CEA、CA125及HE4联合检测在子宫肌瘤中的诊断价值

Diagnostic Value of CEA,CA125 and HE4 in Uterine Fibroids

目的探讨癌胚抗原(CEA)、糖类抗原125(CA125)及人附睾蛋白4(HE4)联合检测子宫肌瘤的诊断价值。方法选择2019年4月至2021年3月我院收治的子宫肌瘤患者83例作为子宫肌瘤组,选取同期于我院健康体检者83例作为健康对照组。比较两组CEA、CA125、HE4水平,并分析CEA、CA125及HE4联合检测在子宫肌瘤中的诊断价值。结果子宫肌瘤组的血清CA125、CEA和HE4均高于健康对照组,差异显著(P<0.05)。子宫肌瘤患者的血清CA125、CEA水平与年龄、流产次数、妊娠胎次、妇科疾病和乳腺增生有关(P<0.05),与肌瘤类型、是否绝经无关(P>0.05)。血清HE4与年龄、流产次数、妇科疾病和乳腺增生有关(P<0.05),与肌瘤类型、妊娠胎次、是否绝经无关(P>0.05)。血清CA125在最佳诊断点32.15U/ml时,AUC为0.813,特异度0.731,灵敏度0.875;血清CEA在最佳诊断点17.24ng/ml时,AUC为0.782,特异度0.705,灵敏度0.746;血清HE4在最佳诊断点48.31pmol/L时,AUC为0.854,特异度0.915,灵敏度0.827。三者联合诊断时AUC最高为0.923,特异度0.958,灵敏度0.897,诊断效能最高。结论癌胚抗原、糖类抗原125和人附睾蛋白4联合检测有助于预测子宫肌瘤,提高诊断的敏感度、特异度和准确性,具有重要意义。

Objective To investigate the diagnostic value of ca rcinoembryonic antigen(CEA),ca rbohydrate antigen 125(CA125)and huma n epididymis protein 4(HE4)in the detection of uterine fibroids.Methods A total of 83 healthy subjects in our hospital from April 2019 to March 2021 were selected as the healthy control group,and 83 patients with uterine fibroids admitted during the same period were selected as the uterine fibroids group.The levels of CEA,CA125 and HE4 were compared between the two groups,and the diagnostic value of CEA,CA125 and H E4 combined detection in uterine fibroids was analyzed.Resuls Seru m CA125,CEA and HE4 in uterine myoma group were significantly higher than those in healt hy control group(P<0.05).The levels of serum CA125 and CEA in patients with uterine fibroids were correlated with age,number of abortions,gestational parity,gynecological diseases and breast hyperplasia(P<0.05),but not with fibroids type and menopause(P>0.05).Serum HE4 was correlated with age,abortion times,gynecological diseases and breast hyperplasia(P<0.05),but not with myoma type,pregnancy parity and menopause(P>0.05).The AUC,specificity and sensitivity of serum CA125 were 0.813,0.731 and 0.875 when the optimal diagnostic point was 32.15 U/mL.When the optimal diagnostic point of seru m CEA was17.24 ng/mL/the AUC,specificity and sensitivity were 0.782,0.705 and 0.746,respectively.The AU C,specificity a nd sensitivity of serum HE4 were 0.854,0.915 and 0.827 when the optimal diagnostic point was 48.31 pmol/L The AUC,specificity and sensitivity were 0.923,0.958 and 0.897 respectively,indicating the highest diagnostic efficiency.Conclusion The combined detection of cea,CARBOHYDRATE antigen 125 a nd human epididymis protein 4 is helpful to predict uterine fibroids and improve the sensitivity,specificity and accu racy of diagnosis,which is of great significance.