血清Mesothelin和CA125联合检测在上皮性卵巢癌诊断中的意义

目的:研究联合检测血清Mesothelin和CA125在上皮性卵巢癌诊断中的临床意义.方法:采用定量酶联免疫吸附试验(ELISA)检测上皮性卵巢癌患者31例,良性卵巢肿瘤32例和正常妇女30例血清中的Mesothelin和CA125水平.结果:上皮性卵巢癌患者的Mesothelin水平明显高于良性卵巢肿瘤患者和正常对照组(P<0.01),良性卵巢肿瘤组患者与正常对照组的差异无显著性(P>0.05).不同类型的上皮性卵巢癌的Mesothelin的差异无显著性(P>0.05).Mesothelin和CA125联合检测对上皮性卵巢癌诊断的灵敏度和正确率明显高于单项检测CA125或Mesothelin(P值均<0.05).结论:血清Mesothelin和CA125联合检测可提高上皮性卵巢癌的早期诊断率.     

HE4、CA125联合ROMA在卵巢癌及盆腔良性疾病中的诊断意义

目的探讨血清中人附睾上皮分泌蛋白4(HE4)、CA125水平和卵巢恶性肿瘤风险模型(ROMA)对卵巢癌及盆腔良性疾病的诊断意义。方法共检测卵巢癌患者68例、卵巢良性疾病135例、健康女性对照者40例,比较各组HE4、CA125水平,结合绝经状态,根据ROMA值预测卵巢恶性肿瘤的发病风险。结果卵巢癌组血清HE4、CA125水平和ROMA值高于健康对照组(P均<0.05),盆腔良性疾病组血清CA125水平和ROMA值高于健康对照组(P均<0.05),盆腔良性疾病组HE4水平与健康对照组差异无统计学意义(P>0.05)。HE4、CA125和ROMA值的敏感性分别为76.47%、70.59%、85.29%,特异性分别为98.52%、74.81%、78.52%,ROMA值敏感性最好,HE4特异性最好。ROMA值绝经前后敏感性分别为73.33%和88.68%,特异性分别为77.36%和82.76%。结论 HE4可作为CA125单项检测卵巢癌的很好补充,且HE4在鉴别盆腔良恶性疾病中具有重要诊断价值,而ROMA值风险预测的敏感性和诊断符合率较HE4和CA125单项高,在临床上可以帮助评估患上皮细胞型卵巢癌的风险性。     

HE4与CA125联合检测在卵巢癌与卵巢子宫内膜异位囊肿鉴别诊断中的临床应用

目的:探讨HE4、CA125单项及联合检测在卵巢癌及卵巢子宫内膜异位囊肿鉴别诊断中的应用价值。方法:分别用ELISA法和化学发光免疫分析法检测38例卵巢癌患者、91例卵巢子宫内膜异位囊肿患者(内异症组)和60例健康者(对照组)的血清中HE4、CA125水平,比较分析两标志物单项及联合检测对卵巢癌、卵巢内异囊肿鉴别诊断的准确性。结果:卵巢癌组血清HE4、CA125水平均明显高于内异症组和健康对照组,差异有统计学意义(P<0.01);内异症组与对照组相比,血清CA125差异有统计学意义(P<0.05),HE4差异无统计学意义(P>0.05)。卵巢癌组以内异症组为参照人群时,HE4、CA1 2 5单项及联合检测的诊断敏感性、特异性、准确性分别为78.95%、90.11%、86.82%;81.58%、69.23%、72.87%和86.84%、80.22%、82.17%;以健康对照组为参考人群时,HE4、CA125单项及联合检测的诊断敏感性、特异性、准确性分别为78.95%、93.33%、87.76%;81.58%、91.67%、87.76%和94.74%、96.67%、95.92%。无论以内异症组或健康对照组为参照,HE4、CA125联合检测的诊断敏感性、准确性明显高于两标志物单项检测。结论:单项检测,HE4诊断卵巢癌特异性优于CA125;HE4+CA125联合检测可进一步提高卵巢癌诊断的准确性,也是卵巢恶性肿瘤与卵巢内异囊肿鉴别诊断的良好指标。     

