血清 CA125和 HE4联合检测在卵巢诊断与判断预后中的价值

目的：探讨糖类抗原125（CA125）和人附睾分泌蛋白4（HE4）联合检测在卵巢诊断与判断预后中的价值。方法82例卵巢上皮癌患者作为 A 组，101例卵巢良性病变患者作为 B 组，100例健康查体者作为 C 组，测定其血清 CA125和 HE4。结果 CA125阳性率在 A、B、C 组分别为93.9%，8.9%、7.0%，卵巢癌组均高于卵巢良性病变组与正常组（P 均〈0.01）；但卵巢良性病变组与正常组比较差异无统计学意义（P 〉0.05）。HE4阳性率在A、B、C 组分别为97.6%，5.0%、2.0%，卵巢癌组均高于卵巢良性病变组与正常组（P 均〈0.01），且卵巢良性病变组阳性率高于正常组（P 〈0.05）。CA125诊断卵巢癌的敏感度为93.9%，特异度为75.2%，准确度为88.7%；HE4诊断卵巢癌的敏感度为97.6%，特异度为97.2%，准确度为92.8%。联合检测时，诊断卵巢癌的敏感度为94.0%，特异度为93.1%，准确度为93.3%，高于单项检测的敏感度（P 〈0.05）与准确度（P 〈0.05）。Ⅲ-Ⅳ期患者血清CA125和 HE4联合检测阳性率明显高于Ⅰ-Ⅱ期患者（P 〈0.05）。随访1年硬终点事件中，CA125、HE4联合检测阳性率明显高于阴性率（P 〈0.01）。结论联合检测血清 CA125和 HE4可以提高诊断卵巢癌的准确性。

Value of combined detection of CA125 and HE4 4 on diagnosis and prognosis for ovarian cancer

Objective To investigate the value of combined detection of carbohydrate antigen （CA125）and human epididymal secretory protein 4（HE4）on diagnosis and prognosis for ovarian canc-er. Methods Eighty-two patients with ovarian cancer were selected as group A,101 patients with be-nign ovarian lesions were selected as group B,100 healthy people were selected as group C. Serum CA125 and HE4 were detected among the three groups. Results CA125-positive rates were 93. 9% , 8. 9% and 7. 0% in group A,B and C. The positive rate of ovarian cancer group were higher than that of benign ovarian lesions and normal group（P 〈 0. 01）,but the difference was not significant between ovar-ian benign group and the normal group（P 〉 0. 05）. HE4-positive rates were 97. 6% ,5. 0% and 2. 0%in group A,B and C,the positive rates of ovarian cancer group were higher than that of benign ovarian lesions and normal group（P 〈 0. 01）,and the benign ovarian lesions group was higher than＆amp;nbsp;that of normal group（ P 〉 0. 05）. CA125 sensitivity of diagnosis of ovarian cancer was 93. 9% , specificity was 75. 2% ,accuracy was 88. 7% ;sensitivity of HE4 diagnosis for ovarian cancer was 97. 6% ,specificity was 97. 2% ,accuracy was 92. 8% . When combined detection diagnosis of o-varian cancer,the sensitivity was 98. 0% ,and specificity was 93. 1% and accuracy was 93. 3% , which was higher than the detection sensitivity of the individual（ P 〈 0. 05 ）and accuracy（ P 〈0. 05）. The serum combined TPA and HE4 positive rate in Ⅲ - Ⅳ stage was significantly higher than that inⅠ - Ⅱ stage（ χ^2 = 9. 72,P 〈 0. 05 ）. 1-year follow-up of hard endpoints incident, TPA,HE4 combined positive rate was significantly higher than the negative rate（ χ^2 = 85. 7,P 〈0. 01）. Conclusions CA125 and HE4 can improve the accuracy of diagnosis of ovarian cancer, and can predict pathological stage and prognosis.