血清HE4、CA125和CA199联合检测对卵巢癌早期诊断的临床研究

摘要

Objective To investigate the value of detection of human epididymal epithelial secretory protein (HE4) ,carbohy-drate antigen (CA125) and carbohydrate antigen (CA199) in the early diagnosis of ovarian cancer .Methods The clinical data of patients admitted to the hospital from June 2014 to August 2016 were collected from Renmin Hospital of Wuhan University .Ac-cording to the postoperative pathology ,the patients were divided into ovarian cancer group and ovarian benign tumor group .There were 90 cases in ovarian cancer group and 94 cases in ovarian benign tumor group ,98 cases of healthy women in the physical exami-nation center of this hospital were selected as healthy control group .HE4 was detected by ELISA ,serum CA125 and CA199 were detected by chemiluminescence method .Results Compared with healthy control group ,the tumor markers of serum HE4 ,CA125 and CA199 levels were significantly increased (P<0 .01) ,and HE4 and CA125 levels increased more significantly .Compared with ovarian benign tumor group ,the levels of HE4 and CA125 significantly increased in ovarian cancer group ,the difference was statisti-cally significant (P<0 .01) ,and the increase of CA199 less(P<0 .05) .Compared with healthy control group ,the levels of CA125 and CA199 in the benign ovarian tumor group were significantly increased (P<0 .05) .Correlation analysis showed that there were strong correlations between the 3 indexes of HE4 ,CA125 and CA199 in the ovarian cancer group(P<0 .01) .The sensitivity of ser-um CA125 was highest (87 .8% ) in the detection of single marker of ovarian cancer ,while the specificity of serum HE4 was the highest(95 .7% ) .The sensitivity of combined detection of serum HE4 ,CA125 and CA199 was the highest (96 .7% ) ,but the speci-ficity was poor (61 .0% ) .Conclusion Combined detection of serum HE4 ,CA125 and CA199 could significantly improve the early detection rate of ovarian cancer ,but the specificity must be combined with other laboratory tests ,comprehensive analysis and diag-nosis .%目的 探讨血清人附睾蛋白4(HE4)、糖类抗原125(CA125)和糖类抗原199(CA199)联合检测在卵巢癌早期诊断中的价值.方法 选取武汉大学人民医院妇产科2014年6月至2016年8月收治入院患者的临床资料,依据术后组织病理报告结果 ,将患者分为卵巢癌组和卵巢良性肿瘤组,其中卵巢癌患者90例,卵巢良性肿瘤患者94例,同期选取该院体检中心体检的健康女性98例作为健康对照组.该研究采用酶联免疫吸附试验(ELISA)法检测血清HE4水平,采用化学发光法检测血清CA125和CA199水平.结果与健康对照组比较,卵巢癌组中血清HE4、CA125、CA199水平均显著升高,差异有统计学意义(P<0.01),其中HE4和CA125水平升高更为明显.与卵巢良性肿瘤组比较,卵巢癌组HE4、CA125水平显著升高,差异有统计学差异(P<0.01),CA199轻度升高(P<0.05).与健康对照组比较,卵巢良性肿瘤组中CA125、CA199水平亦有明显升高(P<0.05).相关性分析结果显示,卵巢癌组中HE4、CA125和CA1993个检测指标间均有较强相关性,差异有统计学意义(P<0.01).在卵巢癌单项标志物检测中,血清CA125的灵敏度最高(87.8%),而血清HE4的特异度最高(95.7%).血清HE4、CA125和CA199联合检测的灵敏度最高(96.7%),而特异度较差(61.0%).结论 血清HE4、CA125和CA199联合检测可显著提高卵巢癌检出率,但特异度尚需结合其他实验室检查综合分析诊断.