血清人附睾蛋白4在肺癌诊断中的临床应用探讨

目的 探讨血清人附睾蛋白4(human epididymis protein 4，HE4)在肺癌诊断中的价值。 方法 选取肺癌患者86例作为肺癌组，健康人76例作为对照组纳入研究，分别采用酶联免疫吸附法(ELISA)和电化学发光仪及配套试剂进行血清HE4和CEA检测，比较检测值变化。以组织病理检查作为金标准，并分别绘制ROC曲线，比较HE4对肺癌的诊断价值。 结果 肺癌组血清HE4水平(257.93±40.51) pmol/L显著高于对照组(257.93±40.51) pmol/L，而不同肺癌分期患者其血清HE4表达水平差异无统计学意义[Ⅰ～Ⅲ:(251.68±38.59) pmol/L；Ⅳ:(268.49±40.66) pmol/L,P=0.60]。不同病理类型肺癌患者其血清HE4表达水平差异无统计学意义[肺腺癌组:(261.37±34.21) pmol/L,肺鳞癌组:(257.42±42.86) pmol/L，肺未分化癌组:(259.75±28.13) pmol/L,肺小细胞癌组:(266.54±35.72) pmol/L]。HE4/CEA的ROC曲线下面积分别为0.908/0.839，敏感性73.3%/57.9%,特异性90.8%/86.7%,HE4明显优于CEA，两者联合检测，亦可明显提高肺癌诊断敏感性，为79.1%，特异性为85.5%。 结论 HE4可作为肺癌诊断的标志物之一，其对于肺癌诊断具有一定的临床价值。 

The diagnostic value of human epididymis protein 4 in lung cancer

Objective To investigate the diagnostic value of human epididymis protein 4(HE4) in lung cancer. Methods Serum HE4 level and carcinoembryonic antigen(CEA) level were measured in serum samples from 86 patients with lung cancer and 76 healthy controls using enzyme-linked immunosorbent assay(ELISA) and with electrochemical luminescence instrument and related reagents. Receiver operating characteristic(ROC) curve of HE4 and CEA for differentiation between lung cancer and healthy controls was drawn with the pathological diagnosis as the golden standard. At last,to explore the diagnostic value of HE4 combined with CEA. Results It proved that serum HE4 levels were significantly higher in lung cancer group[(257. 93 ±40. 51) pmol/L]than in control group[(257. 93 ±40. 51) pmol/L]. No significant difference was observed between stage Ⅰ- Ⅲ group[(251. 68 ±38. 59) pmol/L] and stage Ⅳ group[(268. 49 ±40. 66) pmol/L,P=0. 60)]. No significant difference was observed among Different pathological type of lung cancer(lung adenocarcinoma group:(261. 37 ±261. 37) pmol/L,lung squamous carcinoma group:(257. 42 ±257. 42) pmol/L,undifferentiated carcinoma of the lung group:(259. 75 ±28. 13) pmol/L,small cell lung cancer group:(266. 54 ±266. 54) pmol/L. The areas under the receiver operating characteristic(ROC) curve of serum HE4/CEA was 0. 908/0. 839. And the sensitivity of HE4 combined with CEA was 79. 1% which was larger than CEA(57. 9%) or HE4(73. 3%) alone. The specificity of HE4 combined with CEA was 85. 5%. For HE4,the specificity was 90. 8% and for CEA it was 86. 7%. Conclusion HE4 could be a potential diagnostic marker for lung cancer patients and has certain clinical value in the diagnosis of lung cancer.