HE4、CA125和CA199联合D-二聚体检测在卵巢癌早期诊断中的应用

Combined detection of HE4,CA125,CA199 and D-dimer in the early diagnosis of ovarian cancer

目的探讨人附睾分泌蛋白4(HE4)、糖类抗原125(CA125)和糖类抗原199(CA199)联合血浆D-二聚体检测在卵巢癌早期诊断中的应用价值。方法选取2014年1月至2017年12月间上海市金山区亭林医院收治的50例确诊卵巢癌患者为癌症组,50例良性卵巢肿瘤患者为良性组,另选取同期50例健康体检女性为对照组,采用化学发光法测定三组受试者血清HE4、CA125和CA199的水平,采用免疫比浊法测定血浆D-二聚体水平,分析四项指标水平对卵巢癌早期诊断价值。结果癌症组患者HE4、CA125、CA199及D-二聚体水平均高于良性组和对照组,差异均有统计学意义(均P <0. 05)。癌症组患者HE4、CA125、CA199、D-二聚体及联合检测阳性率均高于良性组和对照组,差异均有统计学意义(均P <0. 05)。单项检测中,HE4敏感性、特异性、阳性预测值、阴性预测值及诊断效率最高;联合检测敏感性、特异性、阳性预测值、阴性预测值及诊断效率均高于单项检测。结论 HE4、CA125、CA199和D-二聚体联合检测可提高卵巢癌早期诊断效率,对卵巢癌的早期诊断和治疗有重要临床价值。

Objective To explore the clinical value of combined detection of human epididymis protein4( HE4),carbohydrate antigen199( CA199),carbohydrate antigen125( CA125) and D-dimer in the early diagnosis of ovarian cancer. Methods Fifty patients with ovarian cancer( cancer group) and 50 patients with benign ovarian tumors( benign group) admitted to Tinglin Hospital of Jinshan District from January 2014 to December 2017 were selected. Another 50 healthy women( control group) were selected at the same time. The serum levels of HE4,CA125 and CA199 were determined by using chemiluminescent immunoassay among the three groups. The serum levels of D-dimer were determined by using immunoassay.Significance of the above four indexes for the early diagnosis of ovarian cancer was analyzed. Results The serum levels of HE4,CA199,CA125 and D-dimer in the ovarian cancer group were higher than in the benign group and control group( all P < 0. 05). The positive rate of HE4,CA199,CA125 and D-dimer in cancer group was significantly higher than in the benign group and the control group( all P < 0. 05). The sensitivity,specificity,positive predictive value,negative predictive value and diagnostic efficiency of HE4 were the highest among the four tests. The sensitivity,specificity,positive predictive value,negative predictive value and diagnostic efficiency of the four combined tests were higher than the single test,and the difference was statistically significant( all P < 0. 05). Conclusion The combined detection of HE4,CA125,CA199 and D-dimer can improve the efficiency of early diagnosis for ovarian cancer,which has important clinical value for early diagnosis and treatment of ovarian cancer.