血清HE4和CA125诊断卵巢癌的临床应用价值比较分析

目的 比较分析人附睾蛋白4（HE4）和糖链抗原125（CA125）对卵巢癌诊断的临床应用价值。方法 用化学发光免疫分析法测定113例卵巢癌、107例盆腔良性疾病和168健康对照血清HE4和CA125水平。结果 卵巢癌患者血清HE4和CA125水平显著高于盆腔良性疾病和健康对照（P〈0.05）。以健康人群为对照,血清HE4对卵巢癌的灵敏度（SEN）、特异性（SPE）和准确度分别为72.6%、100.0%和89.0%,血清CA125对卵巢癌的SEN、SPE和准确度分别为77.9%、94.6%和87.9%,血清HE4/CA125并联试验对卵巢癌的SEN、SPE和准确度分别为84.1%、94.6%和90.4%。以盆腔良性疾病患者为对照,血清HE4对卵巢癌的SEN、SPE和准确度分别为72.6%、91.6%和81.8%,血清CA125对卵巢癌的SEN、SPE和准确度分别为77.9%、83.2%和80.5%,血清HE4/CA125并联试验对卵巢癌的SEN、SPE和准确度分别为84.1%、80.4%和82.3%。HE4对Ⅰ期卵巢癌的灵敏度显著高于CA125（P〈0.05）。结论 对卵巢癌诊断,血清HE4具有较高的特异度,血清CA125具有较高的灵敏度。HE4对卵巢癌诊断和鉴别诊断具有较高的临床价值,尤其是Ⅰ期卵巢癌诊断的较好标志物。

Comparison and Analysis of Clinical Values of Serum Human Epididymal Protein 4 and Carbohydrate Antigen 125 in Diagnosis of Ovarian Cancer

Objective To compare and analyze the clinical values of serum human epididymal protein 4（HE4）and carbohydrate antigen 125（CA125）for diagnosis of ovarian cancer. Methods The levels of serum HE4 and CA125 were measured in 113 ovarian cancer patients,107 patients with benign pelvic disease and 168 healthy persons. Results The levels of HE4 and CA125 were significantly higher in patients with ovarian cancer than those in patients with benign pelvic diseases and healthy persons（P〈0. 05）. Patients with ovarian cancer compared to healthy persons, the diagnosis sensitivity, specificity and accuracy of HE4 were 72. 6%, 100. 0% and 89. 0%, respectively. The diagnosis sensitivity, specificity and accuracy of CA125 were 77. 9%,94. 6% and 87. 9%, respectively. The diagnosis sensitivity, specificity and accuracy of HE4/CA125 parallel detection were 84. 1%,94. 6% and 90. 4%,respectively. In comparison with patients with benign pelvic disease, the diagnosis sensitivity, specificity and accuracy of HE4 were 72. 6%,91. 6% and 81. 8%, respectively. The diagnosis sensitivity, specificity and accura-cy of CA125 were 77. 9%,83. 2% and 80. 5%, respectively. The diagnosis sensitivity, specificity and accuracy of HE4/CA125 parallel detection were 84. 1%,80. 4% and 82. 3%,respectively. The diagnosis sensitivity of HE4 in ovarian cancer stageⅠwas significantly higher than that of CA125. Conclusion The specificity of HE4 in diagnosis of ovarian cancer was higher. The sensitivity of CA125 in diagnosis of ovarian cancer was higher. The clinical value of HE4 was higher in diagnosis and differential diagnosis of ovarian cancer and benign pelvic disease. HE4 was a better marker for ovarian cancer stage Ⅰ.