目的：探讨血清人附睾蛋白（HE4）、CA125和CA199联合检测对子宫内膜癌的诊断价值。方法：选择118例子宫内膜癌患者（A组）与82例子宫良性疾病患者（B组），检测血清HE4、CA125和CA199水平，比较不同指标联合检测的阳性率。结果：A组血清HE4、CA125、CA199水平、阳性率均显著高于B组（P ＜0．05）。 A组血清HE4的阳性率最高，B组无HE4阳性患者。联合检测以HE4＋ CA125＋ CA199灵敏度、准确度最高，分别为94．9％、92．5％。 HE4、CA125和CA199水平及阳性率随FIGO分期均呈增高趋势（P ＜0．05），且各期HE4阳性率均高于CA125、CA199阳性率（P ＜0．05）。结论：HE4可用于鉴别子宫良恶性疾病，且较CA125、CA199对子宫内膜癌具有更高的诊断价值。联合检测HE4、CA125、CA199在鉴别子宫良恶性疾病基础上，提高子宫内膜癌诊断的阳性率、准确度。%Objective To explore the values of combined detection of serumhuman epididymis protein E4 , CA125 and CA199 in diagnosis of endometrial cancer. Methods 118 patients with endometrial cancer were chosen as group A, 82 patients with benign uterine disease were assigned to group B. Serum levels of HE4, CA125 and CA199 were detected and the positive rates were compared between the two groups. Results Serum levels of HE4, CA125, and CA199, the positive rate were significantly higher in group A than in group B (P <0.05). HE4 positive rate was highest in group A, and group B had no HE4-positive patients. The sensitivity and accuracy of HE4 + CA125 + CA199 were the highest, which was 94.9% and 92.5%. Levels of HE4, CA125 and CA199 and positive rate showed a rising trend as FIGO stage increased (P < 0.05), and HE4 positive rate was significantly higher than those of CA125 and CA199 (P < 0.05). Conclusions HE4 can be used to identify benign and malignant diseases in the uterus , and has a higher diagnostic value of endometrial cancer as compared with CA125 and CA199. Combined detection of HE4, CA125 and CA199 can improve the positive rate and diagnosis accuracy in endometrial cancer.
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