3种血清指标联合检测对卵巢癌早期诊断的价值  

Clinical significance of the combined detection of 3 serum markers in early diagnosis of ovarian cancer

作　　者：陈辰[1] 戴楠[2] 高玲娟[1] 曾玉[1] 

机构地区：[1]南京市妇幼保健院检验科,210004 [2]江苏省丹阳市人民医院妇产科,212300

出　　处：《国际检验医学杂志》2017年第1期68-70,共3页International Journal of Laboratory Medicine

摘　　要：目的探讨血清人附睾蛋白4(HE4)诊断卵巢癌的最佳切割值,分析联合检测HE4、糖类抗原125(CA125)和D-二聚体(D-dimer)在卵巢癌早期诊断筛查中的应用价值。方法选取卵巢癌患者40例(卵巢癌组),卵巢良性肿瘤患者65例(良性肿瘤组),健康体检妇女48例(对照组),用化学发光法检测血清CA125和HE4水平,用免疫比浊法测定血浆D-dimer水平。结果 HE4的最佳切割值为54.31pmol/L;卵巢癌组3项指标水平均高于良性肿瘤组、对照组,且差异具有统计学意义(P<0.01);在卵巢良性肿瘤组与对照组中,CA125、D-dimer水平差异无统计学意义(P>0.05),而HE4水平差异有统计学意义(P<0.01);HE4+CA125 2项指标联合检测后敏感度、特异度、准确度分别为91.8%、81.4%、83.2%,其敏感度高于3项指标单独检测,且HE4+CA125+D-dimer联合检测的敏感度、特异度、准确度分别为95.0%、76.5%和81.0%,其敏感度高于HE4+CA1252项联合检测。结论 HE4+CA125+D-dimer联合检测可提高卵巢癌早期筛查的敏感度。Objective To explore the best cut-off value of serum human epididymis protein 4（HE4）in the diagnosis of ovarian cancer,and analyze the clinical significance of combined detection of HE4,carbohydrate antigen 125（CA125）and D-dimer for early screening and diagnosis of ovarian cancer.Methods A total of 49 patients with ovarian cancer,63 patients with benign tumor and47 healthy women were collected.The content of CA125,HE4 and D-dimer were detected by chemical luminescence immunoassay and turbidimetric inhibition immunoassay,respectively.Results The new cut-off value of HE4 was 54.31pmol/L.The serum levels of HE4,CA125 and D-dimer in the ovarian cancer group were all significant higher than those in the ovarian benign tumor group and the healthy group（P〈0.05）.No significant difference between the healthy group and benign disease group was found in CA125 and D-dimer content（P=0.293,0.359）,while a significant difference in HE4 level（P〈0.01）.The sensitivity and specificity of combined detection of the HE4＋CA125increased to 91.8%,85.4%,which was higher than that of the diagnosis detection of the three indicators respectively.The sensitivity and specificity of combined detection of the HE4＋CA125＋D-dimer were 95.0%,76.5%,which was higher than the combined detection of the HE4＋CA125.Conclusion The combined detection of CA125＋HE4＋D-dimer could improve the sensitivity for early diagnosis and screening of ovarian cancer.

关 键 词：卵巢癌 人附睾分泌蛋白4 糖类抗原 D-二聚体 

分 类 号：R737.31[医药卫生—肿瘤] R730.43[医药卫生—临床医学]