糖类抗原125、糖类抗原15-3、糖类抗原19-9和人附睾蛋白4单独及联合检测对卵巢癌的诊断价值

目的研究糖类抗原125(CA125)、CA15-3、CA19-9和人附睾蛋白4(HE4)单独及联合检测对卵巢癌的诊断价值,探讨最优的联合诊断方案。方法选取90例卵巢癌患者、90例良性卵巢疾病患者及90同期健康体检者,分别作为肿瘤组、良性组和健康组。比较3组受试者血清CA125、CA15-3、CA19-9和HE4水平及阳性率,比较上述四种肿瘤标志物单独及联合检测对卵巢癌的诊断灵敏度、特异度及准确度。结果肿瘤组患者CA125、CA15-3、CA19-9和HE4水平及阳性率均高于良性组患者和健康组受试者,良性组患者血清CA125、CA15-3和CA19-9水平均高于健康组受试者,良性组患者血清CA125、CA15-3、CA19-9和HE4阳性率均高于健康组受试者,差异均有统计学意义(P﹤0.05)。CA125+CA15-3+HE4、CA125+CA15-3+CA19-9+HE4诊断卵巢癌灵敏度最高,均为91.11%。HE4单独诊断卵巢癌的特异度最高,为94.44%。CA125+CA15-3+HE4诊断卵巢癌的准确度最高,为85.93%。结论CA125+CA15-3+HE4三项联合检测可提高卵巢癌诊断效率,对临床诊断卵巢癌有参考价值。     

血清Mesothelin和CA125联合检测在上皮性卵巢癌诊断中的意义

目的：研究联合检测血清Mesothelin和CA125在上皮性卵巢癌诊断中的临床意义。方法：采用定量酶联免疫吸附试验（ELISA）检测上皮性卵巢癌患者31例,良性卵巢肿瘤32例和正常妇女30例血清中的Me-sothelin和CA125水平。结果：上皮性卵巢癌患者的Mesothelin水平明显高于良性卵巢肿瘤患者和正常对照组（P〈0.01）,良性卵巢肿瘤组患者与正常对照组的差异无显著性（P〉0.05）。不同类型的上皮性卵巢癌的Mesothelin的差异无显著性（P〉0.05）。Mesothelin和CA125联合检测对上皮性卵巢癌诊断的灵敏度和正确率明显高于单项检测CA125或Mesothelin（P值均〈0.05）。结论：血清Mesothelin和CA125联合检测可提高上皮性卵巢癌的早期诊断率。     

卵巢癌血清HE4、CA72-4、CA125水平测定

目的 探讨卵巢癌血清人附睾分泌蛋白4（HE4）、CA72-4、CA125水平及临床意义.方法 入组我院收治的卵巢癌患者45例、卵巢良性病变30例,并纳入同期女性健康体检者30例作为对照,采用电化学发光法分别检测各组血清中HE4、CA72-4、CA125水平.结果 卵巢癌组血清HE4、CA72-4、CA125水平均高于卵巢良性病变组和健康对照组（P〈0.05）.HE4以〉150 pmol·L-1,CA72-4以5.3 u·mL-1,CA125以35 u·mL-1为阳性参考值,三者联合检测的敏感性为93.3%,特异性为73.3%.结论 卵巢癌患者血清中HE4、CA72-4、CA125处于高水平,联合检测可提高卵巢癌的诊断率.     

血清人附睾分泌蛋白4(HE4)和CA125在卵巢癌患者围手术期的变化及临床意义

目的:监测卵巢癌手术前后血清人附睾分泌蛋白4 (human epididymis secretory protein 4,HE4)、CA125(即糖类抗原125)的变化,分析HE4和CA125在卵巢癌诊治中的价值.方法:选取180例卵巢癌患者,根据临床分期分为早期组90例和中晚期组90例,选取90例卵巢良性疾病者作为良性组、90例健康成年女性作为对照组,在手术前后分别监测各组血清HE4和CA125表达水平,统计分析不同检测方法的诊断价值,同时随访卵巢癌患者12个月,对卵巢癌复发患者与未复发患者在手术前后的血清HE4和CA125进行统计分析.结果:血清HE4联合CA125特异度(98.89％)、阳性预测价值(99.27％)显著高于HE4单独检测及CA125单独检测,P＜0.05,组间有统计差异;手术后,卵巢癌患者血清HE4、CA125显著下降(P＜0.05),但是,在相同监测点,卵巢癌者血清HE4和CA125显著高于对照组和良性组(P＜0.05),且中晚期组血清HE4显著高于早期组(P＜0.05),良性组血清HE4、CA125略高于对照组,组间无显著差异(P＞0.05);卵巢癌复发者血清HE4、CA125显著高于未复发组者,P＜0.05,有统计学差异.结论:卵巢癌患者血清CA125和HE4显著异常升高,联合检测血清HE4和CA125不仅对于提高卵巢癌诊断特异性、阳性准确率具有重要价值,而且能够为预后评估提供可靠信息.     

