糖类抗原125、糖类抗原724和人附睾蛋白4联合检测在子宫内膜癌鉴别诊断中的临床价值
|
摘要
目的探讨血清糖类抗原125 (CA125)、CA724及人附睾蛋白4 (HE4)联合检测在子宫内膜癌鉴别诊断中的临床价值,为临床鉴别诊断提供参考依据。方法选取2016年1月-12月中南大学湘雅医院确诊的80例子宫内膜癌患者(EC组)、子宫内膜增生患者40例(增生组)、健康体检妇女40例(健康组),检测对比3组妇女血清CA125、CA724及HE4的水平。结果 EC组患者血清CA125、CA724、HE4水平显著高于增生组、健康组,差异有统计学意义(均P<0. 05);增生组的血清CA125水平显著高于健康组,差异有统计学意义(均P <0. 05);血清CA125诊断子宫内膜癌的灵敏度为41. 25%、特异度为87. 50%;血清CA724诊断子宫内膜癌的灵敏度为36. 25%、特异度为92. 50%;血清HE4诊断子宫内膜癌的灵敏度为65. 00%、特异度为90. 00%。血清CA125+CA724+HE4正确诊断子宫内膜癌67例,诊断子宫内膜癌的灵敏度为83. 75%、特异度为93. 75%、漏诊率为16. 25%、误诊率为6. 25%、阳性预测值为93. 06%、阴性预测值为85. 23%。结论血清CA125、CA724、HE4联合检测较三者单独应用诊断子宫内膜癌能显著提高诊断效能。
Objective To explore the clinical value of joint detection of carbohydrate antigen 125(CA125),carbohydrate antigen 724(CA724) and human epididymis protein 4(HE4) in differential diagnosis of endometrial carcinoma,provide a reference basis for clinical differential diagnosis.Methods From January to December in 2016,80 patients with endometrial carcinoma(EC group),40 patients with endometrial hyperplasia(hyperplasia group),and 40 healthy women(healthy group) were selected from Xiangya Hospital of Central South University,the levels of serum CA125,CA724,and HE4 in the three groups were compared.Results The levels of serum CA125,CA724,and HE4 in EC group were statistically significantly higher than those in hyperplasia group and healthy group(P<0.05);the level of serum CA125 in hyperplasia group was statistically significantly higher than that in healthy group(P<0.05);the sensitivity and specificity of serum CA125 in diagnosis of endometrial carcinoma were 41.25% and 87.50%,respectively;the sensitivity and specificity of serum CA724 in diagnosis of endometrial carcinoma were 36.25% and 92.50%,respectively;the sensitivity and specificity of serum HE4 in diagnosis of endometrial carcinoma were 65.00% and 90.00%,respectively;67 patients with endometrial carcinoma were diagnosed by joint detection of serum CA125,CA724,and HE4 correctly,the sensitivity,specificity,missed diagnostic rate,misdiagnostic rate,positive predictive value,and negative predictive value were 83.75%,93.75%,16.25%,6.25%,93.06%,and 85.23%,respectively.Conclusion Compared with single detection,joint detection of serum CA125,CA724,and HE4 can significantly improve the diagnostic efficacy of endometrial carcinoma.
Objective To explore the clinical value of joint detection of carbohydrate antigen 125(CA125),carbohydrate antigen 724(CA724) and human epididymis protein 4(HE4) in differential diagnosis of endometrial carcinoma,provide a reference basis for clinical differential diagnosis.Methods From January to December in 2016,80 patients with endometrial carcinoma(EC group),40 patients with endometrial hyperplasia(hyperplasia group),and 40 healthy women(healthy group) were selected from Xiangya Hospital of Central South University,the levels of serum CA125,CA724,and HE4 in the three groups were compared.Results The levels of serum CA125,CA724,and HE4 in EC group were statistically significantly higher than those in hyperplasia group and healthy group(P<0.05);the level of serum CA125 in hyperplasia group was statistically significantly higher than that in healthy group(P<0.05);the sensitivity and specificity of serum CA125 in diagnosis of endometrial carcinoma were 41.25% and 87.50%,respectively;the sensitivity and specificity of serum CA724 in diagnosis of endometrial carcinoma were 36.25% and 92.50%,respectively;the sensitivity and specificity of serum HE4 in diagnosis of endometrial carcinoma were 65.00% and 90.00%,respectively;67 patients with endometrial carcinoma were diagnosed by joint detection of serum CA125,CA724,and HE4 correctly,the sensitivity,specificity,missed diagnostic rate,misdiagnostic rate,positive predictive value,and negative predictive value were 83.75%,93.75%,16.25%,6.25%,93.06%,and 85.23%,respectively.Conclusion Compared with single detection,joint detection of serum CA125,CA724,and HE4 can significantly improve the diagnostic efficacy of endometrial carcinoma.
引文
[1]Hu L,Du S,Guo W,et al.Comparison of serum human epididymis protein 4 and carbohydrate antigen 125 as markers in endometrial cancer[J].Int J Gynecol Cancer,2016,26(2):331-340.
[2]Saarelainen SK,Peltonen N,Lehtimki T,et al.Predictive value of serum human epididymis protein 4 and cancer antigen 125 concentrations in endometrial carcinoma[J].Am J Obstet Gynecol,2013,209(2):141-142.
[3]张彩华.癌胚抗原125与附睾蛋白4联合检测在子宫病变中的诊断意义[J].中国肿瘤临床与康复,2015,22(4):406-408.
