人附睾蛋白4在上皮性卵巢癌中的应用价值

近年来卵巢恶性肿瘤的发病率逐年升高并趋于年轻化.上皮性卵巢癌因早期常无明显症状,亦无有效监测手段,故多于晚期发现,预后较差.即使通过规范的手术及化疗,晚期上皮性卵巢癌的5年生存率为20％～30％,而早期上皮性卵巢癌(I～II期)患者5年生存率可达90％.上皮性卵巢癌患者的生存率与其分期及治疗效果相关.临床上一直在探索一...     

血清中人附睾上皮分泌蛋白4的测定与卵巢上皮性肿瘤患者临床病理特征的关系

为探讨卵巢上皮性肿瘤患者血清人附睾上皮分泌蛋白4（HE4）水平的变化,以及与临床病理特征的关系,采用酶联免疫吸附试验（ELISA）检测21例良性卵巢上皮肿瘤患者、12例交界性卵巢上皮肿瘤患者和49例卵巢癌患者血清HE4水平,并分析其水平与临床病理特征的关系。卵巢癌组血清HE4水平（中位数123.00pmol/L）明显高于交界性卵巢上皮肿瘤组（中位数41.20pmol/L）和良性卵巢上皮肿瘤组（中位数32.80pmol/L）;血清HE4水平与卵巢上皮性癌患者是否绝经、年龄及有无淋巴结转移无关（P〉0.05）,而与患者的临床FIGO分期（Ⅰ＋Ⅱ、Ⅲ＋Ⅳ）、病理组织学类型及有无腹水有关（P〈0.05）,浆液性癌（中位数198.50pmol/L）和子宫内膜样癌患者的血清HE4水平（中位数139.25pmol/L）明显高于黏液性癌患者（中位数30.95pmol/L）（U值分别为17.00和2.00,P〈0.01）。血清HE4水平与卵巢上皮性癌临床病理特征密切相关,并有望成为卵巢上皮性肿瘤恶变的标志物。     

人附睾分泌蛋白4对卵巢恶性肿瘤的诊断价值

为探讨血清人附睾分泌蛋白4在卵巢癌及妇科盆腔良性疾病中的诊断价值,应用ELISA方法检测了31例卵巢癌患者、44例子宫肌腺症、32例卵巢囊肿、30例内膜异位症患者及65名正常健康人血清人附睾分泌蛋白4水平;化学发光微粒子免疫分析法检测以上各疾病组及正常对照组血清CA125水平。结果显示,卵巢癌患者血清人附睾分泌蛋白4水平较其他良性疾病组患者及正常健康人均显著升高,其差异均具有非常显著的统计学意义（P〈0.01）。结果还显示,血清CA125水平升高的妇科盆腔良性疾病组患者血清人附睾分泌蛋白4水平与正常对照组比较,其差异均无统计学意义（P〉0.05）。结果提示,人附睾分泌蛋白4是一种能区分卵巢癌与妇科盆腔良性疾病的新型标记物,可以弥补CA125作为卵巢癌诊断特异性不强的弱点,结合CA125水平,影像学检查,人附睾分泌蛋白4有可能成为卵巢癌诊断的重要标记物。     

血清人附睾蛋白4在辅助诊断卵巢癌中的临床价值

目的探讨血清人附睾蛋白4（human epididymis protein4,HE4）在辅助诊断卵巢癌中的临床意义。方法应用酶联免疫吸附试验法测定82例卵巢癌患者血清HE4水平,并同步检测糖类抗原125（CA125）水平,与143例卵巢良性疾病患者和40例健康体检者进行对照比较。计算敏感性、特异性等诊断性指标,绘制ROC曲线,计算ROC曲线下面积。结果卵巢癌组血清HE4、CA125水平均显著高于健康对照组（P〈0．01）;其卵巢良性疾病组与健康对照组之间均无显著性差异。HFA以≥45．10pmol／L为阳性时,HE4对卵巢癌的诊断敏感性为85．37％（70／82）,特异性为94．54％（173／183）,均高于CA125;HE4的ROC曲线下面积最大（面积：0．949;95％可信区间0．915～0．982）,临床诊断效能优于CA125。结论HE4对诊断卵巢癌有较高的敏感性和特异性,是一个新的卵巢癌辅助诊断标记物。     

人附睾蛋白4在诊断卵巢癌中的临床意义

目的：探讨卵巢癌患者人附睾蛋白4（human epididymis protein4,HE4）的临床意义。方法：用ELISA测定82例卵巢癌患者血清HE4水平,同时应用RIA检测CA125水平,与143例卵巢良性病变患者和40例健康人进行对照比较,评估诊断试验的敏感性、特异性,绘制ROC曲线。结果：HE4对卵巢癌的诊断敏感性82.9%（68/82）,特异性94.54%（173/183）,均高于CA125;HE4的ROC曲线下面积最大（面积：0.949;95%可信区间0.915-0.982）,临床诊断效能优于CA125;HE4与CA125联检针对卵巢癌诊断的敏感性和特异性之和最大。结论：HE4针对卵巢癌诊断显示了较高的敏感性和特异性,可望成为一个新的卵巢癌辅助诊断指标。     

