血清糖类抗原125联合人附睾蛋白4及糖类抗原199检测诊断上皮性卵巢癌的意义

Diagnostic significance of combined CA125,HE4 and CA199 in ovarian cancer

目的探讨血清糖类抗原125(CA125)、人附睾蛋白4(HE4)及糖类抗原199(CA199)对上皮性卵巢癌(EOC)的联合诊断价值。方法随机选取广东省人民医院2017-2019年经病理确诊的上皮性卵巢癌患者61例(卵巢癌组)为观察组,并选取同期的卵巢良性病变组50例、健康体检女性50例(健康组)为对照组,使用电化学发光法检测血清中的CA125、HE4及CA199浓度并进行统计分析。结果卵巢癌组血清中的CA125、HE4及CA199血清浓度和阳性率高于良性病变组和对照组患者,差异有统计学意义(P<0.05)。CA125和HE4在不同病理特征的EOC患者具有一定的相关性。不同标志物检测在不同病理特征的上皮性卵巢癌患者差异无统计学意义(P>0.05)。在95%的置信区间CA125、HE4及CA199在卵巢癌诊断中的曲线下面积分别为0.89,0.81,0.71,且卵巢癌组患者血清中的CA125、HE4和CA199三者联合检出率(88.52%)、ROC曲线下面积(0.94)、灵敏度(92.3%)、阳性预测值(89.2%)及阴性预测值(94.2%)明显高于各指标的单独检出,差异有统计学意义(P<0.05)。结论CA125、HE4及CA199联合检测可提高卵巢癌诊断的灵敏度,HE4和CA125用于诊断浆液性癌与子宫内膜样癌以及CA199诊断黏液癌可能更有价值。

Objective To investigate the clinical effects of carbohydrate antigen 125(CA125),human epididymis protein 4(HE4)and carbohydrate antigen 199(CA199)in epithelial ovarian cancer in the combined diagnosis of the role and significance.Methods From2017 to July 2019 in Guangdong Provincial People’s Hospital,61 cases with epithelial ovarian cancer were enrolled in this study.50 cases of ovarian benignlesion(benign lesion group)and 50 healthy controls(healthy group)were selected as the control group.The serum CA125,HE4 and CA199 levels were used for statistical analysis.Results Thelevelsof CA125,HE4 and CA199 in serum of ovarian cancer patients were significantly higher than those in the control group and ovarian benignlesion,the difference was statistically significant(P<0.05).For detecting different pathological features of ovarian cancer,the detection rate of CA125 and HE4 showed significant difference(P<0.05).At the 95%confidence interval,the ROC curve of the CA125,HE4 and CA199 in the diagnosis of pelvic mass was 0.89,0.81,0.71.The combined detection rate,sensitivity,positive predictive value and negative predictive value of CA125,HE4 and CA199 in serum of patients with epithelial ovarian cancer were significantly higher than those of each index,the differences were statistically significant(P<0.05).Conclusion Combining detection of CA125,HE4 and CA199 can improve the diagnostic sensitivity of EOC,especially early epithelial ovarian cancer.HE4 and CA125 may be important in diagnosis of serous carcinoma and endometrial carcinoma.CA199 may be important in diagnosis of mucinous carcinoma.