HE4蛋白在子宫内膜异位症与卵巢癌鉴别诊断中的意义  

Expression of HE4 protein in pelvic mass and Its clinical significance

作　　者：赵慧[1] 靳卫国[1] 李爱华[1] 

机构地区：[1]聊城市人民医院妇科,山东聊城252000

出　　处：《泰山医学院学报》2013年第12期893-897,共5页Journal of Taishan Medical College

摘　　要：目的检测子宫内膜异位症及卵巢上皮癌患者血清及组织中人附睾分泌蛋白4(human epididymis protein 4,HE4)的表达,探讨HE4蛋白在盆腔包块鉴别诊断中的意义。方法采用生物素双抗体夹心ELISA法及免疫组化S-P法检测86例子宫内膜异位症患者及56例卵巢上皮癌患者血清及组织中HE4蛋白的表达。结果 HE4蛋白在子宫内膜异位症组织中阳性表达率为6.97%(6/86),而卵巢上皮癌组织阳性表达率为78.57%(44/56),表达多为强阳性(P=0.005)。子宫内膜异位症患者术前血清HE4蛋白较对照组略升高,但无显著性差异。卵巢上皮癌患者术前血清HE4蛋白较子宫内膜异位症及其它对照组明显增高(P=0.007),血清HE4以150 pmol/L为界值,卵巢上皮癌灵敏度为57.69%,特异度为90.90%,血清HE4水平卵巢浆液性腺癌明显高于非浆液性,而与其它临床病理指标无相关性。血清CA125以50 U/ml为界值,内异症诊断的灵敏度为60.46%,特异度为50.53%;以100 U/ml为界值,卵巢上皮癌诊断灵敏度为65.85%,特异度为93.22%。而血清HE4和CA125联合检测卵巢上皮癌灵敏度为76.70%,特异度为77.78%。结论血清及组织中HE4蛋白呈低表达,而在卵巢上皮癌中呈高表达,血清HE4蛋白在卵巢上皮癌诊断及与子宫内膜异位症鉴别方面有一定意义。血清CA125以100 U/ml为界值,卵巢上皮癌灵敏度为65.85%,而血清HE4和CA125联合检测卵巢上皮癌灵敏度达76.70%,联合检测在鉴别盆腔包块良恶性方面有一定参考价值。Objective：To investigate the expression of human epididymis protein 4（HE4） in tissues and serum of patients with endometriosis and ovarian cancer , as well as the clinical value of differential diagnosis. Methods： The expression of HE4 in tissue of endometriosis and ovarian cancer was measured by immunohistochemical assay. The content of HE4 in the serum of those patients was measured by biotin double antibody sandwich ELISA assay. Results： The positive expression rate of HE4 protein in endometriosis tissue was 6.97%（6/86）. while it was 78.57% （44 /56） in tissue of ovarian cancer （P= 0.005）, and the expression of HE4 protein was almost strong positive. The content of HE4 protein in serum of endometriosis was slightly higher than controls, but the difference had not statistically significant. The content of HE4 of epithelial ovarian cancer was much higher than that of endometriosis and other control groups （P= 0.007）, If the boundary value of serum HE4 was 150 pmol/L, the sensitivity of ovarian cancer was 57.69%, and the specificity was 90.90%. The serum level of HE4 in ovarian serous adenocarcinoma was significantly higher. which was not correlated with ages, clinical stage, lymphatic metastasis, pathologic grade and ascites of ovarian cancer. If the boundary value of serum CA125 was 50 U/ml, the sensitivity of endometriosis was 60.46%. and the specificity was 50.53%. If the boundary value was 100 U/ml, the sensitivity of ovarian cancer was 65.85%, the specificity was 93.22%. If we combined HE4 with CA125, the sensitivity of ovarian cancer increased to 76.70%, the specificity was 77.78%. Conclusion： HE4 protein was weakly expressed in serum and tissue in endometriosis, but overexpressed in epithelial ovarian cancer, Serum HE4 protein have certain significance in differential diagnosis between them. If the boundary value of serum CA125 was 100 U/ml, the sensitivity of ovarian cancer was 65.85%. Combined with CA125, the sensitivity of ovarian cancer increased to 76.70%. Combined detectio

关 键 词：人附睾分泌蛋白HE4蛋白 CA125 盆腔包块 免疫组织化学 酶联免疫吸附试验方法 

分 类 号：R711.71[医药卫生—妇产科学]