联合检测HE4、CA125、CA19-9和CEA在卵巢癌诊断中的应用

摘要

ObjectiveTo discuss the application value of HE4, CA125, CA19-9 and CEA in the diagnosis of ovarian cancer.Method75 patients who were diagnosed as ovarian cancer and didn't accept surgery were selected and assigned into cancer group, 75 patients with benign gynecologic disease were selected and assigned into benign disease group, 75 healthy women were selected into control group. Tested the levels of HE4, CA125, CA19-9 and CEA in the three groups, and compared the diagnosibility of ovarian cancer among the single detection and combined detection.ResultThe levels of HE4, CA125, CA19-9 and CEA in cancer group were all obviously higher than benign disease group and control group (P<0.01), and the levels of HE4, CA125, CA19-9 and CEA in benign disease group were higher than control group (P<0.05); in single detection, the sensitivity of HE4 and CA125 were both higher than sensitivity of CA19-9 and CEA (P<0.05); the diagnose accordance rate of HEA and CA125 were both higher than sensitivity of CA19-9 and CEA (P<0.01); the sensitivity of combined detection was higher than single detection (P<0.01); the diagnose accordance rate of combined detection was not different from HE4 and CA125 (P>0.05); single detection of four kinds of tumor marker had low diagnosibility forⅠandⅡstage of ovarian cancer; the sensitivity of combined detection forⅠ,Ⅱ andⅢstage of ovarian cance were higher than single detection (P<0.01). ConclusionThe sensitivity of combined detection of HE4, CA19-9, CA125 and CEA in the diagnosis of ovarian cancer is signiifcantly higher than single detection, combined diagnosis has the advantage of early diagnosis of ovarian cancer.%目的：探讨人附睾分泌蛋白4（HE4）、糖类抗原125（CA125）、糖类抗原19-9（CA19-9）及癌胚抗原（CEA）在卵巢癌诊断中的应用价值。方法选取确诊为卵巢癌且未接受手术的患者75例纳入癌症组，选取妇科良性疾病患者75例纳入良性组，选取健康女性75例纳入对照组。检测三组研究对象血清HE4、CA125、CA19-9及CEA的表达水平，并比较单项检测与联合检测上述4种肿瘤标志物诊断卵巢癌的能力。结果癌症组患者血清HE4、CA125、CA19-9及CEA表达水平均明显高于良性组及对照组（P＜0.01），良性组患者血清HE4、CA125、CA19-9及CEA表达水平均高于对照组（P＜0.05）；单项检测中，HE4及CA125灵敏度明显高于CA19-9与CEA（P＜0.05），HE4及CA125诊断符合率明显高于CA19-9及CEA（P＜0.01）；联合检测灵敏度明显高于单项检测（P＜0.01），诊断符合率与HE4及CA125单项检测比较无显著差异（P＞0.05）；单项检测4种肿瘤标志物对Ⅰ、Ⅱ期卵巢癌的诊断能力均较低，联合检测对Ⅰ、Ⅱ及Ⅲ期卵巢癌的检出能力明显高于单项检测（P＜0.01）。结论联合检测HE4、CA125、CA19-9及CEA诊断卵巢癌的灵敏度明显高于单项检测，同时联合检测对早期卵巢癌的检出能力较好。