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目的探讨人附睾蛋白4(HE4)及糖类抗原125(CA125)检测在诊断及鉴别妇女卵巢癌中的应用价值。方法选取2014年4月~11月该院收治的120例妇女为研究对象,其中卵巢恶性肿瘤患者31例为恶性肿瘤组、卵巢良性病变妇女49例为良性病变组、健康妇女40例为健康组,采用酶联免疫吸附法(ELISA)检测3组研究对象的血清HE4、CA125水平,并根据临床分期、组织学类型分别比较卵巢癌妇女HE4、CA125水平的差异并进行诊断学评价。结果恶性肿瘤组的HE4、CA125水平显著高于良性病变组和健康组,3组比较,差异有统计学意义(P<0.05);良性病变组与健康组比较,差异无统计学意义(P>0.05)。Ⅲ~Ⅳ期卵巢癌患者的HE4、CA125水平显著高于Ⅰ~Ⅱ期患者(P<0.05);浆液性癌、子宫内膜癌患者的HE4、CA125水平显著高于黏液性癌、透明细胞癌患者(P<0.05)。HE4诊断卵巢癌的灵敏度为85%、特异度为90%、误诊率为10%、漏诊率为15%,ROC曲线下面积为0.923。CA125诊断卵巢癌的灵敏度为80%、特异度为85%、误诊率为15%、漏诊率为20%,ROC曲线下面积为0.800。结论卵巢癌患者的HE4、CA125水平均显著高于卵巢良性疾病妇女和健康妇女,HE4在鉴别诊断卵巢恶性肿瘤中的价值高于CA125。
Objective To investigate the diagnostic value of human epididymal protein 4 (HE4) and carbohydrate antigen 125 (CA125) in the diagnosis and differential diagnosis of ovarian cancer in women. METHODS: A total of 120 women admitted to our hospital from April 2014 to November 2014 were enrolled. Among them, 31 patients with ovarian cancer were malignant tumor group, 49 patients with benign ovarian disease were benign lesion group and 40 healthy women were healthy group , enzyme-linked immunosorbent assay (ELISA) serum study three groups of HE4, CA125 levels, and in accordance with differences in clinical stage, histological type of cancer of women were compared ovarian HE4, CA125 levels and histological evaluation of diagnosis. Results The levels of HE4 and CA125 in malignant tumors were significantly higher than those in benign lesions and healthy controls (P <0.05). There was no significant difference between benign lesions and healthy controls (P> 0.05). The levels of HE4 and CA125 in stage Ⅲ ~ Ⅳ ovarian cancer patients were significantly higher than those in stage Ⅰ ~ Ⅱ patients (P <0.05). The levels of HE4 and CA125 in serous and endometrial cancer patients were significantly higher than those in mucinous carcinoma and clear cell carcinoma Patients (P <0.05). The sensitivity, specificity, and specificity of HE4 in the diagnosis of ovarian cancer were 85%, 90%, 10%, 15% respectively, and the area under the ROC curve was 0.923. The sensitivity of CA125 in the diagnosis of ovarian cancer was 80%, the specificity was 85%, the misdiagnosis rate was 15%, the rate of misdiagnosis was 20% and the area under the ROC curve was 0.800. Conclusion The levels of HE4 and CA125 in patients with ovarian cancer are significantly higher than those in benign ovarian diseases and healthy women. The value of HE4 in the differential diagnosis of ovarian cancer is higher than that of CA125.