血清HE4与CA125联合检测在上皮性卵巢癌风险评估中的应用

目的探讨血清人附睾上皮分泌蛋白4(HE4)与CA125联合检测在卵巢癌风险评估中的应用价值。方法采用CMIA法检测78例上皮性卵巢癌、41例妇科良性病变及50例健康对照者血清HE4和CA125水平。结果 (1)在未绝经组中,卵巢癌患者HE4与CA125水平明显高于卵巢良性疾病组和健康对照组(P<0.01)。(2)在绝经组中,卵巢癌患者HE4与CA125水平也明显高于卵巢良性疾病组和健康对照组(P<0.01)。(3)在未绝经组中,HE4单项检测对卵巢癌预测的特异度、阳性预测值(分别为95.7%和90.9%)高于CA125单项检测的特异度、阳性预测值(分别为69.9%和60.0%)。(4)在绝经组中,HE4单项检测对卵巢癌预测的特异度、阳性预测值(分别为92.7%和92.1%)也高于CA125单项检测的特异度、阳性预测值(分别为66.0%和69.2%)。(5)对于卵巢疾病患者,未绝经者与绝经者卵巢发病风险计算>7.4%和25.3%时,可能存在卵巢癌发病的高风险。结论 HE4是一种较理想的卵巢癌肿瘤标志物,HE4与CA125敏感性相当,但HE4单项检测诊断卵巢恶性肿瘤的特异性优于CA125单项检测,联合CA125检测对评估患卵巢癌的风险性有重要价值。

Application of joint detection of HE4 and CA125 serum levels on risk assessment of epithelial ovarian cancer

Objective To evaluate the value of joint detection of human epididymis protein 4(HE4) and CA125 serum levels on risk assessment of ovarian cancer.Methods HE4 and CA125 were detected by CMIA in epithelial ovarian cancer patients(n=78),benign ovarian disease patients(n=41) and healthy controls(n=50).Results(1)The level of HE4 was significantly higher in ovarian group than that in benign ovarian disease group and healthy controls group in premenopausal women(P<0.01).(2)The level of HE4 was also significantly higher in ovarian group than that in benign ovarian disease group and healthy controls group in postmenopausal women(P<0.01).(3) The specificity and positive predictive value of HE4 assay were(95.7% and 90.9%),which were higher than those of CA125 assay(69.9% and 60.0%) in premenopausal women.(4)The specificity and positive predictive value of HE4 assay were(92.7% and 92.1%),which were higher than those of CA125 assay(66.0% and 69.2%) in postmenopausal women too.(5)The high risk of malignancy group was defined as the ROMA value>7.4% for premenopausal women and >25.3% for postmenopausal women.Conclusion HE4 is an ideal tumor marker,and the sensitivity of HE4 was similar to that of CA125,but the specificity of HE4 assay is higher than CA125 assay in the diagnosis of ovarian cancer.HE4 combined with CA125 assay has important value in ROMA.