人血清附睾蛋白4和糖类抗原125在卵巢癌诊断中的应用  

Application of human epididymis protein 4 and carbohydrate antigen 125 in diagnosis of ovarian cancer

作　　者：黄震英[1] 孙静[1] Huang Zhenying;Sun Jing(Tianjin Union Medical Center,Tianjin 300121,China)

机构地区：[1]天津市人民医院检验科,天津300121

出　　处：《实用检验医师杂志》2021年第2期113-116,共4页Chinese Journal of Clinical Pathologist

摘　　要：目的探讨人血清中附睾蛋白4(HE4)和糖类抗原125(CA125)在卵巢良恶性肿瘤诊断及鉴别中的应用。方法选择2018年1月1日—2019年4月1日天津市人民医院收治的盆腔肿块拟进行手术患者96例作为研究对象,根据术后病理报告分为良性肿块组(40例)和卵巢癌组(56例);根据病理分期不同,将卵巢癌组患者分为早期组(Ⅰ~Ⅱ期,24例)和晚期组(Ⅲ~Ⅳ期,32例);另外选择同期健康体检者作为健康对照组(50例)。采用全自动酶联免疫分析仪测定所有受试者血清中HE4,采用全自动化学发光分析仪测定CA125,比较各组上述指标的差异,评价HE4、CA125单独与联合检测的诊断效能;绘制受试者工作特征曲线(ROC曲线)并计算曲线下面积(AUC),比较HE4、CA125检测的诊断效能。比较不同病理分期卵巢癌患者的HE4、CA125水平以及阳性检出率;分析并比较卵巢癌患者手术前2~3 d和术后1 d的HE4、CA125水平。结果卵巢癌组HE4和CA125均明显高于良性肿块组和健康对照组〔HE4(pmol/L):365.00(211.98,558.75)比56.55(46.08,73.18)、40.20(29.63,48.30),CA125(kU/L):181.80(76.65,383.68)比22.60(20.23,26.10)、13.35(10.95,18.53),均P<0.05〕。HE4/CA125并联检测诊断卵巢癌的敏感度明显高于单独检测,但特异度和准确度均低于单独检测;HE4+CA125串联检测诊断卵巢癌的敏感度低于单独检测,但特异度和准确度均高于单独检测。ROC曲线分析显示,HE4、CA125联合检测的AUC为0.988〔95%可信区间(95%CI)为0.977~0.996〕,高于HE4、CA125单独检测(AUC分别为0.968、0.913,95%CI分别为0.942~0.990、0.861~0.965)。卵巢癌晚期组HE4、CA125均明显高于早期组〔HE4(pmol/L):539.95(416.03,727.45)比186.85(74.88,260.25),CA125(kU/L):328.55(144.98,518.58)比79.65(31.65,168.83),均P<0.05〕,HE4、CA125的阳性率均明显高于早期组〔HE4:90.63%(29/32)比66.67%(16/24),CA125:81.25%(26/32)比54.17%(13/24),均P<0.05〕。卵巢癌组术后HE4、CA125较术前均明显下降〔HE4(pmol/L)Objective To investigate the significance of human epididymis protein 4 (HE4) and carbohydrate antigen 125 (CA125) in the diagnosis and differential diagnosis of benign and malignant ovarian tumor.Methods Ninety-six patients diagnosed as pelvic mass in Tianjin Union Medical Center from January 1,2018 to April 1,2019 were selected as research subjects,and divided into ovarian cancer group (56 cases) and benign tumor group (40 cases).According to the different pathological stages,the patients were divided into early stage group (stageⅠ-Ⅱ,24 cases) and late stage group (stage Ⅲ-Ⅳ,32 cases).Other 50 healthy subjects during the same period were selected as healthy control group.The levels of HE4 and CA125 in serum of all subjects were measured by automatic enzyme-linked immunosorbent analyzer and automatic chemiluminescence analyzer.The differences of the above indexes were compared among the groups,and the diagnostic efficacy of HE4 and CA125 were evaluated.The receiver operating characteristic curve (ROC) was drawn and the area under the curve (AUC) was calculated to compare the diagnostic efficiency of HE4 and CA125.The levels of HE4 and CA125 and the positive detectable rates in patients with different pathological stages of ovarian cancer were compared.The levels of HE4 and CA125 in patients with ovarian cancer 2-3 days before operation and 1 day after operation were analyzed and compared.Results The levels of HE4 and CA125 in ovarian cancer group were significantly higher than those in benign tumor group and healthy control group[HE4 (pmol/L):365.00 (211.98,558.75) vs.56.55 (46.08,73.18),40.20 (29.63,48.30),CA125 (kU/L):181.80 (76.65,383.68) vs.22.60 (20.23,26.10),13.35 (10.95,18.53),all P < 0.05].The sensitivity of HE4/CA125 parallel detection in the diagnosis of ovarian cancer was significantly higher than that of single detection,but the specificity and accuracy were lower than those of single detection.The sensitivity of HE4+CA125 tandem detection in the diagnosis of ovarian cancer was lower than tho

关 键 词：人附睾蛋白4 糖类抗原125 卵巢癌 

分 类 号：R737.31[医药卫生—肿瘤]