联合检测CA125与HE4在子宫内膜癌诊断中的价值

目的:探讨血清HE4及HE4和CA125联合检测在子宫内膜癌诊断中的应用价值。方法:应用ELISA和放免法分别测定子宫内膜癌、功能失调性子宫出血(功血)患者及健康对照妇女各30例的血清HE4和CA125水平,比较三组间HE4和CA125水平与阳性率的差异,HE4手术治疗前后水平的变化,HE4、CA125及HE4和CA125联合检测诊断子宫内膜癌的敏感度及特异度。结果:①子宫内膜癌患者血清HE4含量较另两组明显升高,诊断子宫内膜癌的敏感度为43.33%,特异度为95.00%;子宫内膜癌患者术后血清HE4水平较术前明显下降,差异有统计学意义。②CA125诊断子宫内膜癌的敏感度为39.67%,特异度为98.33%,较HE4单独检测敏感度低,特异度略高。③HE4和CA125联合检测诊断子宫内膜癌的敏感度为53.33%,特异度为95.00%,较CA125、HE4单项检测敏感度增高,特异度较CA125略低。结论:血清HE4检测对子宫内膜癌诊断敏感度高于CA125,HE4与CA125联合检测具有更高的诊断价值;血清HE4含量还可能作为监测子宫内膜癌治疗效果的指标。

Clinical value of combined detection of CA125 and HE4 in diagnosis of endometrial carcinoma

Objective:To explore the application values of human epididymis secretory protein 4(HE4) and combined detection of serum HE4 and CA125 in diagnosis of endometrial carcinoma.Methods:The serum levels of HE4 and CA125 in 30 women with endometrial carcinoma,30 women with dysfunctional uterine bleeding and 30 health women were detected by ELISA and radioimmunoassay,respectively.The serum levels and positive rates of HE4 and CA125,changes of serum HE4 levels before and after surgery,sensitivities and specificities of HE4 detection,CA125 detection and combined detection of HE4 and CA125 in the three groups were compared.Results:The serum level of HE4 in endometrial carcinoma group was significantly higher than those in the other two groups(P<0.05).The sensitivity and specificity of HE4 detection in diagnosis of endometrial carcinoma were 43.33% and 95.00%,respectively.In endometrial carcinoma group,the serum level of HE4 after surgery was significantly lower than that before surgery,there was significant difference.The sensitivity and specificity of CA125 detection in diagnosis of endometrial carcinoma were 39.67% and 98.33%,respectively;the sensitivity of CA125 detection was significantly lower than that of HE4 detection,while the specificity of CA125 detection was significantly higher than that of HE4 detection.The sensitivity and specificity of combined detection of serum HE4 and CA125 in diagnosis of endometrial carcinoma were 53.33% and 95.00%,respectively;the sensitivity of combined detection of serum HE4 and CA125 was significantly higher than those of HE4 detection and CA125 detection,while the specificity of combined detection of serum HE4 and CA125 was significantly lower than that of CA125 detection.Conclusion:The sensitivity of serum HE4 detection in diagnosis of endometrial carcinoma is significantly higher than that of serum CA125 detection,combined detection of serum HE4 and CA125 has a higher diagnostic value;serum HE4 content can be used as an index to monitor the therapeutic efficacy of endometrial carcinoma treatment.