CA125联合HE4检测对卵巢癌诊断及临床应用中的价值

Value of CA125 combined with HE4 in diagnosis and clinical application of ovarian cancer

目的:探讨人附睾蛋白4(HE4)、糖类抗原125(CA125)和卵巢癌风险预测模型(ROMA指数)联合检测对卵巢癌的诊断价值及与癌灶大小的关系。方法:选取168例经病理确诊的卵巢癌患者为实验组、75例卵巢良性疾病患者为观察组、50例健康妇女为对照组,应用电化学发光法分别对所有研究对象检测HE4和CA125浓度,计算ROMA指数,并分析HE4、CA125浓度与卵巢癌患者癌灶大小的相关性。结果:卵巢癌患者血清HE4、CA125、ROMA指数水平明显高于观察组和对照组,差异显著(P<0.05);卵巢良性疾病组和对照组HE4、CA125浓度差异不显著(P>0.05);HE4水平对卵巢癌诊断的特异性和敏感性都明显高于CA125(P<0.05)。绝经前后女性ROMA指数敏感性分别为79.36%、95.19%,特异性分别为80.36%、91.11%,说明ROMA指数对绝经后的女性鉴别盆腔肿物的意义更大。血清HE4浓度与肿瘤大小呈正相关(r=0.765,P<0.05),而CA125浓度与肿瘤大小的相关性分析显示相关系数r=0.308,两者之间无显著相关性。结论:血清HE4与CA125联合检测有助于提高早期卵巢癌的检出率,且HE4水平与卵巢癌癌灶大小存在明显的相关性,ROMA指数对诊断卵巢癌的特异性较高,尤其是绝经后妇女具有更高的临床价值。

Objectives： To explore the value of human epididymis protein 4（ HE4）,carbohydrate antigen125（ CA125） and ovarian cancer risk prediction model（ an index） joint detection to the diagnosis of ovarian cancer and its relationship with the size of the cancer. Methods： 168 cases of ovarian cancer were selected as experimental group,75 cases of ovarian benign disease were as observation group and 50 healthy women were as control group.Electrochemical luminescence method was used to detect HE4 and CA125 concentrations. Additional,we analyzed the correlation of HE4 and CA125 concentration and the size of the ovarian cancer. Results： The serum HE4 and CA125 levels of ovarian cancer patients was significantly higher than these of observation group and control group,with significant difference（ P〈0. 05）. HE4 and CA125 concentrations of observation group and control group had no significant difference（ P〉0. 05）. The specificity and sensitivity of HE4 level in the diagnosis of ovarian cancer were significantly higher than these of CA125（ P〈0. 05）. ROMA specificity and sensibility of women before and after menopause were 79. 36%,95. 19% and 80. 36%,91. 11% respectively,which showed ROMA index had an important role in identifying pelvic neoplasm. Serum HE4 concentration was positively correlated with cancer size（ r= 0. 764,P〈0. 05）,and correlation coefficient between CA125 concentrations and the size of tumor was r =0. 304,and there was no significant correlation between CA125 concentrations and the size of tumor. Conclusion：Serum HE4 and CA125 joint detection helps to improve the detection rate of early ovarian cancer. Furthermore,HE4 levels have significant correlation with the size of ovarian cancer. The index of ROMA used for the diagnosis of ovarian cancer has high specificity,especially in postmenopausal women.