血清CA125、HE_(4)及D-二聚体联合T淋巴细胞亚群在诊断上皮性卵巢癌中的临床价值

Clinical value of serum CA125,HE_(4) and D-dimer combined with Tlymphocyte subsets in the diagnosis of epithelial ovarian cancer

目的研究血清糖类抗原125(CA125)、人附睾蛋白4(HE_(4))及D-二聚体联合T淋巴细胞亚群在诊断上皮性卵巢癌(EOC)中的临床应用价值。方法选取100例确诊为上皮性卵巢癌患者为恶性组,100例卵巢良性肿物患者为良性组。患者均进行血清CA125、HE_(4)、D-二聚体及T淋巴细胞亚群检查。比较不同情况患者的血清CA125、HE_(4)、D-二聚体以及T淋巴细胞亚群相关指标。使用ROC曲线分析不同指标对恶性肿瘤的诊断价值。结果HE_(4)、CA125、D-二聚体、CD8^(+)水平在恶性组患者、肿瘤分期Ⅲ/Ⅳ期患者、淋巴结转移患者、中/低分化患者体内的水平显著升高,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平则显著降低,差异有统计学意义(P<0.05)。ROC曲线分析显示:HE_(4)+CA125+D-二聚体+T淋巴细胞亚群检测的特异性、准确率、约登指数最高,分别为96.0%、92.5%、0.85o结论血清CA125、HE_(4)、D-二聚体、T淋巴细胞亚群水平可作为上皮性卵巢癌的诊断依据,其中HE4+CA125+D-二聚体+T淋巴细胞亚群联合诊断能够显著提升诊断的敏感性、特异性和准确率。

Objective To study the clinical value of serum carbohydrate antigen 125(CA125),human epididymal protein 4(HE_(4))aiid D-dimer combined T lymphocyte subsets in the diagnosis of epithelial ovarian cancer(EOC).Methods 100 patients with epithelial ovarian cancer were selected as malignant group and 100 patients with benign ovarian masses as benign group.All patients were examined for serum CA125,HE_(4),D-dimer and T lymphocyte subsets.Serum CA125,HE_(4),D-dimer and T lymphocyte subsets were compared in patients with different conditions.ROC curve was used to analyze the diagnostic value of different indicators for malignant tumors.Results The levels of HE_(4),CA125,D-dimer and CD8^(+)in patients with malignant group,patients with tumor stage Ⅲ/Ⅳ,patients with lymph node metastasis and patients with medium/low differentiation were significantly increased,while the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+) were significantly decreased(P<0.05).ROC curve analysis showed that the specificity,accuracy and yoden index of HE_(4)+CA125+D-dimer+T lymphocyte subsets were the highest,96.0%,92.5% and 0.85 respectively.Conclusion The levels of serum CA125,HE_(4),D-dimer and T-lymphocyte subsets can be used as the diagnostic basis for epithelial ovarian cancer.The combined diagnosis of HE_(4)+CA125+D-dimeri-T-lymphocyte subsets can significantly improve the sensitivity,specificity and accuracy of diagnosis.