HE4、OPN、CA125在诊断上皮性卵巢癌中的价值探讨

目的:探讨人附睾蛋白4(HE4)和骨桥蛋白(OPN)、CA125在诊断上皮性卵巢癌(EOC)中的价值。方法:测定EOC患者73例、交界性卵巢肿瘤12例,卵巢良性肿瘤患者56例及50例健康妇女的血清HE4、OPN和CA125水平,并作对比分析。结果:EOC组和交界组患者OPN、HE4的水平明显高于卵巢良性肿瘤患者及健康妇女(P<0.05),后两者OPN、HE4的水平无统计学意义(P>0.05)。HE4、OPN和CA125对EOC诊断的敏感性和特异性分别为83.56%和89.29%、79.45%和83.93%、67.12%和51.79%,且OPN预测黏液性囊腺癌的敏感度高于CA125和HE4。CA125与HE4、OPN三联检敏感性最高可达95.89%,HE4+CA125敏感性93.15%,其特异性82.14%明显优于三联检的特异性57.14%。结论:血清HE4、OPN单检或与CA125联检对早期EOC具有较高的诊断价值,尤其是HE4+CA125可能是EOC早期诊断的最佳组合之一。

The Diagnostic Values of Combined Determination of Serum Tumor Markers HE4,OPN and CA125 Levels in Patients with Epithelial Ovarian Cancer

Objective:To explore the specific value of combined measurement of serum human epididymis protein4(HE4),Osteopontin(OPN),and CA125 in patients with Epithelial ovarian cancer.Methods:Colleted and ascertained serum levels of OPN,HE4 and CA125 in EOC(73 cases),borderline ovarian tumors(12 cases),benign ovarian tumor(56 cases) and healthy women controls(50 cases),By means of enzyme linked immunosorbent assay(ELISA),We analysed values of combined determination of OPN,HE4 and CA125 in Epithelial ovarian cancer.Results:The serum levels of OPN,HE4 and CA125 in EOC group and borderline ovarian tumors were significantly higher than the benign epithelial ovarian tumor group and healthy women group(P<0.05,respectively),but the comparison of the serum levels of CA125,OPN and HE4 were no statistically significant between the former two groups and between the latter two groups(P>0.05,respectively).In the joint test,the specificity(82.14%) of CA125+HE4 were higher,the sensitivity(93.15%) after the joint of three(95.89%),but the specificity of latter was lowest(57.14%).Conclusion:Detect the OPN,HE4 and CA125 in epithelial ovarian cancer has important value for clinical applications.Combined determinationed could greatly improved the early diagnosis rate in epithelial ovarian cancer.The CA125+HE4 can hopefully become the best combination for the early detection of EOC,especially.