血清CA_(125),HE_4与D-2聚体检测在卵巢良恶性肿瘤中的应用价值

Application value of serum HE_4, CA-125 and plasma D-dimer in diagnosis of ovarian benign and malignant tumor

目的探讨检测血清CA_(125)、HE_4、D-2聚体水平在卵巢良恶性诊断中的应用价值。方法将2016年1月-2017年3月新疆医科大学附属肿瘤医院就诊并经术后病理分期的的卵巢恶性肿瘤患者217例,良性卵巢肿瘤患者580例,采用全自动血凝分析仪检测D-2聚体,采用免疫分析法测定血清CA_(125)、HE_4,并分析其检测结果。结果卵巢恶性肿瘤患者的CA_(125)、HE_4、D-2聚体与卵巢良性相比均增高(P<0.01);卵巢恶性肿瘤中Ⅲ,Ⅳ期患者的血清CA_(125)、HE_4、D-2聚体均高于Ⅰ,Ⅱ期的患者(P<0.01);CA_(125)、HE_4、D-2聚体单项检测敏感度以CA_(125)最高为75%,特异度以HE_4最高(89.03%),联合检测的敏感度、特异度分别为93.02%、72.03%,敏感度均高于任一单项。结论 D-2聚体有望成为卵巢癌发生,发展特异性潜在标志物;联合检测血清CA_(125)、HE_4、D-2聚体水平有助于卵巢肿瘤的良恶性判断,可提高对卵巢癌的诊断率。

Objective To study the ovarian benign and malignant tumor patients＇ serum CA（125）, HE4, plasma D-dimer changes and its clinical significance.Methods Between January 2016 and march 2017 in Xinjiang tumor hospital in 217 patients with ovarian malignant tumor（including Ⅰ-Ⅱ period 110 cases, Ⅲ-Ⅳ 107 cases）, 580 patients with benign ovarian tumors, using automatic blood coagulation analyzer test plasma D-dimer, using the method of immune serum CA（125）, HE4, and analyzes the test.Results The serum level CA（125）, HE4,plasma D-dimer the ovarian cancer group were significantly higher than that of benign tumor group（P〈0.01）. The serum CA（125）, HE4,plasma D-dimer in the ovarian cancer patients with the stage Ⅲ, Ⅳ period significantly were higher than that of Ⅰ,Ⅱ period of patients（P〈0.01）, the sensitivity of CA-125 detection in the single index detections was highes（t75%）,the specificity of HE4 highes（t89.03%）,the sensitivity, specificity the combine detection for diagnosis were 93.02%, 72.03%, the combine detection were higher than that of any one of single index detection. Conclusion Plasma D-dimer is expected to be the occurrence of ovarian cancer and develop specific potential markers; combining detection of serum CA（125）, HE4 and plasma D-dimer can help the diagnosis of benign and malignant ovarian tumors, and improve the diagnostic rate of ovarian cancer.