HE4与CA125辅助诊断卵巢癌的价值

摘要

目的 比较人类附睾蛋白4(HE4)与糖链抗原125(CA125)在鉴别诊断卵巢上皮癌(EOC)和良性妇科疾病中的价值.方法 选取2013年1月至2016年6月在武汉天佑医院妇科就诊的70例女性为研究对象,其中40例为卵巢上皮癌患者(卵巢癌组),30例为卵巢良性妇科疾病患者(良性疾病组),选取同期来我院体检的20例女性健康体检者为健康对照组,分别测定选取对象的血清HE4和CA125水平,对检测结果进行统计学分析.结果 卵巢癌组血清HE4[(577.5±800.97)pmol/L]和CA125[(217.5±349.84)U/mL]水平明显高于良性疾病组[HE4(75.4±89.87)pmol/L,CA125[(50.97±69.51)U/mL]和健康对照组[HE4(39.95±18.55)pmol/L,CA125(18.35±13.28)U/mL],差异均有统计学意义(P<0.05).HE4的受试者工作曲线(ROC曲线)下面积为0.96(95%CI 0.99~1.00),而CA125的ROC曲线下面积为0.858(95%CI 0.778~0.938).与CA125比较,HE4具有更高的灵敏度(90.0%vs 82.5%)、特异性(96.0%vs 84.0%),阳性预测值(94.7%vs 80.5%)和阴性预测值(92.3%vs 85.7%).联合测定HE4和CA125的灵敏度可达到95.0%.结论 联合检测血清HE4浓度与CA125浓度可为诊断卵巢上皮癌提供更高的精确度.%Objective To evaluate a novel tumor marker, human epididymis protein 4 (HE4), in comparison with carbohydrate antigen-125 (CA-125), in diagnosis of epithelial ovarian cancer (EOC) and benign gynecological diseases. Methods From Jan. 2013 to Jun. 2016, CA125 and HE4 serum levels were determined in 40 patients with epithe-lial ovarian cancer (ovarian cancer group), 30 patients with benign gynecological diseases (benign diseases group) and 20 healthy women (control group), and the testing results were statistically analyzed. Results Serum HE4 and CA125 con-centrations in the ovarian cancer group were (577.5±800.97) pmol/L and (217.5±349.84) U/mL, which were significantly higher than (75.4 ± 89.87) pmol/L and (50.97 ± 69.51) U/mL in benign diseases group and (39.95 ± 18.55) pmol/L and (18.35 ± 13.28) U/mL in control group (P<0.05). In the receiver operating characteristic analysis (ROC), the area under the curve (AUC) for HE4 was 0.96 (95%confidence interval 0.99-1.00) and that for CA125 was 0.858 (95%confidence interval, 0.778-0.938). Compared to CA125, HE4 had higher sensitivity (90.0%vs 82.5%), specificity (96.0%vs 84.0%), positive predictive value (94.7% vs 80.5%) and negative predictive value (92.3% vs 85.7%). The combination of HE4 and CA125 reached the sensitivity of 95.0%. Conclusion Measuring concentrations of HE4 combined with CA125 may provide higher accuracy for detecting epithelial ovarian cancer.