HE4和CA125联合检测对卵巢肿瘤鉴别诊断和病理分型的关系研究

摘要

目的 探讨糖蛋白抗原125(CA125)与人附睾蛋白4(HE4)联合检测的临床价值.方法 选取2013年6月至2015年8月收治的卵巢恶性肿瘤患者46例(恶性肿瘤组),卵巢良性肿瘤患者48例(良性肿瘤组),均检测血清CA125、HE4水平,并以ROC曲线评价其诊断价值,对不同病理分型患者CA125、HE4指标水平进行对比.结果 CA125最佳诊断切值为47.9 U/L,血清CA125≥47.9 U/L预测卵巢恶性肿瘤阳性的特异性为87.34%,敏感性为76.69%;HE4最佳诊断切值为55.68 pmol/L,血清HE4≥55.68 pmol/L预测卵巢恶性肿瘤阳性的特异性为90.34%,敏感性为83.01%;良、恶性卵巢肿瘤患者CA125与HE4水平差异具有统计学意义(P<0.05);CA125、HE4联合检测诊断卵巢恶性肿瘤特异性与单独检测差异无统计学意义(P>0.05),但敏感性明显高于单独检测,差异具有统计学意义(P<0.05);卵巢上皮性肿瘤患者CA125、HE4水平较非卵巢上皮性肿瘤患者高,且差异具有统计学意义(P<0.05);黏液性卵巢恶性肿瘤患者CA125、HE4水平显著低于浆液性卵巢恶性肿瘤患者,且差异具有统计学意义(P<0.05).结论 通过联合检测血清CA125与HE4,可显著提高卵巢肿瘤鉴别诊断价值,且CA125与HE4在卵巢恶性肿瘤病理分型中具有辅助作用.%Objective To investigate the clinical value of combined detection of glycoprotein 125 (CA125) and human epididymis protein 4 (HE4).Methods 46 patients with ovarian malignant tumor (malignant tumor group) and 48 patients with benign ovarian tumors (benign tumor group) treated in our hospital from June 2013 to August 2015 were selected.The serum levels of CA125 and HE4 were detected in all the patients and its diagnostic value was evaluated by ROC curve.The levels of CA125 and HE4 in patients with different pathological types were compared.Results The best diagnostic value of CA125 was 47.9 U/L,The serum level of CA125 ≥47.9 U/L predicted the specificity of ovarian malignant tumor was 87.34% and that the sensitivity was 76.69%.The best diagnostic value of HE4 was 55.68 pmol/L.The serum level of HE4 ≥ 55.68 pmol/L predicted the specificity of ovarian malignant tumor was 90.34% and that the sensitivity was 83.01%.There was significant difference in CA125 and HE4 between the patients with benign and malignant ovarian tumors (P<0.05).No significant difference in the diagnosis of malignant ovarian tumor and the specificity by using combined detection of HE4 and CA125 (P>0.05)However,the sensitivity was significantly higher than that of single detection,the difference was statistically significant (P<0.05).The levels of CA125 and HE4 in patients with epithelial ovarian tumors were higher than those with non epithelial ovarian tumors,and the difference was statistically significant (P<0.05).The levels of CA125 and HE4 in patients with mucinous ovarian cancer were significantly lower than those in patients with serous ovarian cancer (P<0.05).Conclusion The combined detection of serum CA125 and HE4 can significantly improve the value of differential diagnosis of ovarian tumors,and CA125 and HE4 may play an important role in the pathological classification of malignant ovarian tumors.