卵巢肿瘤患者尿液中间皮素联合人附睾蛋白4检测及临床意义

Predictive value between MSLN and HE4 in urine levels in patients with early stage of epithelial ovarian cancer

目的:探讨卵巢肿瘤患者尿液中间皮素(MSLN)及人附睾蛋白4(HE4)含量及检测的临床意义。方法:73例卵巢肿瘤患者,其中上皮性卵巢癌Ⅰ~Ⅱ期12例,Ⅲ~Ⅳ期29例,卵巢良性肿瘤32例,同时以30例健康体检妇女作为正常对照组,采用酶联免疫吸附试验(ELISA法)检测三组尿液中MSLN、HE4含量,计算单项及联合检测在卵巢肿瘤诊断中的灵敏度、特异性及其相关性。结果:上皮性卵巢癌组尿液中MSLN、HE4浓度均高于良性肿瘤组和对照组(P<0.05);卵巢癌Ⅰ~Ⅱ期与Ⅲ~Ⅳ期患者尿液中MSLN及HE4阳性率差异有统计学意义(P<0.05);MSLN+HE4在卵巢癌尿液中联合检测的灵敏度、特异性均显著高于单一指标检测。结论:MSLN+HE4在尿液中的联合检测无创、便捷、有效、弥补单一指标检测的缺陷,这将为卵巢癌高危人群的早期筛查提供新的途径。

Objective:To study the expression level and its relationship of ovarian cancer tumor markers mesothelin(MSLN) and humanepididymis secretory protein4(HE4) in urine, and improving the early predictive value of epithelial ovarian cancer. Methods:73 patients with ovarian tumors were selected as subjects of study. One group patients with epithelial ovarian cancers,12 cases of the stages Ⅰ~Ⅱperiod,29 cases of the stages Ⅲ~Ⅳ period. The other group have 32 patients with ovarian benign tumor. 30 normal healthy women which were randomly selected by control group. Urine levels of MSLN and HE4 were detected by enzyme-linked immunosorbent assay technique in 73 ovarian tumor, which were divided into two groups by pathology. The sensitivity and specificity of the single and combined detection of urine levels of these markers in the diagnosis of ovarian cancer were calculated and compared. Results:The urine levels of MSLN and HE4 in ovarian cancer group were significantly higher than those of ovarian benign tumor and healthy controls(P<0.05).The positive rates of MSLN and HE4 in urine were significantly higher inⅠ~Ⅱstage than in Ⅲ~Ⅳstage of ovarian cancer(P<0.05).The sensitivity and accuracy of the joint detection in ovarian cancer group were obviously higher than that of the single parameter detection. Conclusion:It has been proved that the combined detection of tumor markers MSLN and HE4 in urine is noninvasive, convenient and effective, and can be used for screening high-risk ovarian cancer, which will also provide a new way for early screening of ovarian cancer.