人血清附睾蛋白4和糖类抗原125联合检测对卵巢癌的诊断价值

目的：测定卵巢癌患者血清附睾蛋白4（HE4）和糖类抗原（CA）125水平，探讨血清HE4和CA125联合测定对卵巢癌的诊断价值。方法选择佛山市第一人民医院、佛山市第二人民医院、佛山中医院、佛山禅城区中心医院2012年1月至2013年5月收治的160例住院或门诊患者，将其分为卵巢癌组91例和卵巢良性肿瘤组69例。同时选择同期健康体检女性60例健康对照组。采用电化学发光免疫分析测定血清 HE4和CA125水平。并检测卵巢癌病理分期与 HE4、CA125水平的关系。结果卵巢癌患者血清 HE4、CA125水平均明显高于卵巢良性肿瘤组和健康对照组（P＜0．01）；指标单独检测，HE4敏感性、特异性和诊断效率均高于CA125；并联试验时，敏感性明显提高，串联试验时，特异性明显提高。单独和联合检测中，并联试验对卵巢癌阳性检出率最高。卵巢癌患者随着病理分期升高血清 HE4和CA125水平依次升高，但卵巢癌患者Ⅰ期血清CA125水平与卵巢良性肿瘤组比较，差异无统计学意义（P＞0．05）。结论与CA125相比，HE4为最佳单项卵巢癌肿瘤标志物，联合检测并联试验可提高诊断敏感性，串联试验可提高诊断特异性。

Values of serum human epididymis protein 4 and carbohydrate antigen 125 in the diagnosis of ovarian cancer

Objective To explore the values of serum human epididymis protein 4 （HE4） and carbohydrate antigen 125 （CA125） in the diagnosis of ovarian cancer .Methods Serum levels of HE4 and CA125 were detected in 91 patients with ovarian cancer ,69 patients with benign ovarian diseases and 60 healthy females by using chemilumi-nescence immune assay .Results Serum levels of HE4 and CA125 in patients with ovarian cancer were significantly higher than patients with benign ovarian diseases and healthy subjects （P＆lt;0 .01） .The sensitivity ,specificity and di-agnostic performance of HE4 were higher than CA125 ,when being detected alone .Combined assay of parallel test of HE4 and CA125 could improve sensitivity and Combined assay of series test could improve specificity .Compared with individual and combined assay ,the positive detection rate of parallel test was higher .With the elevating of staging of ovarian cancer ,serum levels of HE4 and CA125 were also elevated .But there was no significant difference of serum CA125 level between patients with ovarian cancer at stage Ⅰand patients with benign ovarian tumors （P＆gt;0 .05） . Conclusion Compared with CA125 ,HE4 could be the best single tumor marker for diagnosis of ovarian cancer . Combined assay of parallel test could improve the diagnostic sensitivity and combined assay of series test could im-prove the diagnostic specificity .