月经周期及年龄对血清人附睾分泌蛋白4和 CA125水平的影响

摘要

Objective To investigate the fluctuations in serum concentration of human epididymal secretory protein human epididymis -specific protein 4( HE4)during the phases of the menstrual cycle and the correlation between HE4 values and age in healthy young women. Methods Forty - five women with regular menstrual cycles were included in the study. All selected candidates are divided into two groups based on age. Blood samples were collected at follicular(FP),ovulatory(OP),and luteal(LP)phases of the hormonal cycle. Results The values of HE4 observed were 38. 9 ± 1. 2 pmol/ L(FP),45. 7 ± 1. 1 pmol/ L(OP),and 41. 9 ± 1. 2 pmol/ L(LP). The difference between FP and OP was statistically significant( P = 0. 0002). By contrast,serum CA125 levels were 13. 9 ± 0. 7 IU / ml( FP),13. 2 ± 0. 4 IU / ml( OP),and 13. 6 ± 0. 4 IU / ml(LP),respectively. The differences between the three phases of the hormonal cycle were not statistically significant( P >0. 05). The levels of HE4 observed in serum samples of women less than or equal to 35 years were 37. 6 ± 1. 3 pmol/ L in the FP,46. 7 ± 1. 3 pmol / L in the OP,and 42. 7 ± 1. 5 pmol/ L in the LP. In this group,a statistically significant difference was observed in the FP compared with the OP( P < 0. 0001). The levels of HE4 observed in serum samples of women over 35 years were 44. 2 ± 0. 8 pmol/ L in the FP,42. 3 ± 1. 7 pmol/L in the OP,and 39. 1 ± 2. 0 pmol/ L in the LP,no statistically significant difference was observed during the different hormonal phases in the group of women over 35. The levels of CA125 observed in serum samples of women less than or equal to 35 years old were 12. 8 ± 0. 7 IU/ ml in the FP,12. 5 ± 0. 7 IU/ ml in the OP,and 13. 2 ± 0. 7 IU/ ml in the LP. There wasnˊt a statistically significant difference in the group. The levels of CA125 observed in serum samples of women over 35 years were 13. 3 ± 0. 7 IU/ ml in the FP,13. 6 ± 0. 8 IU/ ml in the OP,and 13. 7 ± 0. 6 IU/ml in the LP,no statistically significant difference was observed during the different menstrual phases in the group of women over 35 years old. Conclusion In the young women ,it is essential to define a threshold of normality of the HE4 marker which is affected by menstrual cycle;but the CA125 has little change during different phases of menstrual cycle.%目的：观察育龄女性月经周期和年龄对血清人附睾分泌蛋白4（HE4）和 CA125水平的影响。方法选取2011年1月至2015年10月华北石油管理局总医院和北京友谊医院体检中心45例月经周期正常并排除妊娠的健康女性作为本研究对象。根据年龄分为两组，≤35岁组22例，＞35岁组23例。分别于月经周期的卵泡（ FP）期，排卵（OP）期，黄体（LP）期采集两组妇女血清样本，分别检测 HE4和 CA125水平。结果①月经周期各个阶段 HE4和CA125水平的变化：血清 HE4水平分别为：FP 期（38.9±1.2）pmol/ L，OP 期（45.7±1.1）pmol/ L 和 LP 期（41.9±1.2） pmol/ L，其中 FP 期明显低于 OP 期（ P =0.0002），而 FP 期与 LP 期、LP 期与 OP 期差异无显著性（ P ＞0.05）。血清CA125水平分别为：FP 期：（13.9±0.7）IU/ ml，OP 期：（13.2±0.4）IU/ ml 和 LP 期：（13.6±0.4）IU/ ml，月经各阶段无显著差异。②不同年龄组月经周期各个阶段 HE4和 CA125水平的变化：血清 HE4水平：≤35岁组在 FP 期、OP 期、LP 期分别为（37.6±1.3）pmol/ L、（46.7±1.3）pmol/ L、（42.7±1.5）pmol/ L，该组中观察到 FP 期 HE4水平明显低于 OP 期（ P ＜0.0001），而 FP 期与 LP 期及 LP 期与 OP 期水平比较差异无显著性；＞35岁组 FP 期、OP 期和 LP 期 HE4水平分别为（44.2±0.8）pmol/ L、（42.3±1.7）pmol/ L 和（39.1±2.0）pmol/ L，该组患者月经周期不同阶段 HE4水平比较差异无显著性（ P ＞0.05）。血清 CA125水平：≤35岁组 CA125水平在 FP 期、OP 期和 LP 期水平分别为（12.8±0.7）IU/ ml、（12.5±0.7）IU/ ml、（13.2±0.7）IU/ ml，该组月经周期不同阶段 CA125水平比较差异无显著性（ P ＞0.05）；＞35岁组FP 期、OP 期和 LP 期分别为：（13.3±0.7）IU/ ml、（13.6±0.8）IU/ ml、（13.7±0.6）IU/ ml，＞35岁组月经周期不同阶段CA125水平比较差异无显著性（ P ＞0.05）。结论在育龄女性中界定 HE4诊断界值可能受月经周期不同阶段激素水平的影响，而血清 CA125水平在月经周期各阶段变化不明显。