人附睾分泌蛋白4、糖链多肽抗原125联合超声对绝经后子宫内膜癌的诊断价值

目的探讨人附睾分泌蛋白4（HE4）、糖链多肽抗原125（CA125）联合超声对绝经后子宫内膜癌的诊断价值。方法选取绝经后子宫内膜癌病人101例（恶性组），绝经后子宫内膜增生病人103例（良性组），同时期来院健康体检的绝经健康女性105名（对照组），分别检测3组受试者的HE4、CA125水平，分别计算其合并状态时的敏感度、特异度及诊断比值比，并计算受试者工作特征曲线下面积（AUC）值。结果恶性组阴道彩色多普勒超声检查78例存在异常。恶性组HE4、CA125表达水平及阳性率均高于良性组、对照组，良性组高于对照组（P < 0.05）。联合诊断的敏感度、诊断比值比均高于单独的HE4、CA125及超声诊断（P < 0.01和P < 0.05），而特异度差异无统计学意义（P>0.05）。单纯的HE4、CA125及超声诊断在最佳诊断点时的AUC值分别为0.725、0.713、0.723，三者联合诊断时的AUC值为0.867。结论采用HE4、CA125联合超声诊断较单独诊断子宫内膜癌时整体效能更佳，临床应用与推广价值较好。

Prediction and diagnosis of postmenopausal endometrial cancer by the combination of human epididymal secretory protein 4, carbohydrate antigen 125 and ultrasound

ObjectiveTo investigate the diagnostic value of human epididymal secretory protein 4 (HE4), carbohydrate antigen 125 (CA125) combined with ultrasound in postmenopausal endometrial carcinoma.MethodsA total of 101 patients with postmenopausal endometrial cancer were selected as malignant group, 103 patients with postmenopausal endometrial hyperplasia as benign group, and 105 menopausal healthy examinees as control group.The levels of HE4 and CA125 in three groups were detected.The sensitivity, specificity and diagnostic odds ratio were calculated under combined detection, and the area under the receiver operating characteristic curve (AUC) was calculated.ResultsSeventy-eight abnormal cases were found in malignant group by colorful Doppler ultrasound.The expression level and positive rate of HE4 and CA125 in malignant group were higher than those in benign group and control group, and which in benign group were higher than those in control group(P < 0.05 to P < 0.01).The sensitivity and diagnostic odds ratio of combined diagnosis were higher than that of HE4, CA125 and ultrasound alone(P < 0.01 and P < 0.05), but the specificity between them was not statistically significant(P>0.05).The AUC values of simple HE4, CA125 and ultrasound diagnosis at the best diagnosis point were 0.725, 0.713 and 0.723, respectively, and the AUC value of combined diagnosis of HE4, CA125 and ultrasound was 0.867.ConclusionsCompared with simple diagnosis, the overall diagnostic efficacy of HE4 and CA125 combined with ultrasound for endometrial tumor is better, which has better clinical application and promotion value.