血清CA125、HE4、SMRP联合检测对卵巢癌的诊断价值研究

目的评估糖链抗原125（CA125）、人附睾蛋白4（HE4）、可溶性间皮素相关肽（SMRP）联合检测在卵巢癌早期诊断中的价值及卵巢癌的高风险因素。方法选择43例卵巢恶性肿瘤患者作为恶性组,54例卵巢良性肿瘤患者作为良性组,45例健康妇女作为对照组。采用Roche Cobas 6000全自动电化学发光免疫分析仪,酶联免疫吸附测定（ELISA）检测血清CA125、HE4、SMRP水平,并对卵巢癌高风险因素进行Logistic回归分析。结果恶性组患者血清CA125、HE4及SMRP水平显著高于良性组及对照组（P〈0.01）。CA125、HE4及SMRP单独检测诊断卵巢恶性肿瘤的敏感性分别为73.3%、82.8%及70.8%,特异性分别为79.1%、87.4%及83.3%。CA125与HE4、SMRP三者联合诊断卵巢恶性肿瘤的敏感性为90.2%,特异性为79.3%。Logistic回归分析发现,初潮年龄小于13岁、月经周期小于30d、月经不规则为卵巢恶性肿瘤高危因素,其比值比（OR）分别为2.1195%可信区间（CI）：1.09~4.10]、1.91（95%CI：1.21~3.10）、1.57（95%CI：0.83~2.94）。结论 CA125联合HE4或SMRP检测可明显提高诊断卵巢癌的敏感性。

A study on diagnostic values of combined detection of serum CA 125,HE4,SMRP for ovarian cancer

Objective To evaluate the values of combined detection of carbohydrate antigen 125（CA125） ,human epididymis gene protein 4（HE4） ,soluble mesothelin related peptides（SMRP） in early diagnosis for ovarian cancer and the high-risk factors of ovari-an cancer .Methods 43 patients with malignant ovarian cancer were served as the malignant group ,54 patients with benign ovarian tumors as the benign group ,45 healthy women as the control group .Roche Cobas 6000 Automatic Electrochemiluminescence Immu-noassay Analyzer and enzyme-linked immunosorbent assay （ELISA） were adopted to detect serum CA125 ,HE4 ,SMRP levels . High-risk factors of ovarian cancer was subject to Logistic regression analysis .Results Serum levels of CA125 ,HE4 and SMRP of patients in malignant group were significantly higher than those in the benign group and the control group （P〈0 .01） .The sensitivi-ties of CA125 ,HE4 and SMRP detection alone for ovarian cancer diagnosis were 73 .3% ,82 .8% and 70 .8% ,respectively ,while their specificities were 79 .1% ,87 .4% and 83 .3% ,respectively .The sensitivity and specificity of joint detection of CA 125 ,HE4 , SMRP for ovarian cancer diagnosis were 90 .2% and 79 .3% ,respectively .Logistic regression analysis showed that age at menarche younger than 13 years ,menstrual cycle less than 30 d and irregular menstruation were the high-risk factors of ovarian cancer ,with their odds ratio（OR） of 2 .1195% confidence interval（CI）：1 .09-4 .10 ,1 .91（95% CI：1 .21-3 .10） and 1 .57（95% CI：0 .83-2 .94） .Conclusion CA125 detection combined with HE4 or SMRP can markedly improve the diagnostic sensitivity for ovarian cancer .