血清CA125、HE4及OPN联合检测在卵巢癌诊断中的意义

摘要

目的 探讨血清糖类抗原125(CA125)、人附睾蛋白4(HE4)及骨桥蛋白(OPN)联合检测在卵巢癌中的诊断意义.方法 收集2016年8月至2017年5月本院经病理确诊的卵巢良性囊肿患者血清58例,卵巢癌患者血清66例(按照FIGO临床分期标准,其中Ⅰ期17例,Ⅱ期21例,Ⅲ期13例,Ⅳ期15例)作为观察组,同时收集健康体检妇女(经B超检查排除卵巢及其它妇科疾病)的血清样本60例作为正常对照组.分别利用化学发光法检测各组中的血清CA125含量,酶联免疫法检测HE4及OPN含量,通过受试者工作曲线(receiver operator characteristic,ROC)计算曲线下面积(area under the curve,AUC)及各指标的灵敏度和特异性,评价标志物单独及联合检测对卵巢癌的诊断意义.结果 与正常对照组相比,CA125、HE4及OPN在卵巢癌中均有明显的升高,差异有统计学意义(P＜0.05).在卵巢癌组中的Ⅱ、Ⅲ、Ⅳ期,其CA125、HE4及OPN的含量较卵巢囊肿组升高,有统计学差异.CA125、HF4、OPN及CA125+ HF4+ OPN在诊断卵巢癌时,其ROC曲线下AUC分别为0.74、0.89、0.81和0.95;各指标的诊断灵敏度分别为48.2％、76.8％、71.7％及94.5％;特异性为72.7％、87.4％、79.8％及92.6％.结论 卵巢癌患者的血清CA125、HE4及OPN含量明显高于卵巢囊肿患者(除卵巢癌Ⅰ期)及正常人群;相对于单一项目检测,血清CA125、HE4及OPN三者联合检测能大大提高卵巢癌诊断的特异性(除HE4)和灵敏度,为患者的早期诊断提供帮助.%Objective To investigate the clinical value of serum carbohydrate antigen 125 (CA125) combined with human epididymis protein 4 (HE4) and osteopontin (OPN) in the diagnosis of ovarian cancer.Methods 58 cases of serum sample in benign ovarian tumor,66 cases in ovarian cancer (according to the FIGO,including 17 cases of stage Ⅰ,21 cases of stage Ⅱ,13 cases of stage Ⅲ and 15 cases of stage Ⅲ) were enrolled from Aug 2016 to May 2017 in our hospital as the observation group.Those patients were certified by pathology department.Meanwhile,60 cases of healthy women were selected as the control group.Chemiluminescence method was used to detect serum CA125 content in each group and the contents of HE4 and OPN were measured by enzyme-linked immunosorbent assay (ELISA).Using the receiver operator characteristic(ROC) curves,we calculated the area under the curve (AUC).Results Compared with the control group,the contents of CA125,HE4 and OPN were significantly increased in ovarian cancer group (P ＜ 0.05).The contends of these factors in ovarian cancer group of stage Ⅱ、Ⅲ and Ⅳ were also higher than those in benign ovarian tumor group.For diagnosing of ovarian cancer,the AUC of CA125,HE4,OPN and CA125 + HE4 + OPN were 0.74,0.89,0.81 and 0.95,respectively.The sensitivities were 48.2％,76.8％,71.7％ and 94.5％,while the specificities were 72.7％,87.4％,79.8％ and 92.6％.Conclusion The levels of CA125,HE4 and OPN in ovarian cancer group were higher than those in benign ovarian tumor group (except stage Ⅰ) and control group.The combination of measurements of serum CA125,HE4 and OPN can greatly improve the specificity (except HE4) and sensitivity of ovarian cancer diagnosis,which can provide some help for the early diagnosis of patients.