上皮性卵巢癌患者血清人附睾蛋白4的表达及其对预后的影响

Expression of human epididymal protein 4 in patients with epithelial ovarian cancer and its effect on prognosis

目的探讨上皮性卵巢癌（EOC）患者血清人附睾蛋白4（HE4）的表达及其对预后的影响。方法对我院2009年至2014年收治的98例EOC患者（EOC组）和29例卵巢良性肿瘤患者（良性组）及100名健康查体者（对照组）采用双抗体夹心酶联免疫吸附法检测血清HE4，以血清HE4〉150 pmol/L判定为阳性表达。比较3组研究对象血清HE4浓度及血清HE4阳性率。以治疗前EOC患者中位血清HE4水平为界分为高水平HE4组和低水平HE4组，比较分析两组EOC患者的中位生存时间。结果EOC组患者血清HE4浓度中位值（四分位数）为421.8（68.7-2173.9） pmol/L，良性组为47.8（35.24-68.5） pmol/ L，对照组为43.8（32.91-70.4） pmol/ L，3组比较差异有统计学意义（P=0.000），EOC组患者血清HE4浓度明显高于良性组和对照组（P均〈0.01），而良性组和对照组比较差异无统计学意义（P〉0.05）。EOC组患者血清HE4阳性率为74.5（73/98），良性组和对照组阳性率均为0，3组比较差异有统计学意义（P=0.000），EOC组患者血清HE4阳性率明显高于良性组和对照组（P均〈0.01），而良性组和对照组比较差异无统计学意义（P〉0.05）。低水平HE4组EOC患者的中位生存时间为66.2个月，高水平HE4组为36.9个，两组比较差异有统计学意义（P=0.001）。 结论EOC患者血清HE4水平明显高于卵巢良性肿瘤患者及健康对照组，且血清HE4水平越高，预后越差，患者生存期越短。因此，血清HE4的表达水平可用于卵巢癌的诊断及对其预后的判定。

Objective To investigate the expression of human epididymal protein 4 （HE4） and its effect on prognosis in patients with epithelial ovarian cancer （EOC）.MethodsFrom 2009 to 2014, ninety-eight cases of epithelial ovarian cancer （EOC group） and 29 cases of benign ovarian tumor （benign group） and 100 healthy subjects （control group） were selected as research subjects.The serum HE4 was detected by double antibody sandwich enzyme-linked immunosorbent assay （ELISA）, and the positive expression was determined by HE4〉150 pmol/L in serum.The concentration and positive rate of serum HE4 were compared among the three groups.The median serum HE4 level of EOC patients before treatment was divided into high level HE4 group and low level HE4 group.The median survival time of the two groups of EOC patients was compared.ResultsThe median value of serum HE4 concentration （four percentile） in EOC group was 421.8 （68.7 - 2173.9） pmol/L, 47.8 （35.24 - 68.5） pmol/L in the benign group and 43.8 （32.91 - 70.4） pmol/ L in the control group.The serum concentration of HE4 in the EOC group was significantly higher than that in the benign group and the control group （P=0.000）. The serum HE4 concentration in group EOC was significantly higher than that in benign group and control group （P〈0.01）, but there was no significant difference between benign group and control group （P〉0.05）. The positive rate of serum HE4 in the EOC group was 74.5 （73/98）, the positive rate of the benign group and the control group were 0, the difference between the three groups was statistically significant （P=0.000）. The positive rate of serum HE4 in the EOC group was significantly higher than that in the benign group and the control group （P〈0.01）, while the benign group and the control group had no statistical significance （P〉0.05）. The median survival time of EOC patients in low level HE4 group was 66.2 months, while that in high level HE4 group was 36.9.The difference between two groups was statistically significant （P=0.001）.ConclusionThe serum HE4 level of EOC patients was significantly higher than that of patients with benign ovarian tumors and healthy controls.The higher serum HE4 level, the worse the prognosis, and the shorter the survival time of patients.Therefore, the expression level of serum HE4 can be used for the diagnosis and prognosis of ovarian cancer.