血清CA125、HE4及IL-17检测对上皮性卵巢癌的早期诊断价值分析

目的探讨血清肿瘤标志物CA125、人附睾蛋白4(human epididymis protein 4,HE4)、白介素-17(interleukin-17,IL-17)检测对上皮性卵巢癌(epithelial ovarian cancer,EOC)早期诊断的价值。方法收集2012年5月至2015年5月成都市妇女儿童中心医院妇产科收治的78例卵巢疾病住院患者的临床资料,其中EOC患者38例(A组),卵巢良性肿瘤40例(B组),选取同期健康体检者43例(C组),测定并比较3组空腹血清CA125、HE4、IL-17的浓度及阳性率,分析各标志物与EOC临床病理特征之间的关系,评价单一标志物检测以及联合检测对EOC的诊断价值。结果 A组患者血清CA125、HE4及IL-17含量及阳性率均明显高于其它两组(P0.05)。HE4与IL-17联合或3种标志物联合后卵巢癌组阳性率进一步提高(P0.05)。不同标志物检测在不同病理特征的卵巢癌患者中差异均无统计学意义(P0.05)。HE4诊断卵巢癌灵敏度(84.2%)和特异度(92.8%)均高于其它两种,与病理结果达到极好的一致(Kappa系数=0.770,K≥0.75);IL-17诊断的准确性、预测值、正确诊断指数及Kappa系数均和CA125比较接近。HE4与IL-17联合或3种标志物联合后灵敏度达到92.1%和94.7%。早期卵巢癌HE4和IL-17的诊断灵敏度(88.2%、82.4%)均较CA125高(64.7%),联合CA125后,可以将灵敏度提高到94.1%。结论检测血清中IL-17和HE4的含量对EOC的诊断敏感性较高,可达到或超过CA125,在早期卵巢癌患者血清中阳性率较高。IL-17和HE4联合或进一步联合CA125可以提高对上皮性卵巢癌,尤其早期卵巢癌的诊断敏感性,二者均有较高的临床应用前景。

The diagnostic value analysis of serum CA125, HE4 and IL-17 detection for early epithelial ovarian cancer

Objective To investigate the diagnostic value of serum tumor markers CA 125, human epididymis protein 4 (HE4), interleukin 17 ( IL-17) detection for early epithelial ovarian cancer ( EOC) .Methods Clinical data of 78 cases with ovarian disease from May 2012 to May 2015 in Women and Children's Central Hospital of Chengdu City was retrospectively analyzed .Among them 38 cases of patients with EOC (Group A), 40 cases with benign ovarian tumors (Group B).Selected 43 cases of healthy women (Group C) who had health examinations at the same period as the research objects , serum CA125, HE4 and IL-17 of the research objects were detected, concentration and positive rate of serum CA 125, HE4, IL-17 of three groups were compared , the relationship between the markers and clinical pathological features of EOC were analyzed , and the diagnostic values of single marker detection and combined detection for EOC were evaluated .Results The serum levels of CA125, HE4 and IL-17 in group A were significantly higher than those in the other groups (P<0.05).By combining HE4 and IL-17 or three markers, the positive rates of EOC increased (P<0.05).For detecting different pathological features of ovarian cancer , the detection rate of different markers showed no significant difference (P>0.05).The diagnosis sensitivity (84.2 %) and specificity (92.8%) of HE4 were higher than other two markers, it achieved excellent consistency with pathological results (kappa =0.770, K≥0.75); diagnosis accuracy, prediction values, correct diagnosis index and kappa coefficient of IL -17 and CA125 were close.While combining HE4 with IL-17 or three markers, the sensitivity was increased to 92.1 % and 94.7 %.The diagnostic sensitivity of HE4 and IL-17 in early ovarian cancer (88.2 %, 82.4 %) was higher than that of CA125 (64.7 %), by combining CA125, the sensitivity increased to 94.1 %.Conclusion The sensitivity of detecting serum IL -17 and HE4 levels in the diagnosis of EOC is higher , which can reach or exceed CA 125 and the positive rate is higher in early ovarian cancer .Combining detection of IL -17 and HE4 or further combined with CA 125 can improve the diagnostic sensitivity of EOC , especially early ovarian cancer , and the two tumor markers have high clinical application prospect .