血清人附睾蛋白4对卵巢上皮性癌的诊断价值

目的探讨血清人附睾蛋白4(HE4)对卵巢上皮性癌的诊断价值。方法 2007年12月至2008年12月在河北医科大学第二医院采用酶联免疫吸附试验,检测血清HE4在健康妇女、卵巢良性上皮性肿瘤、卵巢交界性肿瘤及卵巢癌患者血清中的水平。分析血清HE4诊断卵巢上皮性癌的价值。结果在健康妇女、卵巢良性上皮性肿瘤、卵巢交界性肿瘤及卵巢癌患者术前血清中,HE4的中位数分别为41.10、43.98、65.21、260.90pmol/L;HE4在术前卵巢癌组表达水平均高于前3组,差异均有统计学意义(P0.05),前3组比较差异均无统计学意义;卵巢癌患者术后血清中HE4的中位数为124.32pmol/L,术前血清水平明显高于术后血清水平(P0.05)。卵巢癌患者术前血清HE4质量浓度与病理类型、血清CA125质量浓度相关。以健康妇女组+良性肿瘤组为参照人群,HE4检测卵巢癌的ROC-AUC为0.960,HE4质量浓度在107.15pmol/L时,其ROC曲线(敏感性+特异性)-1的差值最大,即为最佳界值点。HE4的界值点为107.15pmol/L或150pmol/L时,HE4、CA125单项检测卵巢癌的敏感性差异无统计学意义;CA125单项检测的敏感性低于HE4+CA125联合检测的敏感性,差异有统计学意义(P0.05);HE4单项检测的敏感性不低于上述联合检测的敏感性(P0.05)。结论血清HE4水平可能成为卵巢癌的肿瘤标志物,其与CA125联合检测可提高卵巢癌的诊断率。     

人附睾蛋白4在子宫内膜非典型增生患者中筛查子宫内膜癌的临床价值

目的：探讨人附睾蛋白4（human epididymis protein 4,HE4）检测在诊断性刮宫（诊刮）病理为子宫内膜非典型增生（atypical endometrial hyperplasia,AEH）患者中筛查子宫内膜癌（endometrial carcinoma,EC）的临床价值。方法：选取2011年1月—2014年12月在天津市中心妇产科医院诊刮病理为AEH进而行手术治疗的患者,术前采用电化学发光免疫分析法检测患者血清HE4、CA125和CA199水平,根据术后病理分为EC组和AEH组,分析2组患者肿瘤标记物的水平差异。制作受试者工作特征曲线（ROC）,以曲线下面积（AUC）反映肿瘤标记物的诊断价值。结果：入选的118例诊刮病理为AEH的患者中,31例术后被诊断为EC（EC组）,其血清HE4、CA125和CA199水平分别为73.4 pmol/L、31.4 kU/L和23.3 kU/L;87例术后诊断仍为AEH（AEH组）,上述3种肿瘤标记物的水平分别为44.3 pmol/L、17.0 kU/L和19.0 kU/L;EC组HE4和CA125水平高于AEH组,差异有统计学意义（P＜0.05）,而CA199水平差异无统计学意义（P＞0.05）。EC组以AEH组为参照时,HE4和CA125单独检测的AUC分别为0.785和0.706,两者联合检测的AUC为0.867,敏感度为76.6%。结论：EC患者血清HE4和CA125水平明显高于AEH患者,两者联合检测有助于筛查出诊刮病理为AEH人群中漏诊的EC患者。     

血清人附睾上皮分泌蛋白4水平检测在卵巢癌的应用价值

目的:研究卵巢癌患者血清人附睾上皮分泌蛋白4(HE4)水平与卵巢癌病理类型的关系,探讨血清HE4检测在卵巢癌的应用价值。方法:比较卵巢癌组(210例)、卵巢良性疾病组(185例)和健康对照组(260例)血清HE4及癌抗原125(CA125)水平,并检测分析卵巢癌不同病理类型血清HE4水平。结果:卵巢癌组血清HE4水平(42.45 pmol/L)明显高于卵巢良性疾病组(17.35 pmol/L)和健康对照组(28.70 pmol/L),差异均有统计学意义(P0.01);血清CA125水平在卵巢癌组(11.85 U/L)和卵巢良性疾病组(19.75 U/L)明显高于健康对照组(8.50 U/L),差异均有统计学意义(P0.01)。卵巢癌组中混合性癌血清HE4水平(82.20 pmol/L)明显高于浆液性癌(53.20 pmol/L)和子宫内膜样癌(50.55 pmol/L),差异均有统计学意义(P0.01,P0.05)。结论:HE4是卵巢癌良好的生物标志物,HE4水平与卵巢癌病理类型有关。     

