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目的:探讨血清HE4及HE4和CA125联合检测在子宫内膜癌诊断中的应用价值。方法:应用ELISA和放免法分别测定子宫内膜癌、功能失调性子宫出血(功血)患者及健康对照妇女各30例的血清HE4和CA125水平,比较三组间HE4和CA125水平与阳性率的差异,HE4手术治疗前后水平的变化,HE4、CA125及HE4和CA125联合检测诊断子宫内膜癌的敏感度及特异度。结果:①子宫内膜癌患者血清HE4含量较另两组明显升高,诊断子宫内膜癌的敏感度为43.33%,特异度为95.00%;子宫内膜癌患者术后血清HE4水平较术前明显下降,差异有统计学意义。②CA125诊断子宫内膜癌的敏感度为39.67%,特异度为98.33%,较HE4单独检测敏感度低,特异度略高。③HE4和CA125联合检测诊断子宫内膜癌的敏感度为53.33%,特异度为95.00%,较CA125、HE4单项检测敏感度增高,特异度较CA125略低。结论:血清HE4检测对子宫内膜癌诊断敏感度高于CA125,HE4与CA125联合检测具有更高的诊断价值;血清HE4含量还可能作为监测子宫内膜癌治疗效果的指标。
Objective: To investigate the value of combined detection of serum HE4, HE4 and CA125 in the diagnosis of endometrial carcinoma. Methods: Serum levels of HE4 and CA125 in 30 patients with endometrial carcinoma, dysfunctional uterine bleeding (dyslipidemia) and healthy controls were detected by ELISA and radioimmunoassay respectively. The levels of HE4 and CA125 in the three groups were compared with the positive rates The changes of HE4, CA125, HE4 and CA125 in detecting the sensitivity and specificity of endometrial cancer. Results: ① The serum HE4 level in patients with endometrial cancer was significantly higher than that in the other two groups. The sensitivity and specificity of diagnosing endometrial carcinoma were 43.33% and 95.00% respectively. The postoperative serum HE4 level in patients with endometrial cancer was significantly higher than that before operation Significantly decreased, the difference was statistically significant. ②CA125 diagnosis of endometrial cancer sensitivity was 39.67%, specificity was 98.33%, compared with the HE4 single detection of low sensitivity and specificity slightly higher. The sensitivity and specificity of combined detection of HE4 and CA125 in the diagnosis of endometrial cancer were 53.33% and 95.00%, respectively, which were higher than the single detection of CA125 and HE4 and the specificity was lower than that of CA125. Conclusion: The detection of serum HE4 is more sensitive than CA125 in the diagnosis of endometrial cancer, and the detection of HE4 and CA125 is of higher diagnostic value. The serum HE4 level may also be used as an indicator of the therapeutic effect of endometrial cancer.