血清CEA,CA125和HE4联合检测对卵巢癌的诊断价值

目的 探讨血清中癌胚抗原(carcinogenic antigen,CEA)、糖链抗原125(CA125)和人附睾蛋白4(human epididymis secretary protein 4,HE4)联合检测在卵巢癌诊断中的临床价值。方法 采用西门子CentaurXP全自动化学发光免疫分析仪检测37例卵巢癌患者(卵巢癌组),42例卵巢良性病变患者(良性病变组)及40例健康者(对照组)血清CEA,CA125和HE4水平,分析比较各组间三项指标水平的差异,三组三项指标单项及联合检测阳性率的比较; 通过敏感度、特异度、阳性预测值评价血清CEA,CA125,HE4联合检测对卵巢癌的临床诊断价值。结果 卵巢癌组与良性卵巢病变组血清CEA,CA125,HE4水平比较差异均有统计学意义(t=6.1,6.0,4.8,均P<0.05); 良性病变组CA125水平与对照组比较差异有统计学意义(t=4.7,P<0.05); CEA和HE4良性病变组与对照组比较差异无统计学意义(t=1.8,0.3,均P>0.05); 卵巢癌组血清CEA,CA125和HE4单项、两两联合和三项联合检测阳性率分别是:32.4%,70.3%,78.4%,75.7%,81.8%83.8%和89.2%。卵巢癌组与良性病变组CEA,CA125,HE4单项,两两联合和三项联合检测比较差异有统计学意义(χ²=13.4～49.4,均P<0.05),卵巢癌组与正常对照组CEA,CA125,HE4单项,两两联合和三项联合检测比较差异有统计学意义(χ²=20.0～49.5,均P<0.05); 三项联合检测敏感度为89.2%,高于各单项和两两联合检测的敏感度。结论 CEA,CA125和HE4三项联合检测敏感度高于各单项及两两联合检测的敏感度,三项联合检测能够提高卵巢癌的诊断水平。

Clinical Value of Combined Detection of Serum CEA,CA125 and HE4 in the Diagnosis of Ovarian Cancer

Objective To investigate the clinical value ofserum carcinogenic antigen(CEA),glycochain antigen 125(CA125)and human epididymis secretein 4(HE4)in the diagnosis of ovarian cancer.Methods The serum CEA,CA125 and HE4 level of 37 patients with ovarian cancer(ovarian cancer group),42 patients with benign ovarian lesions(benign lesions group)and 40 healthy patients(control group)were tested with the fully automatic chemiluminescent immunoassay of Siemens Centaur XP.and the differences of three index levels among the three groups were analyzed,and the positive rates were compared among three groups of three indicators.Evaluated of the clinical diagnostic value of serum CEA,CA125 and HE4 for ovarian cancer by sensitivity,specificity and positive prediction.Results The serum levels of ovarian carcinoma group and benign ovarian lesions group were statistically significant(t=4.8～6.1,all P<0.05).The concentration of CA125 inbenign lesion group was statistically significant(t=4.7,P<0.05).Therewas no statistically significant comparison between the CEA and HE4 benign control groups and the health group(χ²=1.8,0.3,all P>0.05).The positive rates of serum CEA,CA125 and HE4,combined and combined were 32.4%,70.3%,78.4%,75.7%,81.8%,83.8% and 89.2% respectively in ovarian carcinoma group.The ovarian cancer group was statistically significant compared with the benign lesion group(χ²=13.4～49.4,P<0.05).The ovarian cancer group was statistically significant compared with the normal control group(χ²=20.0～49.5,P<0.05).The sensitivity of ovarian cancer detection,89.2% of the sensitivity of the three joint tests,was higher than the sensitivityof each individual and two joint tests.Conclusion Thesensitivity of CEA,CA125,and HE4 was higher than that of individual two combined tests.