血清人附睾蛋白4在子宫内膜癌中的表达及临床意义

摘要

目的初步探讨人附睾蛋白4（serum of Human Epididymis Protein 4, HE4）在子宫内膜癌中的表达及临床意义。方法采用ELISA法检测了2012年10月至2013年6月在广东省中山市博爱医院妇科收治的13例子宫内膜癌患者（A组），12例子宫内膜增生患者（B组），16例子宫内膜息肉患者（C组）及同期妇科门诊拟“健康体检”就诊的29例健康女性（正常对照组，D组）的血清HE4水平，分析各组HE4水平的差异，并比较子宫内膜癌组患者血清HE4水平与临床病理特征的关系，以及HE4作为检测子宫内膜癌的灵敏度和特异度。结果 A、B、C、D各组的血清HE4水平分别为（148.93±70.99）、（59.86±4.36）、（50.86±2.82）、（43.74±1.48）pmol/L，经统计学分析，四组比较差异有统计学意义（F=2.99，P=0.04）。A组与B、C、D组比较，其差异均有统计学意义（t=2.03，P=0.05；t=2.39，P=0.02；t=2.87，P=0.01），其余各组间的差异均无统计学意义（t=0.21，P=0.83；t=0.43，P=0.67；t=0.21，P=0.83）。肌层浸润>1/2的患者血清HE4水平（414.13±290.56 pmol/L）明显高于肌层浸润≤1/2的患者（69.36±7.82 pmol/L）（t=2.44，P=0.03），而在绝经状态（t=0.44，P=0.67），肿瘤分化程度（t=0.22，P=0.83）的差异上均无统计学意义。以70 pmol/l为截断值，HE4作为检测子宫内膜癌的灵敏度和特异度分别为54.55%（6/11），76.66%（23/30）。结论血清HE4作为一个新的肿瘤标志物，在子宫内膜癌的诊断和预后方面有很好的临床应用前景，值得进一步深入研究。%Objective To preliminary explore the expression of different stage of endometrial carcinoma and the relationship with the prognosis. Method Enzyme-linked Immunosorbent Assay(ELISA) technique was applied to detect serum HE4 levels in 13 cases of endometrial carcinoma (group A), 12 cases of endometrial hyperplasia (group B), 16 cases of uterine endometrial polyps (group C) patients and 29 healthy women (normal control group, group D),respectively. Differences of HE4 levels were analyzed between groups, to compare the relationship between the level of serum HE4 and clinicopathologic features in endometrial cancer and the sensitivity and specificity. Results The serum HE4 levels of group A, B, C, D were (148.93± 70.99), (59.86 ± 4.36), (50.86 ± 2.82), (43.74 ± 1.48) pmol/L, respectively. Through statistical analysis, there was statistically significant between group A and group B, C and D(t=2.03,P=0.05;t=2.39,P=0.02;t=2.88, P=0.01;respectively.), but there was no statistically significant among other groups(t=0.21,P=0.83;t=0.43,P=0.67;t=0.21, P=0.83;respectively). The level of serum HE4 of myometrial invasion>1/2 muscle layer (414.13± 290.56) pmol/L was obviously higher than that of muscular invasion≤1/2 muscle layer (69.36±7.82) pmol/L(t=2.44, P=0.03). With 70 pmol/l as cutoff value, the sensitivity and specificity in the detection of endometrial cancer was 54.55%(6/11), 76.66%(23/30), respectively. Conclusions As a new tumor marker, serum HE4 has good clinical application in the diagnosis and prognosis of endometrial cancer, it is worth further study.