HE4联合CA125检测在卵巢癌患者中的应用及诊断价值研究
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摘要
目的探究HE4联合CA125检测在卵巢癌患者中的应用及诊断价值。方法选取2012年2月至2017年2月遂宁市中心医院诊治的68例卵巢肿瘤患者作为研究对象。其中卵巢恶性肿瘤30例,卵巢良性肿瘤38例,设为观察组;另选取同期60例健康女性作为对照组。分别采用酶联免疫吸附测定(ELISA)法和化学发光微粒子免疫分析法检测血清人附睾分泌蛋白4(human epididymis protein 4,HE4)、糖类抗原125(carbohydrate antigen 125,CA125)水平,比较三组患者及不同病理分型血清HE4、CA125水平、血清HE4、CA125单独及联合检测对卵巢癌的诊断情况。结果相比于卵巢良性肿瘤组和健康对照组,卵巢癌组血清HE4、CA125水平显著升高,差异具有统计学意义(P<0.05);卵巢良性肿瘤组与健康对照组差异无统计学意义(P>0.05);相比于混合型上皮癌、子宫内膜样癌及转移性癌,浆液性囊腺癌、黏液性囊腺癌血清HE4、CA125水平显著升高,差异具有统计学意义(P<0.05);血清HE4+CA125诊断卵巢癌的灵敏度、特异度及阳性预测值明显高于单用血清HE4、CA125,差异具有统计学意义(P<0.05);单用血清HE4和CA125灵敏度、特异度及阳性预测值差异无统计学意义(P>0.05)。结论 HE4联合CA125检测有助于提高卵巢癌诊断的敏感性和特异度,对鉴别诊断卵巢癌具有重要意义,进而延长患者生存期,值得在临床上推广应用。
Objective To investigate the application and diagnostic value of human epididymis protein 4(HE4) combined with carbohydrate antigen 125(CA125) in patients with ovarian cancer.Methods 68 patients with ovarian cancer in our hospital from February 2012 to February 2017 were selected as observation group, including 30 cases of malignant ovarian tumor(ovarian cancer group) and 38 cases of benign ovarian tumor(benign ovarian tumor group). Another 60 healthy women in the same period were selected as control group. Enzyme linked immunosorbent assay(ELISA) and chemiluminescence microparticle immunoassay were used to detect serum levels ofHE4 and CA125 respectively. The serum HE4 and CA125 levels were compared among the three groups and different pathological types were compared and the diagnosis value of serum HE4 and CA125 alone and combined were compared. Results Compared with benign ovarian tumor group and the control group, the serum levels of HE4 and CA125 in ovarian cancer group were significantly higher, with statistically significant differences(P<0.05), and there was no statistically significant difference in theserum levels of HE4 and CA125 between benign ovarian tumor group and control group(P>0.05). Compared with mixed epithelial carcinoma, endometrioid carcinoma and metastatic carcinoma, the serum HE4 and CA125 levels of serous cystadenocarcinoma and mucinous cystadenocarcinoma were significantly higher, with statistically significant differences(P<0.05). The sensitivity, specificity and positive predictive value of serum HE4 combined with CA125 in the diagnosis of ovarian cancer were significantly higher than serum HE4 or serum CA125 alone, with statistically significant differences(P<0.05). There was no statistically significant difference in the sensitivity, specificity and positive predictive value between serum HE4 and CA125 alone(P>0.05). Conclusions HE4 combined with CA125 detection is conductive to improving the sensitivity and specificity of the diagnosis of ovarian cancer, which is of great significance for the differential diagnosis of ovarian cancer, thereby prolonging the survival time of patients. It is worthy of clinical application.
