血清3种肿瘤标志物检测在卵巢肿瘤诊断与临床分期中的应用

摘要

目的：研究和评价HE4、CA125和PDGF-BB三种血清肿瘤标志物在恶性卵巢肿瘤诊断、临床分期和治疗中的应用价值。方法选择2012年6月22日~2014年10月28日扬州市苏北人民医院、扬州市第一人民医院收治的卵巢包块患者216例（均行手术等治疗），其中未绝经组恶性卵巢肿瘤26例、良性卵巢肿瘤53例及60例健康女性（对照组）；绝经组恶性卵巢肿瘤50例、良性卵巢肿瘤87例及108例健康女性（对照组）。同期选择在该院体检中心经体检合格的健康女性168例作为对照组，利用免疫化学发光法和ELISA法检测未绝经组和绝经组中患者血清HE4、CA125和PDGF-BB含量，并对比分析三者在恶性卵巢肿瘤的诊断和临床分期中的应用价值。结果恶性卵巢肿瘤患者（包括未绝经组和绝经组）的HE4、CA125和PDGF-BB血清水平均明显高于正常对照组和良性卵巢肿瘤（P均＜0.01）。Spearman相关分析显示相关性具有统计学意义，且HE4的相关性最高（r=0.613)。HE4和CA125的敏感度优于PDGF-BB，差异有统计学意义（均P<0.05），但HE4和CA125两者相比较差异无统计学意义（P＞0.05）。同时HE4的特异度、准确度都是最优的，差异有统计学意义（均P<0.05）。当HE4临界值在未绝经组为36.5 pmol/L时，特异度为88.1%、准确度为87.1%；在绝经组为56.8pmol/L时，特异度为93.5%、准确度为88.7%。结论检测血清HE4、CA125和PDGF-BB肿瘤标志物水平变化，对于了解病情、观察疗效和预后判断均具有实用价值。%ObjectiveTo study and evaluate the application value of HE4, CA125 and PDGF-BB detections for diagnosis and clinical staging of ovarian malignant tumors .Methods216 patients were divided into two groups. Group one (premenopausal group) included26 cases of malignant ovary tumor and53 cases of benign ovary tumor, and60 cases of healthy women as control. Group two (emenopausal group) comprised of50 cases of malignant ovary tumor,87 cases of benign ovary tumor and108 cases of healthy women. HE4, CA125 and PDGF-BB in sera of patients were detected with ICMA and ELISA and the clinical application value in diagnosis of malignant ovarian tumor was analyzed.Results The levels of HE4, CA125 and PDGF-BB in the cases of malignant ovary tumor were significantly higher than those of benign tumors and healthy women (P <0.01). Spearman correlation analysis was staticstically significantly and HE4 was the highest correlation (r=0.613). The sensitivity of HE4 and CA125 was higher than that of PDGF-BB (P <0.05) while no difference was observed between HE4 and CA125 (P>0.05). At the same time, the specificity and accuracy of HE4 reached88.1% and87.1%, respectively when the level of36.5pmol/L was taken as the threshold value in premenopausal group. In the menopausal group, however, the specificity and accuracy were found to be93.5% and88.7% respectively if the cut-off value of56.8pmol/L was used.Conclusion Mornitoring of the three seral tumor markers of serum HE4, CA125 and PDGF-BB possesses a practical significance in helping to master the situation of patients, efficacy of treatments, and assessment of prognosis of malignant ovarian tumors.