肾功能不全卵巢癌患者血清糖类抗原125、人附睾蛋白4水平及其临床价值

Clinical application of serum carbohydrate antigen 125 and human epididymis protein 4 in ovarian carcinoma complicated with renal insufficiency

目的探讨利用血清糖类抗原125(carbohydrate antigen,CA125)和人附睾蛋白4(human epididymis protein 4,HE4)诊断卵巢癌和监测疗效时,如何判断伴有肾功能不全患者的血清CA125、HE4水平与肿瘤的关系。方法良性组50例,良性+肾功能不全组20例,卵巢癌组50例,卵巢癌+肾功能不全组30例,对照组50例。检测各组血清CA125、HE4水平。分析良性+肾功能不全组血清CA125、HE4与肌酐、尿素、尿酸和胱抑素C水平的相关性。分析卵巢癌患者治疗前后血清CA125、HE4水平及肾功能指标。结果良性组、良性+肾功能不全组的血清CA125水平明显高于对照组(P<0.01),卵巢癌组、卵巢癌+肾功能不全组血清CA125水平明显高于其他组(P<0.01)。良性+肾功能不全组血清HE4水平明显高于良性组和对照组(P<0.01),而与卵巢癌组比较差异无统计学意义(P=0.231);卵巢癌+肾功能不全组血清HE4水平显著高于其他组(P<0.01)。血清HE4水平与肌酐、尿素、胱抑素C水平均呈正相关(P<0.05)。20例治疗后伴有肾功能不全的患者血清CA125水平显著降低(P<0.01),但HE4水平显著升高(P<0.01)。结论鉴别卵巢良恶性肿瘤方面血清HE4优于CA125,但肾功能状态对血清HE4的影响更明显。血清尿素、肌酐和胱抑素C结果有助于排除肾功能不全导致的HE4水平增高。

Objective To investigate the relationship between serum carbohydrate antigen 125(CA125)and human epididymal protein 4(HE4)levels and tumor in patients with renal impairment when using serum CA125 and HE4 to diagnose ovarian cancer and monitor the efficacy.Methods Clinically or pathologically confirmed gynecological diseases were grouped,including 50 cases of gynecological benign diseases,20 cases of gynecological benign diseases patients complicated with renal insufficiency,50 cases of epithelial ovarian carcinoma,30 cases of ovarian carcinoma patients complicated with renal insufficiency and 50 normal controls.Serum CA125 and HE4 concentrations of all groups were detected and compared.Analyzed the correlation between serum HE4 and CRE,Urea,UA and cystatin C values in gynecological benign diseases patients complicated with renal insufficiency.Serum CA125 and HE4 levels and renal function indexes of ovarian cancer patients before and after treatment were analyzed.Results Serum CA125 values in gynecological benign diseases and gynecological benign diseases with renal insufficiency group were significantly increased compared with the normal control group(P<0.01).Serum CA125 values in ovarian carcinoma and ovarian carcinoma with renal insufficiency group were significantly increased compared with that in other groups(P<0.01).Serum HE4 values in gynecological benign diseases with renal insufficiency group were significantly increased compared with the gynecological benign diseases and normal control groups(P<0.01).There was no significant difference when compared with ovarian carcinoma group(P=0.231).Serum HE4 level in ovarian carcinoma with renal insufficiency was significantly higher than that in other groups(P<0.01).The serum HE4 values were positively correlated to the serum values of creatinine,urea and cystatin C(P<0.05).Serum CA125 levels were significantly reduced in 20 patients with ovarian cancer after treatment(P<0.01),but the HE4 levels increased significantly(P<0.01).Conclusion Serum HE4 is superior to serum CA125 in identifying benign and malignant ovarian tumors.However,the effect of renal function status on serum HE4 was more obvious.The results of serum creatinine,urea and cystatin C were helpful to exclude the increased serum HE4 level caused by renal insufficiency.