Objective To evaluate the value of detecting serum human epididymis secretory protein 4( HE4) and CA125 in early stage and different pathologic subtypes of endometrial cancer. Methods HE4 and CA125 serum levels of endometrial cancer pa-tients(n=62) and normal people(n =66) were assayed double blindly by ELISA and chemiluminescence methods. The results were analyzed to evaluated the efficiency of two methods in diagnosing endometrial cancer. Results HE4 serum levels of endometrial cancer patients were hingher than that of normal people( 209. 8 ± 27.3 pmol/L vs. 95.0 ± 14.6 pmol/L, P < 0. 05), while CA125 of two groups were similar ( 39.2 ± 9.4 U/L vs. 29. 1 ± 8.5 U/L, P > 0. 05). The optimal critical point of HE4 was determined to be 141. 5pmol/L based on the ROC curve, and CA125 was 54. 5U/L. The statistical difference was distinct of HE4 level between the early stage patients and normal people ( 157. 1 ± 23. 4 pmol/L vs. 95. 0 ± 14. 6 pmol/L, P < 0.05 ), while there was no difference of CA125 in these two groups(29. 9 ± 12. 1 U/L vs. 29. 1 ± 8. 5 U/L, P > 0. 05). There was significant statistical difference between stage I and III both HE4 and CA125( P <0.0167) , and no difference between stage I and II. There was statistical difference of HE4 between the stage II and IK ( P < 0. 0167), but CA125 was not. The sensitivity of HE4 for diagnosing papillary serous endometrial cancer was higher than that of endometrioid adenocarcinoma( 89.4% vs. 45. 1 % , P < 0.05) when specificity was set as 95%. Conclusion HE4 has been proved high sensitivity among early endometrial cancer, and higher authority in diagnosing papillary serous endometrial cancer than that of endometrioid adenocarcinoma.%目的 比较血清人附睾分泌蛋白4(HE4)与CA125检测对早期及不同病理亚型子宫内膜癌的诊断价值.方法分别采用酶联免疫吸附试验及化学发光法对子宫内膜癌组(62例)及正常子宫内膜组(66例)血清HE4及CA125水平进行检测,评估两种诊断方法对子宫内膜癌的诊断价值.结果 (1)与正常组比较,HE4在子宫内膜癌患者血清中明显升高[ (209.8±27.3)pmol/L vs.(95.0±14.6)pmol/L,P＜O.05],而CA125无明显差异[(39.2±9.4)U/Lvs.(29.1±8.5) U/L,P＞0.05].(2)经受试者工作特征曲线法(ROC)计算,血清HE4和CA125诊断子宫内膜癌的最佳临界检测值分别为141.5pmol/L及54.5 U/L.(3)早期子宫内膜癌患者(I期)血清HE4浓度与正常人群比较,差异有统计学意义[(157.1±23.4) pmol/L vs.(95.0±19.2) pmol/L,P＜0.05)],而血清CA125无明显差异[(29.9±12.1)U/L vs.(29.1±9.4) U/L,P＞0.05].血清HE4和CA125在子宫内膜癌Ⅰ、Ⅱ期之间差异无统计学意义(P＞0.0167)；在Ⅰ、Ⅲ期之间差异均有统计学意义(P ＜0.0167)；在Ⅱ、Ⅲ期之间,HE4差异有统计学意义(P＜0.0167),而CA125差异无统计学意义(P＞0.0167).(4)在特异度为95%时,HE4对子宫内膜浆液性乳头状腺癌的敏感性高于子宫内膜样腺癌(89.4% vs.45.1%,P＜0.05).结论血清HE4检测在早期子宫内膜癌的诊断上较CA125更佳,且对子宫内膜浆液性乳头状腺癌的敏感性比对子宫内膜样腺癌更高.
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