[4]胡玲莉,郭万华,陈德柱,等.人附睾蛋白4和糖类抗原125对子宫内膜癌早期诊断价值的系统评价[J].中国循证医学杂志,2015,15(9):1049-1058.
[5]Sadowski EA,Robbins JB,Guite K,et al.Preoperative pelvic MRIand serum cancer antigen-125:selecting women with grade 1 endometrial cancer for lymphadenectomy[J].Am J Roentgenol,2015,205(5):W556-W564.
[6]Shah VI,Mccluggage WG.Cyclin D1 does not distinguish YWHAE-NUTM2 high-grade endometrial stromal sarcoma from undifferentiated endometrial carcinoma[J].Am J Surg Pathol,2015,39(5):722-724.
[7]刘海防,陈旭.糖链抗原125及19-9和中性粒细胞/淋巴细胞比值联合检测诊断子宫内膜异位症价值[J].中华实用诊断与治疗杂志,2016,30(7):663-665.
[8]潘姿女,丁金旺,王克义,等.血清人附睾蛋白4、CA125和CA19-9联合检测在子宫内膜癌诊断中的临床价值[J].中国卫生检验杂志,2014,24(11):1600-1603.
[9]周哲,蒋欣,宋继成,等.人附睾蛋白4在子宫内膜癌患者血清及组织中的表达及临床意义[J].南京医科大学学报(自然科学版),2017,42(4):478-481.
[10]张晶,王宇娟,霍俊玲,等.人附睾蛋白4早期诊断子宫内膜癌价值的系统评价[J].中国循证医学杂志,2014,14(1):72-78.
[11]白朝怡,王颖梅,滕飞,等.血清人附睾分泌蛋白E4及CA125联合检测对子宫内膜癌淋巴结转移的预测价值[J].中华妇产科杂志,2014,49(7):543-546.
[12]栾磊,张丽艳,马颖秋,等.子宫内膜癌患者血清人附睾蛋白4和人软骨糖蛋白-39水平的变化及其临床意义[J].中国妇幼保健,2015,30(19):3293-3294.
[13]潘姿女,丁金旺,樊璠,等.早期子宫内膜癌患者联合检测血清人附睾蛋白4、糖类抗原125及糖类抗原19-9的应用价值探讨[J].中国医师进修杂志,2014,37(27):32-35.
[14]戴素清,曾文红,周涛,等.子宫内膜癌患者血清CA125检测的临床意义[J].中国妇幼健康研究,2015,26(2):322-324.
[2]Saarelainen SK,Peltonen N,Lehtimki T,et al.Predictive value of serum human epididymis protein 4 and cancer antigen 125 concentrations in endometrial carcinoma[J].Am J Obstet Gynecol,2013,209(2):141-142.
[3]张彩华.癌胚抗原125与附睾蛋白4联合检测在子宫病变中的诊断意义[J].中国肿瘤临床与康复,2015,22(4):406-408.
[4]胡玲莉,郭万华,陈德柱,等.人附睾蛋白4和糖类抗原125对子宫内膜癌早期诊断价值的系统评价[J].中国循证医学杂志,2015,15(9):1049-1058.
[5]Sadowski EA,Robbins JB,Guite K,et al.Preoperative pelvic MRIand serum cancer antigen-125:selecting women with grade 1 endometrial cancer for lymphadenectomy[J].Am J Roentgenol,2015,205(5):W556-W564.
[6]Shah VI,Mccluggage WG.Cyclin D1 does not distinguish YWHAE-NUTM2 high-grade endometrial stromal sarcoma from undifferentiated endometrial carcinoma[J].Am J Surg Pathol,2015,39(5):722-724.
[7]刘海防,陈旭.糖链抗原125及19-9和中性粒细胞/淋巴细胞比值联合检测诊断子宫内膜异位症价值[J].中华实用诊断与治疗杂志,2016,30(7):663-665.
[8]潘姿女,丁金旺,王克义,等.血清人附睾蛋白4、CA125和CA19-9联合检测在子宫内膜癌诊断中的临床价值[J].中国卫生检验杂志,2014,24(11):1600-1603.
[9]周哲,蒋欣,宋继成,等.人附睾蛋白4在子宫内膜癌患者血清及组织中的表达及临床意义[J].南京医科大学学报(自然科学版),2017,42(4):478-481.
[10]张晶,王宇娟,霍俊玲,等.人附睾蛋白4早期诊断子宫内膜癌价值的系统评价[J].中国循证医学杂志,2014,14(1):72-78.
[11]白朝怡,王颖梅,滕飞,等.血清人附睾分泌蛋白E4及CA125联合检测对子宫内膜癌淋巴结转移的预测价值[J].中华妇产科杂志,2014,49(7):543-546.
[12]栾磊,张丽艳,马颖秋,等.子宫内膜癌患者血清人附睾蛋白4和人软骨糖蛋白-39水平的变化及其临床意义[J].中国妇幼保健,2015,30(19):3293-3294.
[13]潘姿女,丁金旺,樊璠,等.早期子宫内膜癌患者联合检测血清人附睾蛋白4、糖类抗原125及糖类抗原19-9的应用价值探讨[J].中国医师进修杂志,2014,37(27):32-35.
[14]戴素清,曾文红,周涛,等.子宫内膜癌患者血清CA125检测的临床意义[J].中国妇幼健康研究,2015,26(2):322-324.