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目的探讨血清CA125和人附睾上皮分泌蛋白4(HE4)检测在卵巢癌诊断中的应用及其价值。方法 2011年6月至2012年5月因盆腔肿物行手术治疗的患者238例,根据手术后病理报告将分成卵巢恶性肿瘤组152例和盆腔良性肿瘤组86例,另选健康女性61例为对照组,检测3组血清HE4和CA125水平。结果卵巢癌患者血清HE4和CA125水平均明显高于盆腔良性肿瘤和健康对照者(P均<0.01)。单独检测血清HE4水平对卵巢癌诊断的特异性(91.9%)明显高于CA125(72.1%,P<0.05);单独检测血清CA125对卵巢癌诊断的敏感性(79.6%)明显高于HE4(54.6%,P<0.01);二项联合检测对卵巢癌诊断的敏感性(87.5%)和准确率(80.1%)显著高于HE4单独检测(54.6%和68.1%,P均<0.01)。结论在卵巢癌的诊断上,CA125有较高的灵敏性,特异性较差;HE4有较高的特异性,灵敏性稍低;两者联合检测有利于提高诊断的敏感性和准确率。
Objective To investigate the application of serum CA125 and human epididymal epithelial secreting protein 4 (HE4) in the diagnosis of ovarian cancer and its value. Methods From June 2011 to May 2012, 238 patients undergoing pelvic tumor surgery were divided into 152 cases of ovarian malignant tumor group and 86 cases of pelvic benign tumor group according to the postoperative pathological report, and 61 healthy women Control group, serum HE4 and CA125 levels were measured in 3 groups. Results The levels of serum HE4 and CA125 in ovarian cancer patients were significantly higher than those in benign tumors and healthy controls (all P <0.01). The specificity of serum HE4 alone for the diagnosis of ovarian cancer (91.9%) was significantly higher than that of CA125 (72.1%, P <0.05). The sensitivity of serum CA125 for single diagnosis of ovarian cancer (79.6%) was significantly higher than that of HE4 %, P <0.01). The sensitivity of binomial detection in diagnosis of ovarian cancer (87.5%) and accuracy (80.1%) were significantly higher than those in HE4 alone (54.6% vs 68.1%, P <0.01). Conclusion In the diagnosis of ovarian cancer, CA125 has high sensitivity and poor specificity; HE4 has higher specificity and lower sensitivity; combined detection of the two is beneficial to improve the diagnostic sensitivity and accuracy.