血清CA125、AFP、CA199、CEA、HE4联合检测对卵巢癌及其临床分期的诊断价值

Value of combined detection of serum CA125,AFP,CA199,CEA and HE4 in diagnosis of ovarian neoplasms and its clinical stage

目的探究血清糖类抗原125(CA125)、甲胎蛋白(AFP)、糖类抗原199(CA199)、癌胚抗原(CEA),人附睾蛋白-4(HE4)联合检测对卵巢癌及其临床分期的诊断效能。方法抽取2016年1月至2019年12月郑州市妇幼保健院收治的86例乳腺癌患者(卵巢癌组)和82例卵巢良性肿瘤患者(良性病变组),采集患者血液标本检测血清CA125、AFP、CA199、CEA、HE4水平,比较两组患者及不同病理分期卵巢癌患者检测指标差异,以受试者工作特征曲线(ROC曲线)评价上述血清指标对卵巢癌及其临床分期的诊断效能。结果卵巢癌组患者血清CA125、AFP、CA199、HE4水平均高于良性病变组(P<0.05),CEA水平与良性病变组比较差异未见统计学意义(P>0.05);卵巢癌组患者中,国际妇产科联盟(FIGO)病理分期Ⅲ~Ⅳ期卵巢癌患者血清CA125、AFP、CA199、HE4水平均高于Ⅰ~Ⅱ期患者(P<0.05),CEA水平与Ⅰ~Ⅱ期患者比较差异未见统计学意义(P>0.05);血清CA125、HE4单项检测对卵巢癌及Ⅲ~Ⅳ期分期具有较高诊断效能,血清CA125、AFP、CA199、CEA、HE4联合检测提高了对卵巢癌及其临床分期的诊断效能(ROC曲线下面积=0.976、0.948,95%CI 0.000~1.000、0.000~1.000,P<0.05,灵敏度93.02%、90.70%,特异度95.12%、87.80%)。结论血清CA125、HE4单独用于卵巢癌及其临床分期诊断具有良好诊断效能,血清CA125、AFP、CA199、CEA、HE4联合检测诊断卵巢癌及其临床分期可进一步提高诊断效能。

Objective To investigate the value of combined detection of serum carbohydrate antigen 125(CA125),alpha fetoprotein(AFP),carbohydrate antigen 199(CA199),carcinoembryonic antigen(CEA),and human epididymis protein-4(HE4)in diagnosis of ovarian neoplasms and its clinical stage.Methods Eighty-six patients with ovarian neoplasms(ovarian neoplasms group)and 82 patients with benign ovarian tumor(benign lesion group)admitted to Maternal and Child Health Care Hospital of Zhengzhou from January 2016 to December 2019 were selected.Blood samples were collected to detect the levels of serum CA125,AFP,CA199,CEA,and HE4,and the differences of detection indicators were compared between the two groups,and the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of the above serum indicators on ovarian neoplasms and its clinical staging.Results The levels of serum CA125,AFP,CA199,and HE4 in ovarian neoplasms group were significantly higher than those in benign lesion group(P<0.05).There was no statistically significant difference in the CEA level compared with that in benign lesion group(P>0.05).The levels of serum CA125,AFP,CA199,and HE4 of patients with Federation Internationale of Gynecologie and Obstetrigue(FIGO)pathological stage Ⅲ to Ⅳ ovarian neoplasms were significantly higher than those of patients with stage Ⅰ to Ⅱ(P<0.05).There was no statistical difference in the CEA level compared with that of patients with stage Ⅰ to Ⅱ(P>0.05).Single detection of serum CA125 or HE4 had high diagnostic efficacy of Ovarian Neoplasms and stage Ⅲ to Ⅳ,and the combined detection of serum CA125,AFP,CA199,CEA and HE4 could further improve the diagnostic efficacy of ovarian neoplasms and clinical staging(area under the curve=0.976,0.948,95%CI 0.000-1.000 and 0.000-1.000,P<0.05,sensitivities of 93.02%and 90.70%,specificities of 95.12%and 87.80%).Conclusions Serum CA125 and HE4 alone have good diagnostic efficacy in the diagnosis of ovarian neoplasms and its clinical staging.The combined detection of serum CA125,AFP,CA199,CEA and HE4 can further improve the diagnostic efficacy in the diagnosis of ovarian neoplasms and its clinical stage.