69例卵巢癌患者中,浆液性腺癌34例,黏液性腺癌18例,子宫内膜样癌17例。浆液性腺癌CA125阳性率为85.29%,明显高于黏液性腺癌和子宫内膜样癌(χ2=9.398,P<0.05)。结论 CA125在卵巢癌早期诊断中有较好的应用价值,在浆液性腺癌中其阳性率较高。

Objective To investigate the diagnostic value of serum human epididymis protein 4（HE4）,carbohydrate antigen 125（CA125）,carbohydrate antigen antigen（CA199）,carbohydrate antigen 153（CA153） and alpha fetoprotein（AFP）in the early diagnosis of ovarian cancer.Methods From February 2014 to October 2016,117 patients with ovarian cancers who were treated in this hospital were selected,including 69 cases of ovarian cancer and 48 cases of benign ovarian lesions,and 70 healthy volunteers were selected as control group.The serum levels of HE4,CA125,CA199,CA153 and AFP were measured in all subjects.Results The positive rates of HE4,CA125,CA199,CA153 and AFP in the ovarian cancer group were 59.42%,68.12%,33.33%,46.38% and 39.13%,respectively,which were significantly higher than those in the benign ovarian lesion group and the control group（P〈0.05）.The sensitivity of CA125 in the diagnosis of ovarian cancer was 68.11%,the specificity was 88.98%,the negative predictive value was 78.33%,the positive predictive value was 82.68%,Youden index was 0.571.The diagnostic efficiency was better than that of other tumor markers.Pathological examination revealed 34 cases of serous adenocarcinoma,18 cases of mucinous adenocarcinoma and 17 cases of endometrioid carcinoma in 69 cases of ovarian cancer.The positive rate of serous adenocarcinoma CA125 was 85.29%,significantly higher than mucinous carcinoma and endometrioid carcinoma（χ^2=9.398,P〈0.05）.Conclusion CA125 has a good application value in the early diagnosis of ovarian cancer,the positive rate is higher in serous adenocarcinoma.