血清HE4、CYFRA21-1、CA125在诊断卵巢良、恶性肿瘤中的价值  

Effects of serum HE4,CYFRA21-1,CA125 levels on the benign and malignant varian tumor

作　　者：冷雪娇[1] 郑君涛[1] 侯芹芹[1] 谭秀燕 

机构地区：[1]山东省威海市文登中心医院,264400

出　　处：《中国实用医刊》2014年第18期21-23,共3页Chinese Journal of Practical Medicine

摘　　要：目的：探讨血清人附睾蛋白4（HE4）、细胞角蛋白19片段抗原21-1（CYFRA21-1）、CA125对卵巢良、恶性肿瘤诊断的意义，评价其单独及联合检测在判断卵巢癌高风险中的价值。方法采用电化学发光免疫法（ ECL）检测来威海市文登中心医院就诊的45例原发性卵巢癌、56例良性卵巢肿瘤患者及50例健康体检女性血清中HE4、CYFRA21-1、CA125水平，其中任一指标高于正常上限即定为阳性，分析三者在卵巢癌诊断中的阳性率及符合率，比较三种指标对卵巢良、性肿瘤的诊断价值。结果 HE4和CYFRA21-1水平在卵巢癌组显著升高，与良性肿瘤和健康对照组比较差异有统计学意义（P﹤0.05），而良性肿瘤与对照组比较差异无统计学意义（P﹥0.05）；对于恶性肿瘤两者诊断的特异性和阳性预测值都很高[ HE4（100%，100%），CYFRA21-1（98.2%，96.7%）]，诊断的符合率也比较高（90.1%，83.2%），与CA125相比差异有统计学意义（ P﹤0.05），但两者的敏感性比CA125低。CA125在卵巢良、恶性肿瘤中都会升高，只是升高的程度不同，恶性肿瘤组与良性肿瘤组比较、良性肿瘤组与正常对照组比较差异均有统计学意义（ P均﹤0.05），能简单区分良、恶性肿瘤；但对卵巢癌诊断的特异性不是很高（75%），阳性预测值和诊断符合率也比较低（72%，77.2%），三者联合检测可以提高卵巢癌诊断的敏感性（100%）及准确性（85.1%），达到优化临床诊断的效果。结论 HE4、CYFRA21-1只在恶性肿瘤中升高，主要用于卵巢癌的诊断；CA125在良、恶性肿瘤中都有升高，但升高的程度不同，可用于良、恶性肿瘤的诊断与鉴别，三者联合检测则可提高卵巢癌诊断的敏感性和准确率，对于卵巢癌的早期诊断与治疗监测有重要的意义。Objective To investigate the diagnosis significance of serum HE4 ,CYFRA21-1 , CA125 levels for the benign and malignant varian tumor,and evaluate the value of single detection and combined detection on judging the high risks of ovarian cancer. Methods A total of 45 patients with primary ovarian cancer and 56 patients with benign varian tumor and 50 healthy subjects admitted in Wendeng central hospital whose serum levels of HE4 ,CYFRA21-1 and CA125 were detected by electro-chemiluminescence（ ECL）,any index above the normal limit was setting for positive,the positive rate and coincidence rate of the three indexes in diagnosis of ovarian cancer was analyzed,and the diagnosis values of three indexes in the benign and malignant varian tumors were compared. Results HE4 and CYFRA21-1 levels of ovarian cancer group were significantly higher,compared with the benign tumor group,and healthy contol group and the differences were statistically significant（ P ﹤0. 05 ）,however there was no significant difference between benign tumor group and control group（ P﹥0. 05 ）,for the ma-lignant tumors the specificity and positive predictive value were very high[ HE4（ 100%,100%）,CY-FRA21-1（98. 2%,96. 7%）]and the diagnostic accuracy was relatively high（90. 1%,83. 2%）,com-pared with CA125 the difference was significant（ P﹤0. 05 ）,but both of them the sensitivity was lower than CA125. The CA125 levels were all increased in benign and malignant tumor,only the extent was different,there was significant difference between them（P﹤0. 05）and the difference was also statistical-ly significant in benign and control group（ P﹤0. 05 ）,which can simply distinguish benign and malignant tumors, however the specificity for the diagnosis of ovarian cancer is not very high （75%）and the positive predictive value and diagnostic accuracy was also relatively low（ 72%, 77. 2%）,The sensitivity and accuracy of diagnosis was improved by combining the three indexes and the clinical diagnosis was optimized. Con

关 键 词：人附睾蛋白4 细胞角蛋白19片段抗原21-1 CA125 卵巢癌 电化学发光 

分 类 号：R737.31[医药卫生—肿瘤]