血清人附睾蛋白4和糖链抗原125诊断卵巢癌的价值

Value of serum human epididymal protein 4 and carbohydrate antigen 125 to the diagnosis of ovarian cancer

目的探讨血清人附睾蛋白4(human epididymis protein 4,HE4)和糖链抗原125(carbohydrate,antigen 125,CA125)在卵巢癌诊断中的价值。方法卵巢癌患者42例(卵巢癌组),卵巢良性肿瘤患者42例(良性肿瘤组),采用电化学发光法检测2组血清HE4和CA125水平,比较不同分期卵巢癌患者血清HE4和CA125水平;统计卵巢癌组血清HE4和CA125阳性率,计算血清HE4、CA125单独及联合诊断卵巢癌的准确性、灵敏性和特异性等。结果卵巢癌组CA125水平[(236.14±96.23)u/mL],HE4水平[(346.53±125.67)pmol/L]均高于良性肿瘤组[(32.61±18.59)u/mL、(58.91±29.56)pmol/L](P<0.05);卵巢癌Ⅰ+Ⅱ期患者血清CA125[(61.28±36.21)u/mL]低于Ⅲ期[(424.87±98.65)u/mL]和Ⅳ期[(531.56±194.24)u/mL](P<0.05),Ⅲ期与Ⅳ期差异无统计学意义(P>0.05);卵巢癌Ⅰ+Ⅱ期患者血清HE4[(89.25±45.95)pmol/L]低于Ⅲ期[(321.79±78.69)pmol/L]和Ⅳ期[(768.72±67.83)pmol/L],且Ⅲ期低于Ⅳ期,差异均有统计学意义(P<0.05);卵巢癌组血清HE4阳性36例,CA125阳性33例,HE4+CA125阳性38例,HE4和CA125联合诊断卵巢癌的灵敏性(90.47%)、特异性(97.62%)、阳性预测值(97.44%)、阴性预测值(91.11%)和准确性(96.34%)均高于单独检测HE4(85.71%、95.24%、94.74%、86.96%,90.48%)和CA125(78.57%,57.14%、64.71%、72.73%、65.86%)(P<0.05)。结论与卵巢良性肿瘤患者比较,卵巢癌患者血清HE4、CA125水平明显增高,且其增高水平与卵巢癌临床分期有一定关系;HE4和CA125联合检测诊断卵巢癌的效能优于单独检测血清HE4和CA125。

Objective To investigate the value of serum human epididymis protein 4(HE4) and carbohydrate antigen 125(CA125) to the diagnosis of ovarian cancer.Methods Serum HE4 and CA125 levels were measured by electrochemiluminescence in 42 patients with ovarian cancer(ovarian cancer group) and 42 patients with ovarian benign disease(benign tumor group).The levels of HE4 and CA125 were compared in patients with ovarian cancer in different stages.The positive rates of HE4 and CA125 in ovarian cancer group were analyzed,and the accuracies,sensitivities and specificities of HE4 and/or CA125 for ovarian cancer were calculated.Results The levels of CA125((236.14±96.23)u/mL) and HE4((346.53±125.67) pmol/L) in ovarian cancer group were significantly higher than those in benign tumor group((32.61±18.59) u/mL,(58.91±29.56) pmol/L)(P<0.05).The level of CA125 in stage Ⅰ±Ⅱ((61.28±36.21) u/mL) was significantly lower than that in stage Ⅲ((424.87±98.65) u/mL) and Ⅳ((531.56±194 24) u/mL) in ovarian cancer group(P<0.05),and there was no significant difference between stage Ⅲ and Ⅳ(P>0.05).The level of HE4 in stage I±TJ((89.25±45.95) pmol/L) in ovarian cancer group was significantly lower than that in stage Ⅲ((321.79±78.69) pmol/L) and Ⅳ((768.72±67.83) pmol/L)(P<0.05),and lower in stage Ⅲ than that in stage Ⅳ(P<0.05).In ovarian cancer group,there were 36 patients with HE4 positive,33 patients with CA125 positive,and 38 patients with HE4±CA125 positive.The sensitivity,specificity,positive predictive value,negative predictive value and diagnostic accuracy of combined detection of HE4 and CA125 for ovarian cancer(90.47%,97.62%,97.44%,91.11%,96.34%) were significantly higher than those of single detection of HE4(85.71%,95.24%,94.74%,86.96%,90.48%) CA125(78.57%,57.14%,64.71%,72.73%,65.86%)(P<0.05).Conclusion The levels of serum HE4 and CA125 are significantly higher in patients with ovarian cancer than those in patients with benign ovarian tumors,which are correlated with the clinical stages of ovarian cancer.The combined detection of HE4 and CA125 is superior to the single detection of HE4 or CA125 for ovarian cancer.