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血清CA125、CA72-4与人附睾分泌蛋白4检测在卵巢癌早期诊断中的临床价值
引用本文:杨春玲,夏薇,张桂杰,周杰. 血清CA125、CA72-4与人附睾分泌蛋白4检测在卵巢癌早期诊断中的临床价值[J]. 中国综合临床, 2011, 27(4). DOI: 10.3760/cma.j.issn.1008-6315.2011.04.007
作者姓名:杨春玲  夏薇  张桂杰  周杰
作者单位:中心医院核医学科,吉林省吉林市,132011
摘    要:目的 探讨血清CA125、CA72-4与人附睾分泌蛋白4(human epididymis protein 4,HE 4)联合检测对卵巢癌早期诊断的价值.方法 分别采用ELISA法和电化学发光法测定111例卵巢癌患者(卵巢癌组)、130例良性卵巢疾病患者(良性卵巢疾病组)、90名健康体检者(正常对照组)血清CA125、CA72-4与HE4,分析3种指标单独和联合检测对卵巢癌早期诊断的价值.结果 卵巢癌组CA125、CA72-4与HE 4水平明显高于良性卵巢疾病组和正常对照组(P均<0.01);Ⅰ期卵巢癌患者的HE4阳性率高于CA125、CA72-4,阳性率分别是63.5%、55.8%、42.6%,而CA125、CA72-4与HE 4联合检测Ⅰ期卵巢癌阳性率较高为75.8%;CA125对浆液性癌、子宫内膜样癌、低分化腺癌诊断敏感性均较高,CA72-4对黏液性癌、子宫内膜样癌诊断敏感性较高,HE 4对浆液性癌、子宫内膜样癌诊断敏感性较高.结论 CA125可作为卵巢癌诊断的首选肿瘤标志物,联合检测血清CA72-4、HE4可使卵巢癌Ⅰ期诊断敏感性提高.
Abstract:
Objective To explore the clinical values of combined detection of serum CA125, CA72-4 and HE4 levels in the early diagnosis of ovarian cancer. Methods The serum levels of CA125, CA72-4 and HE4 in 111 patients with ovarian cancer, 130 patients with benign ovarian disease and 90 healthy female controls were measured by electrochemical luminescence immunoassay (ECLIA) and enzyme-linked immunosorbent assay (ELISA) methods. The diagnostic values of the three markers were analyzed separately and combinedly in ovarian cancer. Results The serum levels of CA125, CA72-4 and HE4 of ovarian cancer patients were significantly higher than those of benign ovarian disease patients and healthy controls(Ps < 0. 01). The positive expression rate of HE4(63.5%) in patients with stage Ⅰ ovarian cancer was significantly higher than that of CA125(55. 8%) and CA72-4 (42. 6%)(Ps < 0. 05) . The combined detection of the three markers may improve the overall accuracy of the early diagnosis of ovarian cancer to 75.8%. The diagnostic sensitivity of serum CA125 was relatively higher in serous cystadenocarcinoma, endometrioid carcinoma and poorly differentiated adenocarcinoma; the diagnostic sensitivity of serum CA72-4 was relatively higher in mucinous cystadenocarcinoma and endometrioid carcinoma; the diagnostic sensitivity of serum HE4 was relatively higher in serous cystadenocarcinoma and endometrioid carcinoma. Conclusion CA125 can serve as the first choice of tumor maker in the diagnosis of ovarian cancer, and the combined detection of serum levels of CA125, CA72-4 and HE4 may increase the diagnostic sensitivity of stage Ⅰ ovarian cancer.

关 键 词:卵巢癌  早期诊断  血清肿瘤标志物

Clinical value of CA125, CA72-4 and HE4 detection in the early diagnosis of ovarian cancer
YANG Chun-ling,XIA Wei,ZHANG Gui-jie,ZHOU Jie. Clinical value of CA125, CA72-4 and HE4 detection in the early diagnosis of ovarian cancer[J]. Clinical Medicine of China, 2011, 27(4). DOI: 10.3760/cma.j.issn.1008-6315.2011.04.007
Authors:YANG Chun-ling  XIA Wei  ZHANG Gui-jie  ZHOU Jie
Abstract:Objective To explore the clinical values of combined detection of serum CA125, CA72-4 and HE4 levels in the early diagnosis of ovarian cancer. Methods The serum levels of CA125, CA72-4 and HE4 in 111 patients with ovarian cancer, 130 patients with benign ovarian disease and 90 healthy female controls were measured by electrochemical luminescence immunoassay (ECLIA) and enzyme-linked immunosorbent assay (ELISA) methods. The diagnostic values of the three markers were analyzed separately and combinedly in ovarian cancer. Results The serum levels of CA125, CA72-4 and HE4 of ovarian cancer patients were significantly higher than those of benign ovarian disease patients and healthy controls(Ps < 0. 01). The positive expression rate of HE4(63.5%) in patients with stage Ⅰ ovarian cancer was significantly higher than that of CA125(55. 8%) and CA72-4 (42. 6%)(Ps < 0. 05) . The combined detection of the three markers may improve the overall accuracy of the early diagnosis of ovarian cancer to 75.8%. The diagnostic sensitivity of serum CA125 was relatively higher in serous cystadenocarcinoma, endometrioid carcinoma and poorly differentiated adenocarcinoma; the diagnostic sensitivity of serum CA72-4 was relatively higher in mucinous cystadenocarcinoma and endometrioid carcinoma; the diagnostic sensitivity of serum HE4 was relatively higher in serous cystadenocarcinoma and endometrioid carcinoma. Conclusion CA125 can serve as the first choice of tumor maker in the diagnosis of ovarian cancer, and the combined detection of serum levels of CA125, CA72-4 and HE4 may increase the diagnostic sensitivity of stage Ⅰ ovarian cancer.
Keywords:Ovarian cancer  Early diagnosis  Serum tumor maker
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