HE4和CA_(125)联合检测在卵巢癌诊断及预后评估中的价值研究  

Study on application value of joint detection of serum HE4 and CA_(125) in diagnosis and prognosis evaluation of ovarian cancer

作　　者：尚陈宇 刘冬冬[1] 徐建华[1] 黄景春[1] 罗娅莎[1] 林馥嘉[1] 马骥[1] 石文[1] 丁海明[1] 

机构地区：[1]广东省中医院检验科,广东广州510105

出　　处：《中国妇幼保健》2014年第33期5492-5494,共3页Maternal and Child Health Care of China

基　　金：广东省科技计划项目〔2011B031800207〕

摘　　要：目的:探讨人附睾上皮分泌蛋白4(HE4)与CA125联合检测在卵巢癌的鉴别诊断以及预后评估中的研究价值。方法:189例女性分为卵巢癌患者50例(卵巢癌组),盆腔良性疾病患者99例(良性疾病组),健康女性40例(健康组),计算卵巢恶性肿瘤风险模型值(ROMA),比较3组HE4、CA125水平,比较HE4、CA125、ROMA 3种指标的灵敏度、特异性及比较15例卵巢癌患者术前术后的HE4、CA125的水平。结果:卵巢癌病变组的HE4与CA125水平明显高于良性病变组和健康对照组(P<0.05);良性疾病组与健康对照组之间CA125水平差异有统计学意义(P<0.05),HE4水平差异无统计学意义(P>0.05)。卵巢癌组术前术后CA125与HE4水平差异有统计学意义(P<0.05)。HE4、CA125和ROMA诊断卵巢癌的特异性分别为86.90%、87.90%、90.90%;阳性似然比分别为8.10、4.54、10.33;诊断符合率分别为53.69%、83.89%、87.25%。结论:单项HE4对于卵巢癌的早期诊断以及与盆腔良性疾病的鉴别诊断优于CA125,且术后评估价值高于CA125,HE4与CA125联合检测ROMA值可提高对卵巢癌诊断符合率。Objective： To explore the application value of joint detection of human epididymis secretary protein 4 （HFA） and carbohydrate antigen 125 （CAI25 ） in differential diagnosis and prognosis evaluation of ovarian cancer. Methods：A total of 189 women were divided into ovarian cancer group （50 patients with ovarian cancer）, benign pelvic disease group （99 patients with benign pelvic diseases） and control group （40 healthy women）. Risk of ovarian malignancy algorithm （ROMA） was calculated, the levels of HE4 and CA125 in the three groups were compared; the sensitivities and specificities of the three indicators were compared; the levels of HE4 and CA125 among 15 patients with o- varian cancer before and after surgery were compared. Results ：The levels of HE4 and CA125 in ovarian cancer group were statistically signifi- cantly higher than those in benign pelvic disease group and control group （ P 〈 0. 05 ）. There was statistically significant difference in CAI25 lev- el between benign pelvic disease group and control group （ P 〈 0. 05 ）, but there was no statistically significant difference in HE4 level between benign pelvic disease group and control group （P 〉 0. 05 ）. In ovarian cancer group, there were statistically significant differences in the levels of HE4 and CAt2s between before and after surgery （ P 〈 0. 05 ）. The speeificities of HFA, CA125 and ROMA in diagnosis of ovarian cancer were 86. 90%, 87.90% and 90. 90%, respectively; the positive likelihood ratios were 8. 10, 4. 54 and 10. 33, respectively; the diagnostic accord- ance rates were 53.69% ,83.89% and 87. 25%, respectively. Conclusion： HE4 is better than CA125 in early differential diagnosis of ovarian cancer and benign pelvic diseases, and its postoperative assessment value is higher than CA125. Joint detection of HE4, CAl25 and ROMA can improve the diagnostic accordance rate for ovarian cancer.

关 键 词：卵巢癌 人附睾上皮分泌蛋白4 糖类抗原CA125 卵巢恶性肿瘤风险模型 

分 类 号：R737.31[医药卫生—肿瘤]