血清CA125、HE4及MMP-10联合检测在卵巢癌早期诊断中的临床价值研究  

Clinical value of combined detection of serum CA125,HE4 and MMP-10 in early diagnosis of ovarian cancer

作　　者：张燕 史文雯 Zhang Yan;Shi Wenwen(Department of Laboratory Medicine,The Tenth People’s Hospital Affiliated to Tongji University(Shanghai 200072))

机构地区：[1]同济大学附属第十人民医院检验科,上海200072

出　　处：《陕西医学杂志》2018年第8期1072-1074,共3页Shaanxi Medical Journal

摘　　要：目的:探讨血清糖类抗原125(CA125)、人附睾分泌蛋白4(HE4)及基质金属蛋白酶-10(MMP-10)联合检测在卵巢癌早期诊断中的临床价值,为临床诊治提供指导。方法:分别检测了93例卵巢癌患者,52例卵巢良性肿瘤患者,50例健康体检者血清CA125、HE4、MMP-10水平并分析组间差异,应用受试者工作特征曲线(ROC)分析CA125、HE4、MMP-10以及联合3种标志物诊断卵巢癌的价值。结果:血清CA125、HE4、MMP-10水平在各组水平依次为:卵巢癌组>卵巢良性肿瘤组>健康对照组(P<0.05)。联合检测在卵巢癌I、Ⅱ期组和Ⅲ、Ⅳ期组的阳性检出率分别为:97.44%、96.30%,高于单独检测。联合检测诊断卵巢癌的灵敏度、特异度、阳性预测值、阴性预测值、准确度、阳性似然比分别为:89.35%、92.81%、90.25%、93.04%、93.77%、9.02高于单独检测,阴性似然比1.02低于单独检测。ROC分析CA125、HE4、MMP-10、联合检测诊断卵巢癌的曲线下面积(AUC)分别为0.687(95%CI:0.027~1.384)、0.721(95%CI:0.635~9.034)、0.759(95%CI:0.027~13.057)、0.895(95%CI:0.034~6.314)。结论:血清CA125、HE4、MMP-10联合检测可提高卵巢癌的早期诊断正确率,对卵巢癌诊断的价值更高。Objective:To explore the clinical value of combined detection of serum carbohydrate antigen 125(CA125),human epididymal secretory protein 4(HE4)and matrix metalloproteinase-10(MMP-10)in the early diagnosis of ovarian cancer,and to provide guidance for clinical diagnosis and treatment.Methods:The serum levels of CA125,HE4 and MMP-10 were measured in 93 cases of ovarian cancer,52 cases of benign ovarian tumors and 50 healthy subjects.The value of CA125,HE4,MMP-10 and combined 3 markers for diagnosis of ovarian cancer was analyzed by the subjects'working characteristic curve(ROC).Results:The levels of serum CA125,HE4 and MMP-10 in each group were:ovarian cancer group>ovarian benign tumor group>healthy control group(P<0.05).The positive rates of combined detection in ovarian cancer I,II and III and IV groups were 97.44%and 96.30%,respectively,which were higher than those detected separately.The sensitivity,specificity,positive predictive value,negative predictive value,accuracy and positive likelihood ratio of the combined detection of ovarian cancer were 89.35%,92.81%,90.25%,93.04%,93.77%and 9.02 respectively,and the negative likelihood ratio 1.02 was lower than that of the single test.The area(AUC)of CA125,HE4,MMP-10 and joint detection in the diagnosis of ovarian cancer by ROC was 0.687(95%CI:0.027~1.384),0.721(95%CI:0.635~9.034),0.759(95%CI:0.027~13.057),0.895(95%CI:0.034~6.314),respectively.Conclusion:Combined detection of serum CA125,HE4 and MMP-10 can improve the accuracy of early diagnosis of ovarian cancer,and is of higher value in the diagnosis of ovarian cancer.

关 键 词：卵巢肿瘤/诊断 CA-125抗原/血液 基质金属蛋白酶10/血液 附睾分泌蛋白质类/血液 

分 类 号：R737.31[医药卫生—肿瘤]