人附睾蛋白4在早期子宫内膜癌中的诊断价值

Diagnostic value of serum HE4 in early endometrial carcinoma

目的探讨人附睾蛋白4(HE4)在子宫内膜腺癌中的诊断价值。方法选取2014年5~12月首都医科大学附属北京妇产医院收治的病理证实的36例Ⅰ期子宫内膜癌患者(子宫内膜癌组)、19例子宫内膜非典型增生患者(子宫内膜非典型增生组)及45例正常子宫内膜患者(正常子宫内膜组)为研究对象,采用酶联免疫吸附试验法分别检测各组血清HE4水平,并对其诊断价值进行分析。结果子宫内膜癌组HE4水平[(65.01±40.54)pmol/L]显著高于子宫内膜非典型增生组[(41.01±15.23)pmol/L]及正常子宫内膜组[(40.03±19.03)pmol/L],差异均有高度统计学意义(P<0.01);正常子宫内膜组与子宫内膜非典型增生组HE4水平比较差异无统计学意义(P>0.05);不同肌层浸润深度、组织分化程度及脉管间隙受浸程度的子宫内膜癌患者血清HE4水平不同(P<0.05);受试者工作特征曲线下面积AUC为0.733。根据ROC曲线确定HE4最佳临界值为46.25 pmol/L,该临界值早期诊断子宫内膜癌的敏感性为68.4%,特异性为76.6%。结论早期子宫内膜癌患者血清HE4水平明显升高,可作为子宫内膜癌早期诊断的重要指标,并与肌层浸润深度、组织分化及脉管间隙受浸相关,可用于术前高危因素的预测及评估。

Objective To explore the diagnostic value of serum human epididymis protein 4(HE4)in early endometrial carcinoma.Methods Thirty-six cases of stageⅠendometrium carcinoma(endometrial carcinoma group),19 cases of endometrium atypical hyperplasia(endometrium atypical hyperplasia group)and 45 cases of normal endometrium(normal endometrium group)from May to December 2014 in Bejing Obstetrics and Gynecology Hospital,Capital Medical University were selected,the levels of serum HE4 of patients in each group were detected by enzyme-linked immunosorbent assay(ELISA).The diagnostic value of serum HE4 levels were analyzed.Results The level of HE4 in endometrial carcinoma group[(65.01±40.54)pmol/L]was significantly higher than that in endometrium atypical hyperplasia group[(41.01±15.23)pmol/L]and the normal endometrium group[(40.03±19.03)pmol/L],the differences were statistically significant(P<0.01).There was no statistically significant difference in serum level of HE4 between the endometrium atypical hyperplasia group and endometrium atypical hyperplasia group(P>0.05).In endometrial carcinoma group,the levels of serum HE4 were different in patients with different Myometrial infiltration depth,degree of tissue differentiation and vascular clearance.The AUC under the ROC curve was 0.733,and according to the ROC curve the cut-off of HE4 was 46.25 pmol/L,the sensitivity of early diagnosis of endometrial cancer was 68.4%,the specificity was 76.6%.Conclusion The level of serum HE4 in Endometial carcinoma patients is significantly increased,it can be used as biological markers of early diagnosis of endometrial carcinoma,the serum level of HE4 may assist to predict and evaluate risk factors before operation.