HE4与CA125联检在卵巢恶性肿瘤诊断中的价值

目的:探讨人血清附睾蛋白4(HE4)和CA125在卵巢恶性肿瘤诊断中的价值.方法:检测卵巢恶性病变组(n=116)和良性病变组(n=92)女性患者血清HE4、CA125的水平;并与48例体检健康妇女(正常对照组)相比较.结果:在卵巢恶性病变组中,HE4、CA125的水平显著高于良性病变组和正常对照组(P＜0.05);H...     

上皮性卵巢癌患者血清HE4水平的改变与临床病理特征的关系

目的：探讨上皮性卵巢癌患者血清人附睾上皮分泌蛋白4（HE4）水平的改变及与临床病理特征的关系。方法：用ELISA检测术前上皮性卵巢癌组（62例）、良性卵巢疾病组（22例）和健康对照组（30例）血清HE4水平。结果：上皮性卵巢癌组HE4水平（中位数50.80pmol/L）明显高于卵巢良性疾病组（中位数33.20pmol/L）和健康对照组（中位数26.35pmol/L）（U值分别为778.0和654.5,P值分别为〈0.05,〈0.01）;血清HE4水平与上皮性卵巢癌患者是否绝经、临床FIGO分期（Ⅰ＋Ⅱ、Ⅲ＋Ⅳ）、有无淋巴结转移及有无腹腔积液无关（P〉0.05）,而与病理组织学类型有关,浆液性癌（中位数70.45pmol/L）和子宫内膜样癌的HE4水平（中位数98.00pmol/L）明显高于黏液性癌（中位数22.30pmol/L）（U值分别为189.0和35.0,P〈0.01）。上皮性卵巢癌（Ⅰ、Ⅱ期）组血清HE4水平明显高于非癌组。结论：HE4是上皮性卵巢癌较好的肿瘤标志物,与肿瘤的良恶性及组织学类型有关。     

人附睾分泌蛋白4时间分辨荧光免疫分析法的建立

目的:采用时间分辨荧光免疫技术(TrFIA)建立高灵敏的人附睾分泌蛋白4(HE4)的检测方法.方法:双抗体夹心法建立HE4-TrFIA,并对该试剂的各项性能指标进行评价.结果:该法的检测范围为1.08pmol/L ~2000pmol/L,灵敏度为1.08pmol/L,HE4的回收率95.6%,批内和批间变异系数分别3.6%~7.3%,4.6%~10.2%.与CA125交叉反应率0.01%.破坏试验表明,试剂在37℃可稳定7d.62例卵巢癌患者和60例健康人血清,用该试剂盒测得卵巢癌患者血清HE4浓度显著高于健康人(P<0.001).该试剂盒检测结果与进口HE4 kit检测结果r为0.951.结论:自建的HE4-TrFIA是一种敏感度高、特异性强、准确度高的适用方法,具有良好的临床应用前景.     

HE4在肺癌诊断中的临床价值探讨

目的 研究肿瘤标志物人附睾蛋白4(HE4)对肺癌的诊断价值.方法 采用电化学发光法对46例肺癌患者、52例肺良性疾病患者及50例健康体检者进行血清HF4水平检测,同时检测癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)和神经元特异性烯醇化酶(NSE),并进行比较分析.结果 肺癌患者血清HE4水平为257.38(106.51,387.67)pmoL/L,显著高于肺良性病患者96.17(62.37,129.42) pmol/L及健康体检者78.42 (49.67,l19.26)pmoL/L,(P＜0.01).联合检测中,CEA、CYFRA21-1、NSE联合检测对肺癌的阳性率为78.27％,HE4参与联合检测阳性率为89.21％.结论 HE4对肺癌的诊断有一定的帮助作用.     

血清人附睾蛋白4和糖类抗原125检测在早期卵巢癌诊断中的应用

目的:检测分析肿瘤标志物人附睾蛋白4(HE4)和糖类抗原125(CA125)在早期卵巢癌诊断中的应用价值。方法:临床病检确诊早期卵巢癌患者32例为卵巢癌组,女性良性肿块患者79例为良性肿块组,另选30例健康女性作为健康对照组。术前采血,应用电化学发光法平行检测各组血清HE4和CA125水平,分析HE4、CA125单独和联合检测对卵巢癌的诊断效能。结果:卵巢癌组HE4和CA125水平均显著高于良性肿块组和健康对照组(P均0.01);HE4和CA125诊断卵巢癌的受试者工作特征曲线下面积(AUC)分别为0.935和0.896,差异无统计学意义(P0.05);HE4、CA125单独和联合检测诊断卵巢癌的敏感度分别为84.38%、87.50%和81.25%,差异无统计学意义(P0.05),HE4单独和HE4、CA125两者联合检测的特异性分别为96.20%和98.73%,均显著高于CA125单独检测(P0.01)。结论:HE4是特异性较高的卵巢癌血清标志物,其与CA125联用可以提高对早期卵巢癌的诊断准确性。     