Objective To investigate the application and diagnostic value of human epididymis protein 4(HE4) combined with carbohydrate antigen 125(CA125) in patients with ovarian cancer.Methods 68 patients with ovarian cancer in our hospital from February 2012 to February 2017 were selected as observation group, including 30 cases of malignant ovarian tumor(ovarian cancer group) and 38 cases of benign ovarian tumor(benign ovarian tumor group). Another 60 healthy women in the same period were selected as control group. Enzyme linked immunosorbent assay(ELISA) and chemiluminescence microparticle immunoassay were used to detect serum levels ofHE4 and CA125 respectively. The serum HE4 and CA125 levels were compared among the three groups and different pathological types were compared and the diagnosis value of serum HE4 and CA125 alone and combined were compared. Results Compared with benign ovarian tumor group and the control group, the serum levels of HE4 and CA125 in ovarian cancer group were significantly higher, with statistically significant differences(P<0.05), and there was no statistically significant difference in theserum levels of HE4 and CA125 between benign ovarian tumor group and control group(P>0.05). Compared with mixed epithelial carcinoma, endometrioid carcinoma and metastatic carcinoma, the serum HE4 and CA125 levels of serous cystadenocarcinoma and mucinous cystadenocarcinoma were significantly higher, with statistically significant differences(P<0.05). The sensitivity, specificity and positive predictive value of serum HE4 combined with CA125 in the diagnosis of ovarian cancer were significantly higher than serum HE4 or serum CA125 alone, with statistically significant differences(P<0.05). There was no statistically significant difference in the sensitivity, specificity and positive predictive value between serum HE4 and CA125 alone(P>0.05). Conclusions HE4 combined with CA125 detection is conductive to improving the sensitivity and specificity of the diagnosis of ovarian cancer, which is of great significance for the differential diagnosis of ovarian cancer, thereby prolonging the survival time of patients. It is worthy of clinical application.
引文
[1] 韩文明.HE4和CA125联合检测在卵巢癌诊断中的应用价值[J].国际检验医学杂志,2012,33(14):1757-1758.
[2] 刘树皖,杨修军.HE4、CA125及血浆Fbg联合检测在卵巢癌患者早期诊断中的临床价值[J].中国现代医生,2017,55(36):131-133.
[3] American College of Obstetricians and Gynecologists Committee on Gynecologic Practice.Committee opinion No.477:The role of the obstetrician-gynecologist in the early detection of epithelial ovarian cancer[J].Gynecologic Oncology,2002,87(3):237-239.
[4] 石榴花,任传路,丁磊,等.联合检测血清HE4、SMRP、CEA与CA125在卵巢癌诊断中的应用价值研究[J].检验医学与临床,2016,13(8):1068-1070.
[5] Vrzalova J,Prazakova M,Anovotn Z,et al.Test of ovarian cancer multiplex xMAP technology panel[J].Anticancer Research,2009,29(2):573-576.
[6] 苏彤,刘辉,任清霞,等.HE4、TSGF和CA125联合检测诊断卵巢癌的价值[J].山东医药,2011,51(39):62-64.
[7] 刘红梅.HE4与CA125联合检测在卵巢癌诊断中的应用价值研究[J].国际检验医学杂志,2017,38(11):1563-1565.
[8] 崔永伟,颜廷婷.CT、超声、CA125联合检测在卵巢癌诊断中的应用分析[J].中国性科学,2012,21 (9):37-38.
[9] 蔡徐山,陈怡,黄秋兰,等.血清人附睾分泌蛋白4和糖链抗原125联合检测在卵巢癌诊断中的应用[J].诊断学理论与实践,2010,9(5):465-468.
[10] 潘秀芳,郑志昂,麦燕.血清附睾蛋白4、糖类抗原125及19-9水平在老年卵巢癌诊断及病理类型鉴别中的临床价值[J].国老年学杂志,2015,72(12):3343-3344.
[11] 李子军,郑雅琴,徐仙凤,等.血清HE4和 CA125水平联合ROMA预测和诊断卵巢癌的临床价值[J].肿瘤学杂志,2013,19(3):219-222.
[12] 熊雯,周新娥,黄娟,等.血清CA125、HE4及IL-17检测对上皮性卵巢癌的早期诊断价值分析[J].中国计划生育和妇产科,2016,8(3):69-73.
[13] 宋晓翠,张文增,滕洪涛,等.血清HE4、CA125联合检测在卵巢癌术后复发诊断中的应用[J].山东医药,2012,52(14):75-76.
[14] 王芝琴,许剑,陈茵,等.卵巢癌患者血清和肿瘤组织HE4和CA125联合检测的临床意义[J].实用癌症杂志,2014,29(4):412-414.
[15] 杨文杰,柯振符,邱国英,等.联合检测血清HE4、CA125、CA72-4及IL-6在卵巢恶性肿瘤诊断中的应用价值[J].国际检验医学杂志,2015,36(6):755-757.