新辅助化疗联合中间性肿瘤细胞减灭术治疗晚期上皮性卵巢癌的疗效及对HE4、VEGF、CA125水平的影响

目的 探讨新辅助化疗联合中间性肿瘤细胞减灭术治疗晚期上皮性卵巢癌的疗效及其对血清人附睾蛋白4(HE4)、血管内皮细胞生长因子(VEGF)、糖类抗原125(CA125)水平的影响.方法 回顾性分析68例晚期上皮性卵巢癌患者的病历资料,根据治疗方法不同将患者分为联合组与对照组,每组34例.联合组患者采用新辅助化疗联合中间性肿瘤细胞减灭术治疗,对照组患者仅接受卵巢肿瘤细胞减灭术治疗.观察并比较两组患者的近期疗效,手术相关指标,血清HE4、VEGF、CA125水平及预后情况.结果 联合组患者的治疗总有效率为79.4%,高于对照组的52.9%(P﹤0.05);联合组患者的手术时间明显短于对照组(P﹤0.01);联合组患者的术中失血量、腹腔积液量均明显低于对照组(P﹤0.01);治疗后,联合组患者的血清HE4、VEGF、CA125水平均明显低于对照组(P﹤0.01);治疗后,两组患者的1年、2年、3年生存率比较,差异均无统计学意义(P﹥0.05).联合组和对照组患者的中位生存时间分别为32.0个月(95%CI:25.3~35.6)和28.0个月(95%CI:22.1~33.9),两组患者的生存情况比较,差异无统计学意义(χ2=1.96,P﹥0.05).结论 新辅助化疗联合中间性肿瘤细胞减灭术治疗晚期上皮性卵巢癌可以缩短手术时间,减少术中出血量,降低血清肿瘤相关标志物水平,但该方法对改善患者的远期生存意义不大.     

上皮性卵巢癌患者血清肿瘤标志物水平对临床疗效及预后价值的探讨

目的探讨上皮性卵巢癌(EOC)患者血清糖类抗原125(CA125)、糖类抗原199(CA199)及人附睾蛋白4(HE4)水平对临床疗效及预后的价值。方法选取2015年6月至2016年12月间辽宁营口市妇产儿童医院收治的70例EOC患者为EOC组,另选取同期70例卵巢良性肿瘤患者为良性组,健康志愿者70例为对照组。比较三组受试者血清CA125、CA199及HE4水平,EOC组患者手术前后、化疗前后、不同预后的血清CA125、CA199及HE4水平。结果 EOC组患者血清CA125、CA199和HE4水平较良性组和对照组高,差异均有统计学意义(均P <0. 05)。良性组患者血清CA125、CA199和HE4水平与对照组比较,差异无统计学意义(P>0. 05)。术后,EOC组患者血清CA125、CA199和HE4水平均较术前降低,差异均有统计学意义(均P <0. 05)。化疗后,EOC组患者血清CA125、CA199和HE4水平均较化疗前降低,差异均有统计学意义(均P <0. 05)。EOC组存活患者的血清CA125、CA199和HE4水平均较死亡患者低,差异均有统计学意义(均P <0. 05)。结论 EOS患者血清CA125、CA199和HE4水平均呈高表达,经手术、化疗后明显降低,说明各指标水平可预测EOS患者的临床疗效及预后。     