S-100 Protein in Ovarian Tumors

The distribution of S 100 protein in 135 ovarian tumors, of which 127 were epithelial, was investigated using the im-munoperoxidase method. S 100 protein has been demonstrated previously in tumors of various origins. The present study further revealed its characteristic distribution in common epithelial tumors of the ovary. S 100 protein was present in 69% of serous tumors (benign, 50%; borderline, 100%; malignant, 71%), as well as in the serous elements of serous & mucinous mixed tumors (30%). S 100 protein was also demonstrated in 25% of clear cell carcinomas and 29% of endometrioid carcinomas. Interestingly, none of the mucinous tumors were positive for S 100 protein. In addition, the expression of S-100 protein by epithelial ovarian tumors was compared with that of CA 125 and carcinoembryonic antigen (CEA). The distribution of S 100 protein was similar to that of CA 125, since both antigens were frequently present in serous tumors, although their expression patterns were different. On the other hand, S 100 protein positive cases were almost negative for CEA or vice versa. Our observations indicate that demonstration of S 100 protein in common epithelial tumors of the ovary and comparison of S-100 protein distribution with that of CA 125 and CEA may further clarify the characteristics of common epithelial tumors of the ovary.     

血清HE4、TPS和CA125联检在卵巢癌诊断中的应用价值

目的：探讨血清人附睾分泌蛋白4（HE4）、组织特异性抗原（TPS）和CA125联检在卵巢癌诊断中的应用价值。方法：采用EIA、ELISA和ECLIA分别检测卵巢癌患者（n=30）、卵巢良性疾病患者（n=30）和健康对照者（n=31）的血清HE4、TPS和CA125血清水平。结果：卵巢癌组与卵巢良性疾病组、健康对照组、卵巢良性疾病组＋健康对照组比较,血清HE4、TPS和CA125的水平都有显著统计学差异（P〈0.01）。HE4在64.28pmol/L时约顿指数最大（0.667）,敏感性为70.0%,特异性为96.7%,ROC-AUC为0.878;TPS在63.20U/L时约顿指数最大（0.469）,敏感性为63.3%,特异性为83.6%,ROC-AUC为0.761;CA125在48.86U/ml时约顿指数最大（0.602）,敏感性为73.3%,特异性为86.9%,ROC-AUC为0.836;HE4＋CA125联检后敏感性为93.3%,特异性为82.0%,ROC-AUC为0.938;HE4＋CA125＋TPS联检后敏感性为93.3%,特异性为86.9%,ROC-AUC为0.941;HE4与CA125、HE4＋CA125、HE4＋CA125＋TPS比较ROC-AUC无显著差异,HE4和CA125联检后其ROC-AUC增大为0.938,与CA125、TPS二个单项指标相比,P值均〈0.05,与HE4、CA125、TPS三个指标联检后的ROC-AUC值0.941比较P〉0.05,不存在统计学差异。结论：血清HE4是卵巢癌诊断的良好指标,HE4和CA125联检是理想的组合方式,兼顾了敏感性和特异性,提高了对卵巢癌的诊断能力。     

The Value of CA 125 and CA72-4 in Management of Patients with Epithelial Ovarian Cancer

The role of the tumor markers CA125 and CA72-4 has been evaluated in the diagnosis and management of ovarian cancer. Both markers were measured in 30 patients with proven epithelial ovarian cancer, 30 patients with benign pelvic masses and 30 normal women. CA125 and CA72-4 were measured using the luminometric immunoassay and immuno-radiometric assay respectively. All patients with ovarian cancer were submitted to surgical staging and cytoreduction followed by adjuvant platinum based chemotherapy for 3–6 courses. Fixing the specificity at 95%, CA125 had a sensitivity of 76.7% at a cut-off 85u/ml while CA72-4 had a sensitivity of 70% at a cut-off 8.5 u/ml. The combination of CA72-4 with CA125 increased the sensitivity to 95% while fixing the specificity at 95%. Among seven cases with stage I and II ovarian cancer five cases had CA125 level below 85 U/ml, three patients out of them had CA72-4 above 8.5 U/ml. CA 72-4 could reflect the residual disease following cytoreduction and could improve the detection of relapse by CA125.Conclusion: CA72-4 could complement the standard tumor marker CA125 both in diagnosis and follow up of patients with epithelial ovarian cancer.