血清糖类抗原125、人附睾蛋白4和D二聚体联合检测对卵巢癌的诊断价值

Diagnostic value of combined detection of CA125,HE-4 and D-Dimer in ovarian cancer

目的 探讨血清糖类抗原125（CA125）、人附睾蛋白4（HE-4）及D二聚体单独检测和联合检测对卵巢癌的诊断价值.方法 选取卵巢癌患者120例作为观察组,卵巢良性肿瘤患者120例作为良性组,健康体检女性80名作为对照组.使用化学发光免疫法检测3组患者血清CA125、HE-4的表达,使用免疫比浊法检测D二聚体表达水平.计算CA125、HE-4及D二聚体单独检测和联合检测的诊断效能.结果 观察组血清CA125为（623.07±274.18） U/ml、HE-4为（594.22±329.068） μg/L、D二聚体为（418.57±276.75） ng/L,良性组中CA125为（45.09±32.58） U/ml、HE-4为（97.92±57.52） μg/L、D二聚体为（204.52±80.07） ng/L;对照组CA125为（40.23±28.16） U/ml、HE-4为（85.65±37.27） μg/L、D二聚体为（187.57±65.74） ng/L,3组间比较差异均有统计学意义（F值分别为122.82、89.91、54.46;P均〈0.05）.晚期（III-IV期）卵巢癌患者血清中CA125为（586.10±278.33 U/ml、HE-4为（437.49±238.06） μg/L,D二聚体为（493.78±274.45） ng/L,早期（I-II期）卵巢癌患者血清中CA125为（372.12±265.31） U/ml、HE-4为（673.64±301.68） μg/L,D二聚体为（364.84±267.54） ng/L,早期与晚期比较差异有统计学意义（t值分别为4.244、4.778、2.560,P均〈0.05）.在诊断卵巢癌上,CA125检测灵敏度为71.67%,特异度为62.50%;HE-4检测灵敏度为74.17%,特异度为75.00%;D二聚体检测灵敏度为62.5%,特异度为60.00%.三者联合检测灵敏度为80.00%,特异度为77.5%.结论 CA125、HE-4和D二聚体联合检测与单独检测相比,灵敏度与特异度均高于三者单独检测,可进一步提高卵巢癌的诊断水平.

Objective To investigate the separate and combined detection value of serum carbohydrate antigen 125 （CA125）,human epididymis protein 4 （HE-4） and D dimer （D-dimer） in the diagnosis of ovarian cancer.Methods One hundred and twenty ovarian cancer patients were selected as the observation group,one hundred and twenty patients with ovarian benign tumor as the benign group,eighty women with healthy physical examination results as the control group,then the chemiluminescence immunoassay was used to detect the expression of serum CA125 and HE-4 of the three groups,and the immune turbidimetric method was applied to examine the expression of D-dimer.At last,the diagnosis efficiency of CA125,HE-4 and D-dimer in separate and combined detection was calculated.Results CA125 in the observation group was （623.07±274.18） U/ml,HE-4 was （594.22±329.068） ng/ml and D-dimer was （418.57±276.75） ng/L,CA125 in the benign group was （45.09±32.58） U/ml,HE-4 was （97.92±57.52） ng/ml and D-dimer was （204.52±80.07） ng/L;CA125 in the control group was （40.23±28.16） U/ ml,HE-4 was （85.65±37.27） ng/ml and D-dimer was （187.57±65.74） ng/L,the differences between the three groups were statistically significant （F=122.82,89.91,54.46;P〈0.05）.The level of CA125 in the serum of patients with advanced stage （stage III-IV） was （586.10±278.33） U/ml,HE-4 was （437.49±238.06） ng/ml,D-dimer was （493.78±274.45） ng/L,in the early stage （stage I-II）,the level of CA125 in the serum of patients with ovarian cancer was （372.12±265.31） U/ml,HE-4 was （673.64±301.68） ng/ml,D-dimer was （364.84±267.54） ng/L,and the difference was statistically significant （t=4.244,4.78,2.560,P〈0.05）.The detection sensitivity and specificity of CA-125 were 71.67% and 62.50% respectively.The sensitivity of HE-4 was 74.17% and the specificity was 75.00%.The sensitivity of D-dimer was 62.5% and the specificity was 60.00%.The combined detection sensitivity of the three was 80.00% and the specificity was 77.5%.Conclusion The sensitivity and specificity of the three tumor markers in combined detection were higher than those of separate detections,so the combined detection of CA125,HE-4 and D-dimer can further improve the diagnosis level of ovarian cancer.