联合检测血清人附睾分泌蛋白4和癌抗原125对卵巢癌的诊断价值

目的：探讨血清人附睾上皮分泌蛋白4（HE4）和癌抗原（CA125）单独或联合检测对卵巢癌的诊断价值。方法：分别应用酶联免疫吸附试验和电化学发光技术测定经病理确诊的卵巢癌患者112例、盆腔良性疾病患者68例及健康对照者80例血清肿瘤标志物HE4、CA125的含量水平,并计算各项目的灵敏性、特异性、准确性、阳性及阴性预测值等诊断性能指标。结果：①卵巢癌组HE4和CA125水平明显高于其他2组,差异有统计学意义（P〈0.01）;健康对照组和良性疾病组比较HE4差异无统计学意义（P〉0.05）;CA1252组差异有统计学意义（P〈0.01）。②以卵巢良性疾病作参照,单独检测血清HE4水平对卵巢癌诊断的敏感性为57.8%,低于单独检测CA125的75.3%;但其特异性为97.0%,高于CA125的85.5%。以二者其中之一高于参考值即视为阳性时,联合检测HE4和CA125对卵巢癌诊断的敏感性为94.6%,特异性可达85.0%。结论：HE4单项检测诊断卵巢癌的特异性优于CA125单项检测,两者联合检测可以提高诊断。

Diagnostic value of combined detection of serum human epididymis protein 4 and cancer antigen 125 assay in ovarian carcinoma

Objective：To evaluate the diagnostic value of serum human epididymis protein 4 （HE4） and cancer antigen 125assay in ovarian carcinoma.Method：Serum HE4 and CA125 levels of malignant ovarian tumor （112 cases）,benign ovarian diseases （68cases）and health women group（80cases）were detected by enzyme-linked immunosorbent assay （ELISA） and electrochemiluminescence assay,respectively.The levels and diagnosis efficiency of HE4 and CA125 were analyzed.Result：The serum levels of both HE4 and CA125 were significantly higher（P 0.01）in ovarian cancer than those in benign tumor group and healthy control.There was no significant difference （P0.05）between ovarian benign disease group and healthy control.Compared with that in benign ovarian disease group,the diagnostic sensitivity of serum HE4 level in ovarian cancer was 57.8%,lower than that（75.3%） of serum CA125;however,the diagnostic specificity（97.0%） of HE4 was higher than that（85.5%） of CA125. When combined detection of HE4 and CA125,either one or both higher than the reference value shall be deemed positive,ovarian cancer diagnostic sensitivity and specificity reached to 94.6% and 85.0% respectively.Conclusion： The specificity of HE4 assay was higher than CAl25 assay in the diagnosis of ovarian cancer and HE4 combined with CA125 assay could improve the diagnosis accuracy.