人附睾蛋白4、CA125和CA19-9单项和联合检测对子宫内膜癌的诊断价值

Diagnostic value of human epiditidine 4, CA125 and CA19-9 with single detection and combineddetection in endometrial carcinoma

目的分析人附睾蛋白4(HE4)、CA125和CA19-9单项和联合检测对子宫内膜癌的诊断价值。方法选择我院2013年3月至2018年3月收治的100例子宫内膜癌患者为EC组,选择同期在我院接受检查的子宫内膜良性病变患者100例为良性病变组,同期在我院进行健康体检的100例健康女性作为健康对照组,采用酶联免疫吸附法(ELISA)检测HE4水平,CA125与CA19-9采用化学发光法检测,绘制受试者工作曲线,计算各指标最佳临界值、单项检测与联合检测诊断效能,分析各指标在不同病理因素中的表达水平。结果子宫内膜癌组HE4、CA125和CA19-9均显著高于子宫内膜良性病变组与健康对照组(P<0.05);HE4的AUC值为(0.804±0.012),CA125的AUC值为(0.677±0.011),CA19-9的AUC值为(0.618±0.009),联合检测的的AUC值为(0.846±0.017),联合检测AUC值显著高于各标记物单项检测AUC值(P<0.05);联合检测诊断敏感性为76%,特异性为98%,准确度为87%,阳性预测值为97%,阴性预测值为80%,约登指数为0.74,联合检测组各值显著高于CA125、CA19-9单项检测值(P<0.05),与HE4无明显差异(P>0.05);肌层浸润深度≥1/2、宫颈间质受累、G1-G2分化期的HE4、CA125和CA19-9水平显著高于肌层浸润深度<1/2、宫颈间质未受累、G3分化期水平(P<0.05)。结论术前采用三项指标联合检测,诊断效能更高,且有助于分析患者病情严重程度,并采取更有针对性的治疗方法,提高治疗效果。

Objective To analyze the diagnostic value of human epiditidine 4(HE4),CA125 and CA19-9 with single detection and combineddetection in endometrial carcinoma.Methods The data of 100 patients diagnosed with endometrial carcinoma was selected from March 2013 to March 2018,100 patients with benign endometrial lesions were examined in our hospital,and 100 healthy women were enrolled in our hospital as the control group.The level of HE4 was detected by ELISA,the level of CA125 and CA19-9 were detected by chemiluminescence method,and mapped the working curve of the subjects and calculated the best critical values of each indicator,diagnostic efficacy of individual detection and combined detection.The expression level of each index in different pathological factors was analyzed.Results The level of HE4,CA125 and CA19-9 in endometrial carcinoma group were significantly higher than those in benign endometrial lesion group and healthy control group(P<0.05).The AUC value of HE4 was(0.804±0.012),the AUC value of CA125 was(0.677±0.011),the AUC value of CA19-9 was(0.618±0.009),and the AUC value of the combined test was(0.846±0.017).The AUC value of the combined test was significantly higher than the AUC value of single test(P<0.05).The sensitivity,specificity and accuracy of the combined test was 76%,98%and 87%,and the positive prediction value was 97%,the negative prediction value was 80%,the log index was 0.74.The values of the combined test group was significantly higher than individual detection value(CA125 or CA19-9,P<0.05),and there were no statistical significantly differences compared with HE4(P>0.05).The depth of muscle infiltration≥1/2,cervical interstitial involvement,the levels of HE4,CA125,and CA19-9 during G1-2 differentiation were significantly higher than the opposite patients(P<0.05).Conclusion It is could attained better diagnostic efficacy combined examination of three indexes before operation,and it is helpful to analyze the patient's condition for applying more targeted treatment methods to improve the therapeutic effect.