HE4联合 CA125检测对卵巢良恶性肿瘤的诊断价值

目的：探讨人附睾上皮分泌蛋白4（HE4）对卵巢癌的诊断意义及其与糖链抗原CA125联合检测对卵巢良、恶性肿瘤的诊断价值。方法检测22例卵巢癌患者、46例卵巢良性肿瘤患者及35例健康女性血清中的HE4和CA125水平。 CA125的测定采用适用于96微孔反应板的时间分辨荧光测定仪测量，通过双抗体夹心时间分辨免疫荧光分析法进行测定。 HE4的测定应用电化学发光法进行测定。结果卵巢癌组HE4水平明显高于卵巢良性肿瘤和健康对照组，差异均具有统计学意义（t1＝3．356， t2＝3．865，均P＜0．05）；卵巢癌组血清CA125水平也高于卵巢良性肿瘤组和健康对照组，差异均有统计学意义（ t1＝4．656，t2＝5．126，均P＜0．05）。单独检测HE4的灵敏度和特异度分别为77．27％和84．78％；单独检测CA125的灵敏度和特异度分别为90．91％和80．43％；二者联合检测时灵敏度和特异度分别为72．73％和89．13％。结论 HE4对卵巢癌的诊断有较高的特异度；CA125的特异度低于HE4；HE4对卵巢癌的诊断价值优于单独CA125检测；联合检测提高了特异度，降低了的灵敏度。

Values of human epididymis protein 4 combined with carbohydrate antigen 125 in diagnosis of human ovarian cancer and ovarian benign tumors

Objective To explore the diagnostic value of human epididymis protein 4 （HE4） in ovarian cancer and that of HE4 combined with carbohydrate antigen 125 （ CA125） in human ovarian cancer and ovarian benign tumors .Methods Serum levels of HE4 and CA125 in 22 cases of ovarian cancer , 46 cases of ovarian benign tumors and 35 cases of healthy controls were detected .Time-resolved fluorescence measurement apparatus applicable to 96 microporous reaction plate was used , and CA125 was measured by double antibody sandwich time-resolved immunofluorescence analysis method .Electrochemical luminescence method was used to determine HE 4.Results Serum levels of HE4 among ovarian cancer patients were obviously higher than those of ovarian benign tumors and healthy controls , and the difference was statistically significant （t1 =3.356,t2 =3.865, both P〈0.05）.Serum levels of CA125 among ovarian cancer patients were obviously higher than those of ovarian benign tumors and healthy controls , and there was significant difference （ t1 =4.656,t2 =5.126, both P〈0.05）.The sensitivity and specificity of HE4 was 77.27%and 84.78%, respectively, while the sensitivity and specificity of CA125 was 90.91%and 80.43%, respectively.The sensitivity and specificity of joint detection was 72.73%and 89.13%, respectively.Conclusion HE4 has high specificity in detecting ovarian cancer , which is higher than CA125.The diagnostic value of HE4 is superior to CA125 in detecting ovarian cancer .Joint detection improves specificity but reduces sensitivity .