血清HE4检测在腹腔肿瘤诊断中应用价值研究  

Diagnostic value of serum HE4 levels for abdominal tumor

作　　者：张文辉[1] 吴少强[2] 徐琦煜[1] 陈丽玲[1] 林晓梅[1] 

机构地区：[1]温州医学院附属第一医院实验诊断中心,浙江温州325003 [2]中国人民解放军第一七四医院,福建厦门361000

出　　处：《中国卫生检验杂志》2010年第6期1452-1453,1516,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的:探讨血清HE4(human epididymis protein 4,HE4)检测在腹腔肿瘤鉴别诊断及疗效观察中的价值。方法:用ELISA法对17例宫颈癌、14例卵巢肿瘤、17例子宫平滑肌瘤、20例消化道恶性肿瘤患者和20例正常对照血清HE4浓度进行测定,同时检测14例卵巢肿瘤术后血清HE4的浓度。采用电化学发光法检测14例卵巢肿瘤术前和术后血清CA125的浓度。通过受试者工作特征(ROC)曲线和Kappa一致性检验,评价HE4在腹腔恶性肿瘤诊断中的价值。结果:正常对照组血清HE4范围是23.5 pmol/L～46.0 pmol/L,中位数为34.1 pmol/L,子宫肌瘤组血清HE4范围是41.57 pmol/L～74.77 pmol/L,中位数为46.87 pmol/L(P>0.05);宫颈癌血清HE4范围是57.90 pmol/L～135.17 pmol/L,中位数为73.4 pmol/L;卵巢肿瘤血清HE4范围是39.69 pmol/L～192.35 pmol/L,中位数为54.4 pmol/L;消化道恶性肿瘤血清HE4范围是60.15 pmol/L～98.57 pmol/L,中位数为46.87 pmol/L(P均<0.05)。比较卵巢肿瘤患者术前、术后血清HE4和CA125的含量,P值均>0.05,无显著性差异。而HE4和CA125含量相关性分析得知相关系数为0.557,P值为0.009<0.01,说明差异有显著性。当HE4在48.9 pmol/L时诊断指数最大(0.8),灵敏性和特异性分别为94.1%和81.3%,ROC曲线下面积0.726(95%CI 0.553～0.806,P=0.024)。以HE4浓度超出48.9 pmol/L为阳性,根据组织病理结果确定腹腔肿瘤的良、恶性,作诊断一致性检验,结果Kappa统计量为0.962>0.75,说明已经取得相当满意的一致性程度。结论:HE4对腹腔良恶性肿瘤具有一定的鉴别诊断价值,但并非卵巢肿瘤诊断的特异性标志物,且尚不能将HE4作为卵巢肿瘤疗效观察指标。Objective：To investigate the value of sera human epididymis protein 4（HE4） in the differential diagnosis and observation of treatment of abdominal tumor.Methods：Enzyme linked immunosorbent assay was used to examine HE4 levels in sera of 17 cases of cervical cancer,14 cases of ovarian tumor including preoperation and postoperative,17 cases of leiomyoma of uterus,20 cases of malignant tumor of digestive tract,20 cases of healthy controls.Electrochemiluminescence immunoassay was used to detect CA125 levels in sera of 14 cases of ovarian tumor including preoperative and postoperative.The diagnostic value of HE4 was analyzed by receiver operative characteristic（ROC） curve and Kappa consistency test.Results：The range of serum HE4 levels in the normal control group was 23.5 pmol/L～46.0 pmol/L,with a median of 34.1 pmol/L.The range of serum HE4 levels in the leiomyoma of uterus group was 41.57 pmol/L～74.77 pmol/L,with a median of 46.87 pmol/L（P〉0.05）.The range of serum HE4 levels in the cervical cancer group was 57.90 pmol/L～135.17 pmol/L,with a median of 73.4 pmol/L.The range of serum HE4 levels in the ovarian tumor group was 39.69 pmol/L～192.35 pmol/L,with a median of 54.4 pmol/L.The range of serum HE4 levels in the malignant tumor of digestive tract group was 60.15 pmol/L～98.57 pmol/L,with a median of 46.87 pmol/L.The level of HE4 in the malignant group was significantly higher than that in the other two groups（all P〈0.05）.But there was not significant difference between preoperation and postoperative of the ovarian tumor group about sera HE4 and CA125 levels,and the sera HE4 levels was correlated with sera CA125 levels in the ovarian tumor group（P〈0.01）.A serum HE4 level of 48.9 pmol/l had the most significant diagnostic index（0.8）,with a sensitivity of 94.1% and a specificity of 81.3%.The ROC area under the curve was 0.726（95% CI 0.553～0.806,P=0.024）.Checking the Kappa value of HE4 in diagnosing abdominal tumor gave a consistency of 0.962〉0.75.Conclusion：Serum

关 键 词：卵巢癌差异蛋白(HE4) 腹腔肿瘤 卵巢肿瘤 

分 类 号：R446.11[医药卫生—诊断学]