人附睾蛋白4、溶血磷脂酸和糖类抗原125联合检测在上皮性卵巢癌诊断中的价值

目的探讨人附睾蛋白4(HE4)、溶血磷脂酸(LPA)和糖类抗原125(CA125)联合检测在上皮性卵巢癌诊断中的价值。方法按照入选标准选取2013年1月至2014年2月新乡医学院第一附属医院妇产科收治的上皮性卵巢癌患者(卵巢癌组)30例、卵巢良性肿瘤患者(良性肿瘤组)30例及同期门诊体检的健康女性(健康对照组)20例,分别采用酶联免疫吸附法测定受检者血清HE4水平,电化学免疫发光法测定血清CA125水平,无机定磷法检测血浆LPA水平,通过绘制受试者工作特征曲线,计算曲线下面积(AUC)、敏感度及约登指数,分析HE4、LPA、CA125单项及联合检测在诊断上皮性卵巢癌中的价值。结果卵巢癌组血清HE4、CA125及血浆LPA水平明显高于良性肿瘤组及健康对照组,差异有统计学意义(P<0.05),良性肿瘤组与健康对照组比较差异无统计学意义(P>0.05)。Ⅲ^Ⅳ期卵巢癌患者血HE4、CA125、LPA水平明显高于ⅠⅣ期卵巢癌患者血HE4、CA125、LPA水平明显高于Ⅰ^Ⅱ期患者,差异有统计学意义(P<0.05)。以病理诊断为金标准,将良性肿瘤组及健康对照组作为参照人群,并取特异度90%作为诊断界值时,血HE4、LPA、CA125联合检测与单项及2项联合检测相比,AUC、敏感度、约登指数显著提高,差异有统计学意义(P<0.05)。结论 HE4、LPA和CA125联合检测有利于提高上皮性卵巢癌的诊断率,减少漏诊,且其水平高低可以在一定程度上反映上皮性卵巢癌的恶性程度。

Value of combined detection of human epididymis secretory protein 4,lysophosphatidic acid and cancer antigen 125 in the diagnosis of epithelial ovarian cancer

Objective To evaluate the value of combined detection of human epididymis secretory protein 4（HE4）,lysophosphatidic acid（LPA） and cancer antigen 125（CA125） in the diagnosis of epithelial ovarian cancer. Methods A total of80 cases consist of 30 cases with epithelial ovarian cancer（ epithelial ovarian cancer group）,30 cases with ovarian benign tumor（ovarian benign tumor group） and 20 healthy people who had physical examination during the same period（healthy control group） in Department of Gynecology and Obstetrics,the First Affiliated Hospital of Xinxiang Medical University,from January 2013 to February 2014 were enrolled in this prospective study. The level of HE4 was measured by enzyme-linked immunosorbent assay,the level of CA125 was measured by chemiluminescence analysis system,while LPA was measured by inorganic phosphorus method. The receiver-operating characteristics curve was used to calculate the area under the curve（AUC）,sensitivity and about index in order to investigate the difference of clinical application value of HE4,LPA and CA125 between single detection and joint detection in diagnosis of epithelial ovarian cancer. Results The levels of HE4,CA125 and LPA in ovarian cancer group were significantly higher than those in ovarian benign tumor group and healthy control group（P〈0. 05）,while there was no significant difference between ovarian benign tumor group and healthy control group（P〉0. 05）. The levels of HE4 and CA125 in Ⅲ- Ⅳ pathological grade were significantly higher than those of in Ⅰ- Ⅱ pathological grade（ P〈0. 05）. In pathological diagnosis as the gold standard,and ovarian benign tumor group and healthy control group were made as a reference to the crowd,and specificity of 90% was took as a diagnostic specificity,the AUC,sensitivity and about index of combined detection of HE4,LPA and CA125 were significantly higher than those of single tumor marker and two joint tumor markers detection,the differences were statistically significant（ P〈