HE4 联合 CA125 在卵巢癌早期诊断中的应用价值

目的：探讨人附睾蛋白4（HE4）联合癌抗原125（CA125）在卵巢癌早期诊断中的应用价值.方法：应用电化学发光法及酶联免疫法,测定20例卵巢癌患者、20例良性肿瘤患者（子宫肌瘤和卵巢肿瘤）及30例健康妇女血清CA125、HE4水平,比较各组血清CA125、HE4水平,分析两标记物联合在卵巢癌患者检测中的意义.结果：卵巢癌组CA125、HE4水平明显高于健康组及良性肿瘤组,差异有统计学意义（P＜0.05）,晚期卵巢癌组CA125、HE4水平明显高于早期卵巢癌组,差异有统计学意义（P＜0.05）.联合检测HE4及CA125敏感性高于二者中任一标志物,特异性与CA125检测一致,低于HE4检测.结论：HE4联合CA125测定有助于卵巢癌的诊断,可作为很好的卵巢癌标志物,提高早期卵巢癌的诊断率.     

血清中人附睾蛋白4、抑制素A及癌胚抗原125联合检测在卵巢癌诊断中的意义

目的：探讨人附睾蛋白4（HE4）、抑制素A（inhibinA）及癌胚抗原125（CA125）在卵巢癌患者中的诊断价值。方法：应用ELISA法检测卵巢癌组、卵巢良性肿瘤组及正常对照组患者血清中HE4、InhibinA、CA125水平。结果：血清HE4水平：卵巢癌组（133.86±127.94）pmol/L、卵巢良性肿瘤组（42.67±22.77）pmol/L、正常对照组（33.40±19.50）pmol/L;血清InhibinA水平：卵巢癌组（177.22±114.35）ng/L、卵巢良性肿瘤组（76.60±14.10）ng/L、正常对照组（70.70±21.66）ng/L;血清CA125水平：卵巢癌组（750.52±1230.34）U/L、卵巢良性肿瘤组（67.25±106.16）U/L、正常对照组（17.69±6.13）U/L。统计学分析血清HE4、InhibinA数值显示：卵巢癌组与卵巢良性肿瘤组、正常对照组比较,P〈0.05,差异有统计学意义;而卵巢良性肿瘤组与正常对照组比较,P〉0.05,差异无统计学意义。血清CA125卵巢癌组与卵巢良性肿瘤组、正常对照组比较,P〈0.05,差异有统计学意义;良性肿瘤组与正常对照组比较,P〈0.05,差异有统计学意义。卵巢癌诊断中的阳性率分别是：HE4 71.8%、InhibinA 66.7%、CA125 61.5%,三者联合阳性率为92.3%。结论：HE4、InhibinA、CA125在卵巢癌诊断中有重要意义,三者联合检测能明显提高卵巢癌的诊断率。     

HE4 as a Serum Biomarker for ROMA Prediction and Prognosis of Epithelial Ovarian Cancer

Background and Purpose: Human epididymis protein 4 (HE4) has been suggested to be a novel biomarkerof epithelial ovarian cancer (EOC). The present study aimed to evaluate and compare HE4 with the commonlyused marker, carbohydrate antigen 125 (CA125), in prediction and therapy-monitoring of EOC. Patients andMethods: Serum HE4 concentrations from 123 ovarian cancer patients and 174 controls were measured by Rocheelectrochemiluminescent immunoassay (ECLIA). Risk of ovarian malignancy algorithm (ROMA) values werecalculated and assessed. In addition, the prospects of HE4 detection for therapy-monitoring were evaluated inEOC patients. Results: The ROMA score could classify patients into high- and low-risk groups with malignancy.Indeed, lower serum HE4 was significantly associated with successful surgical therapy. Specifically, 38 patientswith EOC exhibited a greater decline of HE4 compared with CA125. In contrast, elevation of HE4 better predictedrecurrence (of 46, 11 patients developed recurrence, and with it increased HE4 serum concentrations) and apoor prognosis than CA125. Conclusions: This study suggests that serum HE4 levels are closely associated withoutcome of surgical therapy and disease prognosis in Chinese EOC patients.     

