术前HE4单项及联合CA125检测在子宫内膜癌中的临床价值  

Diagnostic and prognostic value of serum HE4 detection for endometrial carcinoma patients compared with CA 125

作　　者：林莺莺[1] 陈燕[1] 胡敏华[1] 陈岩松[1] 郑瑜宏[1] 

机构地区：[1]福建医科大学福建省肿瘤医院教学医院检验科,福州350014

出　　处：《现代免疫学》2014年第1期47-51,共5页Current Immunology

摘　　要：分别在ARCHITECT i2000_(SR)化学发光免疫分析仪(微粒子化学发光法)和E170电化学发光免疫分析仪(电化学发光法)上测定术前85例子宫内膜癌患者和100例健康体检者的HE4和CA125血清水平,绘制ROC曲线并确立HE4最佳诊断临界值,分析HE4和CA125单项和联合检测的诊断指标,进而评价术前HE4单项及联合CA125检测在子宫内膜癌的早期诊断价值。临床回顾子宫内膜癌患者预后相关因素,以单变量统计分析治疗前HE4和CA125与子宫内膜癌预后因素的相关性。结果显示术前子宫内膜癌组HE4和CA125血清水平与正常对照组比较,差异有统计学意义(P<0.01)。HE4和CAl25单项检测的工作特征曲线下面积分别为0.797和0.746,以约登指数确定HE4的临界参考值为69.45 pmol/L,在100%特异性下,HE4单项和联合CA125检测的敏感性分别为50.59%和58.82%,均显著高于CA125(28.24%)。HE4和CA125均与患者FIGO分期、附件受侵、阴道和(或)宫旁受侵和盆腔或(和)腹主动脉旁淋巴结转移显著相关;HE4和CA125的阳性率随着子宫内膜癌的分期、恶性程度和播散范围的升高而升高。HE4在绝经妇女及早期内膜癌的阳性率显著高于CA125(P<0.01)。由此可见HE4作为子宫内膜癌的肿瘤标志物,具有比CA125更好的早期诊断价值,术前HE4和CA125的联合检测可辅助判断子宫内膜癌患者预后,提高术后生存率。To evaluate the diagnostic and prognostic significance of HE4 and CA125 in endometrial carcinoma, we collected 85 serum samples of patients with endometrial carcinoma and 100 serum samples of normal control. ARCHITECT i2000sR and Roche El70 were used to detect the concentrations of HE4 and CA125. The sensitivity of assay was evaluated by receiver operating characteristic-area under the curve （ROC-AUC）,unvaried analyses were used to investigate the relationship between the preoperative serologic markers and clinical pathological parameters. The results showed that both the median levels of HE4 and CA125 were significantly higher in endometrial carcinoma group than those in the normal control group. The HE4 assay had advantage over the CA125 assay （0. 797 vs 0. 746） in ROC-AUC Detection sensitivity of HE4 assay alone , and combined with CA125 were 50.59% and 58.82; respectively, all being significantly higher than that of CA125 assay alone （28.24%）. HE4 and CA125 levels were significantly associated with FIGO stage, attachment invasion, vaginal and/or the palace next to the invasion and pelvic or （and） by the abdominal aorta was significantly associated with lymph node metastasis; HE4 and CA125 levels were also related to patients＇ age and cervical stroma involvement. HE4 and CA125 positive rates were positively associ- ated with the staging of endometrial carcinoma, malignant degree and disseminated area HE4 positivist in postmenopausal women and early endometrial carcinoma patients was significantly higher than that of CA125（P〈0.01）. Altogether, HE4 as a tumor marker for endometrial cancer, has a better diagnostic value than CA125 with respect to early diagnosis, we concluded that preoperative joint detection of HE4 and CA125 can help the judgment to the prognosis of patients with endometrial cancer and improve the postoperative survival rate.

关 键 词：HE4 CA125 子宫内膜癌 诊断 预后 

分 类 号：R392[医药卫生—免疫学]