糖类抗原125、糖类抗原724和人附睾蛋白4联合检测在子宫内膜癌鉴别诊断中的临床价值

目的探讨血清糖类抗原125 (CA125)、CA724及人附睾蛋白4 (HE4)联合检测在子宫内膜癌鉴别诊断中的临床价值,为临床鉴别诊断提供参考依据。方法选取2016年1月-12月中南大学湘雅医院确诊的80例子宫内膜癌患者(EC组)、子宫内膜增生患者40例(增生组)、健康体检妇女40例(健康组),检测对比3组妇女血清CA125、CA724及HE4的水平。结果 EC组患者血清CA125、CA724、HE4水平显著高于增生组、健康组,差异有统计学意义(均P<0. 05);增生组的血清CA125水平显著高于健康组,差异有统计学意义(均P <0. 05);血清CA125诊断子宫内膜癌的灵敏度为41. 25%、特异度为87. 50%;血清CA724诊断子宫内膜癌的灵敏度为36. 25%、特异度为92. 50%;血清HE4诊断子宫内膜癌的灵敏度为65. 00%、特异度为90. 00%。血清CA125+CA724+HE4正确诊断子宫内膜癌67例,诊断子宫内膜癌的灵敏度为83. 75%、特异度为93. 75%、漏诊率为16. 25%、误诊率为6. 25%、阳性预测值为93. 06%、阴性预测值为85. 23%。结论血清CA125、CA724、HE4联合检测较三者单独应用诊断子宫内膜癌能显著提高诊断效能。

Clinical value of joint detection of CA125,CA724 and HE4 in differential diagnosis of endometrial carcinoma

Objective To explore the clinical value of joint detection of carbohydrate antigen 125(CA125),carbohydrate antigen 724(CA724) and human epididymis protein 4(HE4) in differential diagnosis of endometrial carcinoma,provide a reference basis for clinical differential diagnosis.Methods From January to December in 2016,80 patients with endometrial carcinoma(EC group),40 patients with endometrial hyperplasia(hyperplasia group),and 40 healthy women(healthy group) were selected from Xiangya Hospital of Central South University,the levels of serum CA125,CA724,and HE4 in the three groups were compared.Results The levels of serum CA125,CA724,and HE4 in EC group were statistically significantly higher than those in hyperplasia group and healthy group(P<0.05);the level of serum CA125 in hyperplasia group was statistically significantly higher than that in healthy group(P<0.05);the sensitivity and specificity of serum CA125 in diagnosis of endometrial carcinoma were 41.25% and 87.50%,respectively;the sensitivity and specificity of serum CA724 in diagnosis of endometrial carcinoma were 36.25% and 92.50%,respectively;the sensitivity and specificity of serum HE4 in diagnosis of endometrial carcinoma were 65.00% and 90.00%,respectively;67 patients with endometrial carcinoma were diagnosed by joint detection of serum CA125,CA724,and HE4 correctly,the sensitivity,specificity,missed diagnostic rate,misdiagnostic rate,positive predictive value,and negative predictive value were 83.75%,93.75%,16.25%,6.25%,93.06%,and 85.23%,respectively.Conclusion Compared with single detection,joint detection of serum CA125,CA724,and HE4 can significantly improve the diagnostic efficacy of endometrial carcinoma.