血清AFP、CEA、CA199、CA125、HE4联合检测在卵巢癌诊断中的应用价值

Clinical value of combined detection of serum AFP,CEA,CA199,CA125 and HE4 in diagnosis of ovarian cancer

目的探讨血清AFP、CEA、CA199、CA125、HE4联合检测对卵巢癌的诊断价值。方法选择收治的卵巢癌患者188例,另选取同期163例卵巢良性肿瘤患者及151例健康体检者作为对照,比较3组研究对象血清AFP、CEA、CA199、CA125、HE4水平差异,计算各指标诊断效能以及相关性。结果3组研究对象AFP、CEA、CA199、CA125和HE4水平均存在明显差异(P<0.05)。Ⅲ~Ⅳ期卵巢癌患者上述5项指标水平均明显高于Ⅰ~Ⅱ期卵巢癌患者(P<0.05)。单一指标检测,HE4的灵敏度,阳性预测值,阴性预测值最高,分别为77.7%、83.0%以及87.1%,CEA的特异度最高,为93.3%。各指标联用,显著提高了灵敏度以及阴性预测值,分别为95.2%和96.3%。HE4和CA125存在明显的正相关(r=0.348,P<0.05)。结论AFP、CEA、CA199、CA125、HE4联合检测能够提升对卵巢癌的诊断效能,有助于卵巢癌的早期筛查和诊断。

Objective To investigate the diagnostic value of combined detection of serum AFP,CEA,CA199,CA125 and HE4 in ovarian cancer.Methods A total of 188 patients with ovarian cancer were enrolled in the study,at the same time,the other 163 patients with benign ovarian tumor were enrolled as control group,and 151 healthy subjects were enrolled as normal control group.The serum levels of AFP,CEA,CA199,CA125 and HE4 were observed and compared among the three groups,and the diagnostic efficacy and correlation of thses indexes were analyzed.Results There were significant differences in the above five indexes among the three groups(P<0.05).The levels of the above five indexes in patients with stageⅢ~Ⅳovarian cancer were significantly higher than those in patients with stageⅠ~Ⅱovarian cancer(P<0.05).In single index detection,HE4 had the highest sensitivity,positive predictive value and negative predictive value(77.7%,83.0%and 87.1%,respectively),CEA had the highest specificity(93.3%).The sensitivity and negative predictive value were significantly improved by the combination detection of these indexes(95.2%and 96.3%respectively).There was a significant positive correlation between HE4 and CA125(P<0.05).Conclusion The combined detection of AFP,CEA,CA199,CA125 and HE4 can improve the diagnostic efficiency of ovarian cancer,which is helpful for the early screening and diagnosis of ovarian cancer.