可溶性E-钙粘蛋白、糖类抗原125、人附睾蛋白4联合检测在卵巢癌早期诊断中的临床价值

目的:探讨联合检测sE-CAD、CA125和HE4在卵巢癌早期诊断中的临床应用价值，以改善传统CA125和HE4检测在早期卵巢癌诊断中的不足。方法:检测40例健康体检者、64例卵巢良性肿瘤患者、112例卵巢癌患者（I期:14例，II期:23例，Ⅲ期:41例，IV期:34例）血清中sE-CAD、CA125和HE4的表达水平，结合临床资料，进行相关统计学分析。结果:不同临床分期卵巢癌组、卵巢良性疾病组和健康对照组sE-CAD、CA125和HE4的表达水平比较，差异均有统计学意义（P＜0.05），卵巢良性疾病组与健康对照组比较，CA125表达水平明显升高，差异具有统计学意义（P＜0.05），sE-CAD、HE4水平则无显著变化（P＞0.05）。sE-CAD、CA125和HE4联合检测用于早期卵巢癌（I-II期）的诊断时，其灵敏度、特异度、阳性预测值和阴性预测值分别达到90.8%、91.1%、83.4%、93.6%，ROC曲线下面积也升高至0.956 5，95%CI为0.916 9~0.996 1，比各指标单独检测均有所提升。结论:sE-CAD、CA125和HE4联合检测具有较高的灵敏度、特异度和ROC曲线下面积，是诊断早期卵巢癌（I-II期）较为理想的生物标志物组合。

Clinical value of sE-CAD combined with CA125 and HE4 in the diagnosis of early ovarian cancer

Objective:To evaluate the clinical value of sE-CAD combined with CA125 and HE4 as a new association marker in the diagnosis of early ovarian cancer.Methods:The expression of sE-CAD,CA125 and HE4 in 40 healthy control,64 cases of benign ovarian tumor and 112 cases of ovarian cancer were measured in department of clinical laboratory.The sensitivity,specificity and ROC curves were used to evaluate the diagnostic value in the diagnosis of early ovarian cancer.Results:The expression of sE-CAD,CA125 and HE4 in patients with ovarian cancer were significantly higher than those in the benign ovarian tumor and the healthy control(P＜0.05).Compared with the healthy control,the expression of CA125 was significantly higher in benign ovarian (P＜0.05),but the levels of sE-CAD and HE4 were not significantly different (P＞0.05).The sensitivity,specificity,positive predictive value,negative predictive value and ROC AUC of sE-CAD+CA125+HE4 were respectively 90.8%,91.1%,83.4%,93.6% and 0.956 5(95%CI 0.916 9~0.996 1).It performed better than any single test of sE-CAD,CA125 and HE4.Conclusion:The combined detection sE-CAD+CA125+HE4 shows higher sensitivity,specificity and ROC AUC.It is an ideal serum marker combination for the diagnosis of early ovarian cancer (stage I-II) patients.