HE4与CA125联合检测鉴别诊断卵巢癌与卵巢子宫内膜异位囊肿的临床应用价值

The Clinical Value of Combined Detection of HE4 and CA125 in the Differential Diagnosis of Ovarian Cancer and Ovarian Endometriotic Cysts

目的分析HE4与CA125联合检测鉴别诊断卵巢癌与卵巢子宫内膜异位囊肿的临床应用价值。方法该研究便利择取2019年4月—2020年4月该院接收的卵巢疾病患者258例为研究样本。依照术后病理结果,将其分为卵巢子宫内膜异位囊肿组182例以及卵巢癌组76例。另取同期内来该院接受体检的120名健康女性为对照组,分析HE4与CA125联合检测鉴别诊断卵巢癌与卵巢子宫内膜异位囊肿的临床应用情况。结果卵巢癌者CA125(506.25±559.63)U/mL以及HE4(396.52±420.25)pmol/L水平明显高于卵巢子宫内膜异位囊肿CA125(40.28±29.63)U/mL、HE4(48.52±21.25)pmol/L和健康者CA125(13.34±8.47)U/mL、HE4(45.26±12.27)pmol/L,差异有统计学意义(P<0.05)。相较于对照组而言。卵巢子宫内异位囊肿组CA125水平差异有统计学意义(P<0.05)。两组HE4差异无统计学意义(P>0.05)。将卵巢子宫内异位囊肿组和卵巢癌组作对比时,CA125、HE4单项与联合测定诊断疾病的准确性、特异性以及敏感性分别为76.8%、90.1%以及79.0%;72.9%、69.2%、81.6%;82.2%、80.2%、86.8%。将健康者为参照人群时,HE4和CA125单项联合检测敏感性、特异性以及准确性分别为79.0%,93.3%,87.8%;81.6%,91.7%,87.8%以及94.7%,96.7%,95.9%。不管是将卵巢子宫内异位囊肿组或者对照组为对照,CA125联合HE4诊断疾病的准确性以及敏感性均比单项检查要高。结论对患者实施单项检测HE4诊断卵巢癌疾病的特异性比CA125要好。联合检测能进一步提升卵巢癌疾病的诊断准确度。同时其也为卵巢恶性肿瘤和卵巢子宫内异位囊肿鉴别的优秀指标。

Objective To analyze the clinical value of combined detection of HE4 and CA125 in the differential diagnosis of ovarian cancer and ovarian endometriotic cysts.Methods The study convenience selection 258 patients with ovarian disease admitted to the hospital from April 2019 to April 2020 as the study samples.According to the postoperative pathological results,they were divided into 182 cases of ovarian endometriotic cyst group and 76 cases of ovarian cancer group.In addition,120 healthy women who came to the hospital for physical examination during the same period were selected as control group to analyze the clinical application of HE4 and CA125 in the differential diagnosis of ovarian cancer and ovarian endometriotic cysts.Results The levels of CA125(506.25±559.63)U/mL and HE4(396.52±420.25)pmol/L in ovarian cancer group were significantly higher than those in ovarian endometriotic cysts group CA125(40.28±29.63)U/mL HE4(48.52±21.25)pmol/L and healthy people CA125(13.34±8.47)U/mL HE4(45.26±12.27)Pmol/L,the difference was statistically significant(P<0.05).Compared to the control group,there was a statistically significant difference in CA125 levels in ovarian endometriotic cysts(P<0.05).There was no statistically significant difference in HE4 between the two groups(P>0.05).When comparing patients with ovarian endometriotic cysts group and ovarian cancer group,the accuracy,specificity and sensitivity of CA125,HE4 single item and combined determination of the diagnosis of disease were 86.8%,90.1%and 79.0%;72.9%,69.2%,81.6%;82.2%,80.2%,86.8%.When healthy people were used as the reference population,the sensitivity,specificity and accuracy of the single combined detection of HE4 and CA125 were 79.0%,93.3%,87.8%;81.6%,91.7%,87.8%and 94.7%,96.7%,95.9%,respectively.Regardless of whether the ovarian endometriotic cysts group or the control group as the control,the accuracy and sensitivity of CA125 combined with HE4 in diagnosing diseases were higher than that of a single examination.Conclusion The specificity of HE4 in the diagnosis of ovarian cancer is better than that of CA125.Combined detection can further improve the accuracy of diagnosis of ovarian cancer.At the same time,it is also an excellent indicator for the identification of ovarian malignant tumors and orarian endome triotic cysts.