血清HE4、CEA、CA125与卵巢癌早期诊断及疗效的关系

Association of Serum HE4,CEA and CA125 with Early Diagnosis and Clinical Outcome of Ovarian Cancer

目的研究血清人附睾蛋白4(HE4)、癌胚蛋白(CEA)、糖类抗原125(CA125)与卵巢癌早期诊断及临床疗效的关系。方法选取186例卵巢肿瘤患者,根据术后病理组织检查结果分为卵巢良性肿瘤组(n=92)与卵巢癌组(n=94);同期选取100例体检健康人群作为对照组。比较三组血清HE4、CEA、CA125水平,根据标志物阳性表达情况比较HE4、CEA、CA125对卵巢癌诊断的灵敏度、特异性与准确度。卵巢癌患者经化疗后根据疗效分为有效组(n=51)与无效组(n=43),比较两组血清HE4、CEA、CA125水平,采用pearson相关性分析血清与疗效关系。结果卵巢良性肿瘤组与卵巢癌组血清HE4、CEA、CA125水平高于对照组(P<0.05),且卵巢癌组水平高于卵巢良性肿瘤组(P<0.05)。HE4对卵巢癌诊断的灵敏度为94.46%、特异性为94.79%、准确率为94.76%,CEA分别为93.62%、94.27%、94.06%,CA125分别为91.49%、94.27%、93.36%;三种标志物对卵巢癌的诊断结果无统计学意义(P>0.05)。化疗后有效组血清HE4、CEA、CA125水平低于无效组(P<0.05)。经pearson相关性分析,血清HE4、CEA、CA125表达与卵巢癌化疗有效性呈负相关(P<0.05)。结论血清HE4、CEA、CA125水平表达能反映卵巢癌病变程度,联合检测有助于提高卵巢癌诊断检出率,可作为卵巢癌早期诊断与疗效评估的重要指标。

Objective To investigate the relationship between serum human epididymis protein 4(HE4),carcinoembryonic antigen(CEA)and cancer antigen125(CA125)and the early diagnosis and clinical outcome of ovarian cancer.Methods 186 patients with ovarian cancer were enrolled,and divided into 2 groups according to the pathological results,benign ovarian tumor group(n=92)and ovarian cancer group(n=94);Meanwhile,another 100 cases of healthy individuals were set as the control group.Serum HE4,CEA and CA125 levels of three groups were compared,and the sensitivity,specificity and accuracy of three indicators in the diagnosis of ovarian cancer were analyzed according to the positive expression of markers.Ovarian cancer patients were further divided into effective subgroup(n=51)and ineffective subgroup(n=43)according to efficacy of chemotherapy.Serum HE4,CEA and CA125 levels were compared between 2 subgroups,and Pearson correlation was used to discuss the relationship between serum markers and chemotherapy efficacy.Results The levels of serum HE4,CEA and CA125 among 3 groups were the highest in ovarian cancer group,and followed by benign ovarian tumor group,and were the lowest in normal group,with statistical difference(P<0.05).In the diagnosis of ovarian cancer,the sensitivity,specificity and accuracy were 94.46%,94.79%and 94.76%for HE4,93.62%,94.27%and 94.06%for CEA,and 91.49%,94.27%and 93.36%for CA125,respectively.The 3 tumor markers showed no significant difference in the diagnosis of ovarian cancer(P>0.05).The levels of serum HE4,CEA and CA125 in effective group were lower than those in ineffective group after chemotherapy(P<0.05).Pearson correlation analysis found that the expression of serum HE4,CEA and CA125 was negatively correlated with the efficacy of chemotherapy for ovarian cancer(P<0.05).Conclusion Serum HE4,CEA and CA125 levels can reflect the degree of ovarian cancer lesions,and combined detection has high detection rate of ovarian cancer,so the 3 can be used as important indicators for early diagnosis and efficacy evaluation of ovarian cancer.