HE4等血清标志物检测在卵巢肿瘤早期诊断及随访中的应用

目的探讨HE4等血清标志物检测在卵巢肿瘤早期诊断及随访中的应用价值。方法选择卵巢恶性疾病肿瘤患者35例(研究组)和卵巢良性疾病患者152例(对照组)。检测血清人附睾蛋白4(HE4)、糖类抗原125(CA125)、糖类抗原199(CA199)、癌胚抗原(CEA)、甲胎蛋白(AFP)水平,并对卵巢癌患者随访时检测HE4和CA125水平。结果研究组HE4、CA125和CA199显著高于对照组,CEA、AFP在两组中无显著差异。HE4+CA125+CA199检测获得了最高诊断效能,其灵敏度、特异度、阳性预测值、阴性预测值、符合率分别为91.4%、81.6%、53.3%、97.6%、83.4%,ROC曲线下面积为0.86。HE4浓度变化预测卵巢癌阴转、阳转的符合率分别为75.9%和83.3%。HE4+CAl25联合检测预测卵巢癌阴转、阳转的符合率分别为79.3%和100%。结论 HE4+CA125+CA199对早期卵巢癌有较高的诊断效能;HE4+CA125可作为卵巢癌较好的病情和疗效动态监测指标。

HE4 and other serum markers in the early diagnosis and follow-up of ovarian cancer

Objective To investigate human epididymis protein 4（ HE4） and other serum markers in the early diagnosis and follow-up of ovarian cancer. Methods Thirty- five patients with ovarian cancer（ study group） and 152 patients with benign ovarian diseases（ control group） were collected. Serum HE4,CA125,CA199,CEA,alpha- fetoprotein（ AFP） levels were detected. The levels of HE4 and CA125 were also detected in ovarian cancer patients at follow- up. Results HE4,CA125 and CA199 levels were significantly higher in study group. There were no significant differences in the levels of CEA and AFP between two groups. The combined detection of HE4,CA125 and CA199 reached highest diagnostic performance,with sensitivity,specificity,positive predictive value,negative predictive value,and consistent rate of 91. 4%,81. 6%,53. 3%,97. 6%,and 83. 4%,respectively. The area under the ROC curve was 0. 86. Consistent rates in HE4 concentration to predict positive change and negative change in ovarian cancer were 75. 9% and 83. 3%,respectively. Consistent rates in combined detection of HE4 and CA125 to predict positive change and negative change in ovarian cancer were 79. 3% and 100%,respectively. Conclusion The combined detection of HE4,CA125,and CA199 has a high performance in early diagnosis of ovarian cancer; and the combined detection of HE4 and CA125 can be a good indicator for dynamic monitoring of disease status and therapeutic effect in ovarian cancer patients.