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目的探讨利用人附睾蛋白4(human epididymis protein 4,HE4)诊断妇科疾病和监测疗效时,如何减少肾功能损害对HE4水平的影响。方法比较各疾病组和对照组血清HE4、CA125水平。分析血清HE4与尿素、肌酐、尿酸和胱抑素C水平的相关性。结果良性+肾功能损害组血清HE4明显高于对照组、良性组和内膜癌组,差异有统计学意义(P<0.01),与卵巢癌组比较,差异无统计学意义(P>0.05)。良性+肾功能损害组、良性组、内膜癌组血清CA125比较差异无统计学意义(P>0.05)。血清HE4与尿素、肌酐、胱抑素C水平呈正相关(P<0.05),与尿酸水平无相关性(P>0.05)。卵巢癌+肾功能损害组、内膜癌+肾功能损害组血清HE4水平明显高于卵巢癌组、内膜癌组,差异有统计学意义(P<0.05)。结论血清尿素、肌酐和胱抑素C结果有助于排除肾功能损害导致的血清HE4水平增高。应注意高HE4伴肾功能损害患者的肿瘤性质分析,避免对妇科恶性肿瘤伴肾功能损害患者病情估计过重。
Objective To explore how to reduce the effect of renal dysfunction on the level of HE4 when using human epididymis protein 4 (HE4) to diagnose gynecological diseases and to monitor the curative effect. Methods The serum levels of HE4 and CA125 in each disease group and control group were compared. The correlation between serum HE4 and urea, creatinine, uric acid and cystatin C levels was analyzed. Results The serum level of HE4 in benign and renal dysfunction group was significantly higher than that in control group, benign group and endometrial carcinoma group (P <0.01), but there was no significant difference between ovarian cancer group and ovarian cancer group (P> 0.05) . There was no significant difference in serum CA125 between benign + renal dysfunction group, benign group and endometrial carcinoma group (P> 0.05). Serum HE4 was positively correlated with urea, creatinine and cystatin C (P <0.05), but not with uric acid (P> 0.05). The level of HE4 in ovarian cancer + renal dysfunction group and intimal cancer + renal dysfunction group was significantly higher than that in ovarian cancer group and endometrial cancer group (P <0.05). Conclusion The results of serum urea, creatinine and cystatin C can help to exclude the increase of serum HE4 caused by renal dysfunction. Should pay attention to high HE4 with renal dysfunction in patients with tumor nature of analysis, to avoid gynecological malignancy with renal dysfunction in patients with over-estimated condition.