[16] 梁美蓉,曾四元,王素兰,等.人附睾蛋白4联合CA125检测在卵巢良恶性肿瘤诊断中的应用价值[J].中华临床医师杂志(电子版),2013,7(20):9148-9152.
[17] 徐萌,李慧源.联合检测血清HE4和CA125对卵巢恶性肿瘤的诊断价值[J].中国计划生育和妇产科杂志,2011,3(3):52-55.
[18] 李青,宋晓玲,吴祺琰,等.HE4与CA125联合检测在卵巢癌与卵巢子宫内膜异位囊肿鉴别诊断中的临床应用[J].现代肿瘤医学,2013,21(2):389-392.
[2] 刘树皖,杨修军.HE4、CA125及血浆Fbg联合检测在卵巢癌患者早期诊断中的临床价值[J].中国现代医生,2017,55(36):131-133.
[3] American College of Obstetricians and Gynecologists Committee on Gynecologic Practice.Committee opinion No.477:The role of the obstetrician-gynecologist in the early detection of epithelial ovarian cancer[J].Gynecologic Oncology,2002,87(3):237-239.
[4] 石榴花,任传路,丁磊,等.联合检测血清HE4、SMRP、CEA与CA125在卵巢癌诊断中的应用价值研究[J].检验医学与临床,2016,13(8):1068-1070.
[5] Vrzalova J,Prazakova M,Anovotn Z,et al.Test of ovarian cancer multiplex xMAP technology panel[J].Anticancer Research,2009,29(2):573-576.
[6] 苏彤,刘辉,任清霞,等.HE4、TSGF和CA125联合检测诊断卵巢癌的价值[J].山东医药,2011,51(39):62-64.
[7] 刘红梅.HE4与CA125联合检测在卵巢癌诊断中的应用价值研究[J].国际检验医学杂志,2017,38(11):1563-1565.
[8] 崔永伟,颜廷婷.CT、超声、CA125联合检测在卵巢癌诊断中的应用分析[J].中国性科学,2012,21 (9):37-38.
[9] 蔡徐山,陈怡,黄秋兰,等.血清人附睾分泌蛋白4和糖链抗原125联合检测在卵巢癌诊断中的应用[J].诊断学理论与实践,2010,9(5):465-468.
[10] 潘秀芳,郑志昂,麦燕.血清附睾蛋白4、糖类抗原125及19-9水平在老年卵巢癌诊断及病理类型鉴别中的临床价值[J].国老年学杂志,2015,72(12):3343-3344.
[11] 李子军,郑雅琴,徐仙凤,等.血清HE4和 CA125水平联合ROMA预测和诊断卵巢癌的临床价值[J].肿瘤学杂志,2013,19(3):219-222.
[12] 熊雯,周新娥,黄娟,等.血清CA125、HE4及IL-17检测对上皮性卵巢癌的早期诊断价值分析[J].中国计划生育和妇产科,2016,8(3):69-73.
[13] 宋晓翠,张文增,滕洪涛,等.血清HE4、CA125联合检测在卵巢癌术后复发诊断中的应用[J].山东医药,2012,52(14):75-76.
[14] 王芝琴,许剑,陈茵,等.卵巢癌患者血清和肿瘤组织HE4和CA125联合检测的临床意义[J].实用癌症杂志,2014,29(4):412-414.
[15] 杨文杰,柯振符,邱国英,等.联合检测血清HE4、CA125、CA72-4及IL-6在卵巢恶性肿瘤诊断中的应用价值[J].国际检验医学杂志,2015,36(6):755-757.
[16] 梁美蓉,曾四元,王素兰,等.人附睾蛋白4联合CA125检测在卵巢良恶性肿瘤诊断中的应用价值[J].中华临床医师杂志(电子版),2013,7(20):9148-9152.
[17] 徐萌,李慧源.联合检测血清HE4和CA125对卵巢恶性肿瘤的诊断价值[J].中国计划生育和妇产科杂志,2011,3(3):52-55.
[18] 李青,宋晓玲,吴祺琰,等.HE4与CA125联合检测在卵巢癌与卵巢子宫内膜异位囊肿鉴别诊断中的临床应用[J].现代肿瘤医学,2013,21(2):389-392.