HE4结合CA125预测卵巢癌治疗预后的价值

Value of HE4 Combined with CA125 in Predicting the Prognosis of Ovarian Cancer

目的探讨血清人附睾分泌蛋白4(serum human epididymis secretory protein 4,HE4)联合糖类抗原125(carbohydrate antigen 125,CA125)预测卵巢癌(ovarian cancer,OC)治疗预后的价值。方法选取笔者医院诊治的OC患者256例,随访4年。以患者复发、分期上升、淋巴结转移、死亡定义为终点事件并分组。比较分析两组患者的临床资料,将差异有统计学意义的结果进行COX多因素分析,运用ROC曲线进一步分析CA125、HE4对卵巢癌预后的预测能力。结果病灶直径(P=0. 023)、分化程度(P=0. 021)、分期(P=0. 014)、肌层浸润程度(P=0. 041)、HE4(P=0. 023)、CA125(P=0. 034)是影响预后的独立影响因素。根据ROC曲线得知,CA125预测卵巢癌预后的曲线下面积(area under curve,AUC)为0. 88,最佳诊断点为692. 53U/ml,其敏感度为64. 30%,特异性为93. 00%; HE4的AUC为0. 74,低于指标CA125,最佳诊断点为256. 05pmol/L,其敏感度为59. 20%,特异性为82. 90%。而CA125和HE4两者联合预测卵巢癌预后的AUC最高为0. 89。结论 CA125和HE4两者联合预测卵巢癌患者治疗后淋巴结转移敏感度高于两者单独检测,临床上可通过联合检测提高卵巢癌患者预后判断的准确性,及时制定医疗方案从而改善患者预后。

Objective To investigate the value of serum human epididymis secretory protein 4(HE4)combined with carbohydrate antigen 125(CA125)in predicting the prognosis of ovarian cancer(OC).Methods Totally 256 patients with ovarian cancer(ovarian cancer,OC)diagnosed and treated in our hospital were followed up for 4 years.Recurrence,staging,lymph node metastasis,and death were defined as end-point events and patients were defined as two groups according to end-point events.The clinical data of two groups of patients were compared and analyzed.COX multivariate analysis was performed with statistically significant results.ROC curves were used to further analyze the predictive power of CA125 and HE4 in the prognosis of ovarian cancer.Results Lesion diameter(P=0.023),differentiation(P=0.021),pathological type(serous and mucinous),staging(P=0.014),myometrial infiltration(P=0.041),HE4(P=0.023),CA125(P=0.034)were independent factors that affected the prognosis.According to the ROC curve,the area under curve(AUC)of CA125 predicting ovarian cancer prognosis was 0.88.The best diagnostic point was 692.53U/ml.The sensitivity was 64.30%,and the specificity was 93.00%,The AUC of HE4 was 0.74,lower than CA125.The best diagnostic point was 256.05pmol/L.The sensitivity was 59.20%and the specificity was 82.90%.The highest AUC was the combination of CA125 and HE4(0.89).Conclusion The combination of CA125 and HE4 predicts the sensitivity of lymph node metastasis in patients with ovarian cancer after treatment is higher than that of the two separately.Clinically,the combination of CA125 and HE4 can improve the prognosis of patients with ovarian cancer and develop the medical plan in time to improve the prognosis of patients.