CA125、HE4对卵巢恶性肿瘤的辅助诊断价值

Auxiliary diagnostic value of CA125 and HE4 in ovarian malignant tumors

目的筛选卵巢恶性肿瘤相关肿瘤标志物,探讨糖类抗原125(CA125)、人附睾蛋白4(HE4)在卵巢癌中的辅助诊断价值。方法回顾性收集2015年1月至2017年8月广州市番禺区中心医院收治的卵巢恶性肿瘤患者35例,卵巢良性疾病85例,健康体检者123例,检测其外周血中CEA、AFP、CAl25、CAl99及HE4浓度,先采用Logistic回归筛选出差异有统计学意义的肿瘤标志物,再进一步采用决策树CHAID法确定上述肿瘤标志物在辅助诊断卵巢癌中的价值。结果以上5类肿瘤标记物使用非参数检验结果显示,卵巢恶性肿瘤、卵巢良性肿瘤患者、健康体检者的外周血AFP、CEA、CA125、HE4浓度比较差异均有统计学意义(P<0.05);进一步使用二元Logistic回归筛选分析结果显示,CA125、HE4对卵巢恶性肿瘤与卵巢良性疾病的鉴别有意义,分别为CA125(Waldχ~2=4.131,P=0.042)、HE4(Waldχ~2=2.990,P=0.084),而CA125相关性更为显著。使用决策树法分析,随着HE4浓度升高,卵巢恶性肿瘤的患者比例也逐渐升高,当HE4>140.00 pmol/L时,阳性预测值达到95%。结论 CA125、HE4对卵巢恶性肿瘤具有良好的辅助诊断价值。

Objective To screen tumor markers associated with ovarian tumors and explore the diagnostic value of carbohydrate antigen 125（CA125） and human epididymal protein 4（HE4） in ovarian cancer. Methods Thirty-five patients with ovarian malignancies admitted to Guangzhou Panyu Central Hospital from January 2015 to August2017, 85 patients with benign ovarian disease and 123 healthy subjects were enrolled in this study. The levels of carcino-embryonic antigen（CEA）, alpha fetoprotein（AFP）, carbohydrate antigen 125（CA125）, carbohydrate antigen 199（CA199）, human epididymis protein 4（HE4） were measured and analyzed. Results Non-parametric test showed that the serum levels of AFP, CEA, CA125 and HE4 in ovarian malignant tumors, benign ovarian tumors and healthy subjects showed statistically significant differences（P〈0.05）. Binary logistic regression analysis showed that CA125 and HE4 had significant difference in ovarian malignancy and benign ovarian tumors, for CA125（Waldχ^2=4.131, P=0.042）,HE4（Waldχ^2=2.990, P=0.084）, and CA125 was more significant. CHAID analysis showed that with the increase of HE4 concentration, the proportion of ovarian cancer patients gradually increased. When HE4140.00 pmol/L, the positive predictive value was 95%. Conclusion CA125 and HE4 have a good diagnostic effect on ovarian malignant tumors.