血清肿瘤标志物在卵巢癌早期诊断中的临床价值  

Clinical value of serum tumor marker in early diagnosis ovarian cancer

作　　者：侯娟娟 虎淑妍 刘婷婷[2] 张玲 席维岳 郑红军 潘云燕[4] 

机构地区：[1]庆阳市人民医院检验科,庆阳745000 [2]甘肃省妇幼保健院妇瘤科,兰州730050 [3]庆阳市西峰区人民医院检验科,庆阳745000 [4]兰州大学第二医院检验科,兰州730030

出　　处：《中国免疫学杂志》2014年第8期1101-1104,1107,共5页Chinese Journal of Immunology

基　　金：甘肃省庆阳市科技支撑计划项目(2013114)

摘　　要：目的:研究血清中人附睾蛋白4(HE4)、癌胚抗原(CEA)、糖类抗原(CA125、CA199、CA153)、甲胎蛋白(AFP)和人绒毛膜促性腺激素(β-HCG)7种肿瘤标志物在卵巢癌早期诊断中的临床价值。方法:选取卵巢癌、卵巢良性肿瘤患者以及门诊健康体检女性各60例,用Abbott Architect i2000SR系统检测其术前血清中7种肿瘤标志物的浓度。结果:卵巢癌组血清中HE4、CA125、CA199、CEA、CA153、AFP和β-HCG水平显著高于卵巢良性肿瘤组和对照组中的水平,其差异有统计学意义(P<0.05)。各肿瘤标志物对卵巢癌诊断的特异性均较高,但敏感性除HE4和CA125分别为76.67%和68.33%,其他肿瘤标记物的敏感性都不是很高。结合Youden指数和ROC曲线下面积可以看出,HE4单项检测卵巢癌的特异性、敏感性和准确度较高,CA125、CA199和CEA对卵巢癌的诊断价值中等。肿瘤标志物联合检测可以提高卵巢癌诊断的敏感性,但特异性会相应降低,综合考虑以HE4、CA125、CA199和CEA联合检测效果最好。结论:CA153、AFP及β-HCG对卵巢癌诊断能力较差,HE4、CA125、CA199、CEA联合检测用于卵巢癌早期诊断的特异性,敏感性和准确度较高。To evaluate the value of serum human epididymis protein 4（HE4）,cancer embryonic antigen（CEA）, carbohydrate antigen（CA125,CA19-9,CA153）,alpha fetoprotein（AFP） and β-human chorionic gonadotrophin （β-HCG） in ovarian cancer early diagnosis.Methods：Abbott Architect i2000SR was used to detect the levels of preoperative serum tumor markers （n=7） in ovarian cancer group,benign ovarian tumor group and the normal control （each n=60）.Results：The levels of serum HE4,CA125, CA199,CEA,CA153,AFP and β-HCG in ovarian cancer group were markedly higher than the benign ovarian tumor group and the control group.There was statistically significant difference （ P〈0.05 ）.The diagnosis of ovarian cancer tumor markers were high specificity,but sensitivity was not high except HE4 （76.67%） and CA125 （68.33%）.With Youden Index,the area under curve of ROC,the HE4 was demonstrated higher specificity ,sensitivity and accuracy.There was also medium diagnostic value of CA 125 ,CA199 and CEA for ovarian cancer.The sensitivity of ovarian cancer diagnosis is raised by combined assay with serum tumor marker ,but the specificity would be reduced accordingly.HE4, CA125, CA199 and CEA combined detection is considered the best.Conclusion：CA153,AFP and β-HCG have lowered diagnosis for ovarian cancer.HE4, CA125, CA199 and CEA combined detection could significantly improve specificity ,sensitivity and accuracy in the early diagnosis of ovarian cancer.

关 键 词：肿瘤标记物 卵巢癌 早期诊断 

分 类 号：R737[医药卫生—肿瘤]