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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) in the diagnosis of ovarian cancer. Methods 42 cases of ovarian cancer (ovarian cancer group) and 42 cases of benign ovarian tumor (benign tumor group) were collected. The levels of HE4 and CA125 in serum of two groups were detected by electrochemiluminescence. The levels of serum HE4 and CA125 in patients with different stages of ovarian cancer were compared. The positive rates of HE4 and CA125 in ovarian cancer group were calculated and the accuracy, sensitivity and specificity of serum HE4 and CA125 alone and in combination for diagnosis of ovarian cancer were calculated. Results The level of CA125 in ovarian cancer group was significantly higher than that in benign tumor group [(236.14 ± 96.23) u / mL] and HE4 level [(346.53 ± 125.67) pmol / L] (61.28 ± 36.21) u / mL] was lower than that in stage Ⅲ [(424.87 ± 98.65) u / mL] and stage Ⅳ [(531.56 ± 194.24) u / mL] (P <0.05), while there was no significant difference between stage Ⅲ and Ⅳ (P> 0.05). The serum level of HE4 was 89.25 ± 45.95 pmol / L in patients with stage Ⅰ + Ⅱ ovarian cancer, (321.79 ± 78.69) pmol / L and Ⅳ [(768.72 ± 67.83) pmol / L), and the stage Ⅲ was lower than that of stage Ⅳ (P <0.05) 36 cases were positive, 33 cases were positive for CA125, 38 cases were positive for HE4 + CA125. The sensitivity and specificity of HE4 and CA125 in the diagnosis of ovarian cancer were 90.47%, 97.62%, 97.44% 91.11%) and accuracy (96.34%) were higher than that of HE4 alone (85.71%, 95.24%, 94.74%, 86.96%, 90.48%) and CA125 (78.57%, 57.14%, 64.71%, 72.73%, 65.86% (P <0.05). Conclusion Compared with patients with benign ovarian tumors, the serum levels of HE4 and CA125 in patients with ovarian cancer were significantly higher than those in patients with benign ovarian tumors, and the level of HE4 and CA125 was correlated with the clinical stage of ovarian cancer. The combined detection of HE4 and CA125 was superior to the detection of serum HE4 and CA125 .