血清HE4、CA125、ROMA联合检测在上皮性卵巢癌诊断中的应用

目的:观察HE4、CA125、ROMA值及联合检测对早期卵巢癌风险的预测价值。方法:收集确诊为卵巢肿物女性患者术前的血清样本,分析血清HE4、CA125的表达水平和ROMA值,并与术后病理结果对比,使用受试者工作曲线（ROC-curve）做数据跟踪分析。结果:血清HE4、CA125表达水平和ROMA值在恶性组中高于其他组（P<0.001）。ROMA值良性组与健康组比较差异无显著性（P>0.05）。在早期卵巢癌血清肿瘤标志物对比中,HE4+CA125+ROMA的联合检测与其它血清标志物的差异有显著性（P<0.01）,敏感度98.7%;特异度74.6%;准确度71.5%。结论:在早期卵巢癌检测中HE4单独检测有最高的灵敏度,但HE4+CA125+ROMA联合检测可以在早期更加准确的预测早期卵巢恶性肿瘤的风险。     

复发性卵巢上皮癌腹水的个体化治疗

目的：观察个体化治疗对铂类或紫杉类治疗后复发的卵巢癌腹水的近期及远期效果。方法：2004年2月-2006年8月收治铂类或紫杉类药物治疗后复发卵巢上皮癌并腹水患者37例,据不同耐药情况给予尽早腹腔灌注吡柔比星、铂类药物等;适当放腹水、给利尿剂及白蛋白;全身化疗用吉西他滨／依托泊甙（GE）或依托泊甙／环磷酰胺（CE）、多西紫杉醇／卡铂或顺铂（TC或TP）等方案。结果：腹水CR67．57％,PR16.21％,NC16．21％;实体肿瘤CR68．00％,PR16．00%,NC16．00％;患者治疗后生存8—48个月,中位时间19个月;1年生存率81．10％,2年生存率67．57％。血中CA-125浓度与肿瘤复发呈正相关。结论：个体化治疗铂类或紫杉类药物治疗后复发的卵巢癌腹水仍可获效;血CA-125值是提示卵巢癌复发转移特异性及敏感性较强的指标。     

Does Human Epididymis Protein 4 (HE4) Have a Role in Prediction of Recurrent Epithelial Ovarian Cancer

Background: Despite the fact that ovarian cancer is the seventh most common cancer in women worldwide and the fth leading cause of cancer death, It is the most common cause of death due to reproductive cancers in Thailand where epithelial ovarian cancer (EOC) is commonly found. According to a Thai statistical analysis in 2010 by the Department of Medical Services, epithelial ovarian cancer was the sixth most common cancer in Thailand from 2001 to 2003.The incidence of 5.1 per 100,000 women per year. Human epididymis protein 4 (HE4) is a novo diagnostic tumor marker for EOC. The combination of HE4 and carcinoma antigen 125 (CA 125) is a tool for detecting epithelial ovarian cancer (EOC) better than using CA 125 alone. Therefore, the researcher is interested in HE4 does have a role to predict recurrent epithelial ovarian cancer. Materials and Methods: The patients who had complete response after diagnosed with epithelial ovarian cancer by pathology, FIGO stage 3 or more had been treated through surgery and chemotherapy at the Sunpasitthiprasong Hospital from June 2014 until March 2016. The patients were followed up every three months, using tumor marker (CA 125, HE4,Carcinoma antigen 19-9) together with other checkup methods, such as rectovaginal examination, CXR every year and other imaging as indication. Afterwards, the data was analyzed for the ability of HE4 to detect recurrence of epithelial ovarian cancer. Results: In 47 patients in this study follow-up for 22 months after complete response treatment from surgery and chemotherapy in epithelial ovarian cancer, 23 had recurrent disease and HE4 titer rising .The patients with recurrent epithelial ovarian cancer demonstrated high levels of both HE4 and CA125 with sensitivity of 91.3% and 52.7% respectively, speci city of 87.5% and 95.6% and positive predictive values of 87.5% and 85.7% . HE4 can predict recurrent epithelial ovarian cancer (p-value=0.02242). Comparing HE4 and CA125 in predicting recurrent epithelial ovarian cancer HE4 had more potential than CA125 (p-value =0.8314). Conclusions: The present study showed HE4 to have a role in predicting recurrent epithelial ovarian cancer and HE4 is potentially better than CA125 as a marker for this purpose.