上皮性卵巢肿瘤患者血清中YKL-40、HE4的表达及临床意义

目的:探讨血清甲壳质酶蛋白40(YKL-40)、人附睾蛋白4(HE4)在上皮性卵巢肿瘤的表达及临床意义。方法:用酶联免疫吸附试验,检测健康妇女、上皮性良性卵巢肿瘤、交界性卵巢肿瘤及卵巢癌患者血清中YKL-40、HE4的水平。结果:(1)健康妇女、上皮性良性卵巢肿瘤、交界性卵巢肿瘤及卵巢癌患者术前血清中,YKL-40表达中位数分别为35.56、41.42、44.34和130.25μg/L;HE4的表达中位数分别为41.10、43.98、65.21和260.90pmol/L;在术前卵巢癌组YKL-40、HE4的表达水平均高于前3组,差异有统计学意义(P<0.05),前3组之间差异无统计学意义;卵巢癌患者术后血清中YKL-40、HE4中位数分别为58.57μg/L、124.32pmol/L,术前血清水平明显高于术后(P<0.05);(2)卵巢癌患者术前血清YKL-40浓度与FIGO分期、血清CA125浓度呈正相关(P<0.05);术前血清HE4浓度与病理类型、血清CA125浓度、年龄相关。结论:血清YKL-40、HE4有望成为卵巢癌标志物,用于早期诊断和预后分析。     

血清HE4水平对预测卵巢癌铂类化疗效果的临床观察

目的:探讨卵巢上皮癌患者血清中人附睾蛋白4(HE4)的水平与患者铂类化疗效果的关系。方法:回顾分析52例卵巢上皮癌患者的临床资料和随访信息,采用电化学发光法检测患者治疗前和随访时血清HE4及CA125水平,分析血清HE4及CA125水平与铂类化疗效果的关系。结果:52例患者中,31例铂类化疗敏感,21例铂类化疗抵抗。铂类化疗抵抗组患者治疗前血清HE4及CA125水平明显高于铂类化疗敏感组。治疗前血清HE4水平对卵巢癌铂类化疗疗效的预测效能高于CA125。铂类化疗抵抗组患者随访时血清HE4水平明显高于铂类化疗敏感组(276.5pmo/L vs 56.38pmo/L,P0.001)。随访时血清HE4可预测铂类化疗效果,当界值点为127.40pmo/L时,灵敏度达81%,特异度达93.5%,阳性预测值(PPV)为89.5%,阴性预测值(NPV)为87.9%,曲线下面积(AUC)为0.919。随访时血清CA125取界值点为76.4U/L时预测铂类化疗效果的灵敏度为95.2%,特异度为90.3%,PPV为85%,NPV为87.5%,AUC为0.876。随访时血清HE4预测铂类化疗效果的AUC也大于CA125。Logistic多因素回归分析结果显示,随访时血清HE4水平与发生铂类化疗抵抗密切相关(P=0.027)。结论:随访时血清HE4水平可以预测卵巢癌铂类化疗的反应。     

人附睾分泌蛋白4在卵巢成熟畸胎瘤诊断中的临床应用价值

目的:探讨人附睾分泌蛋白4(HE4)在卵巢成熟畸胎瘤诊断中的临床应用价值.方法:选取88例卵巢成熟畸胎瘤患者(实验组)、80例健康女性(对照组),术前、术后采用酶联免疫法(ELISA)检测血清HE4水平;电化学发光免疫分析法检测血清CA 199水平.通过制作受试者工作特征曲线(ROC),以曲线下面积(AUC)反映诊断的准确性,比较HE4及CA199对卵巢成熟畸胎瘤诊断的敏感度、特异度和阳性率.结果:实验组术前血清HE4和CA 199水平分别为94.56 pmol/L和54.72 kU/L,对照组为29.13 pmol/L和15.47 kU/L,实验组均明显高于对照组,分别比较,差异有统计学意义(P ＜0.01,P＜0.05).实验组术后血清HE4和CA199水平分别为29.21 pmol/L和18.23 kU/L,术后血清HE4和CA199水平下降幅度比较,差异有统计学意义(P＜0.01).实验组检测HE4阳性率54.5％,CA 199阳性率26.1％ (P ＜0.05).血清HE4和CA199单项检测的AUC分别为0.921和0.628;特异度为95％时的敏感度分别为64.3％和21.6％;特异度分别为96.2％和88.9％.结论:HE4在卵巢成熟畸胎瘤诊断中有意义,其检测阳性率高于CA 199,诊断准确性、敏感度和特异度均优于CA199.     

人附睾分泌蛋白4联合CA125在卵巢恶性肿瘤与子宫内膜异位症鉴别诊断中的价值

目的 探讨血清人附睾分泌蛋白4(HE4)联合CA125水平检测在卵巢恶性肿瘤与子宫内膜异位症鉴别诊断中的价值.方法 采用酶联免疫吸附试验(ELISA)检测卵巢子宫内膜异位囊肿(内异症组)46例、卵巢上皮性癌(卵巢癌组)36例、卵巢非内膜异位良性肿瘤(良性肿瘤组)60例和健康妇女(对照组)50例血清中HE4和CA125水平,结果以中位数表示.血清HFA和CA125正常值分别为0～150 pmo/L和0～35 kU/L,单独或联合检测时,其中任一指标高于正常上限即定为阳性.通过制作受试者工作特征(ROC)曲线,以曲线下面积(AUC)反映诊断的准确性;以Mann-Whitney U 检验及相关性分析探讨两项指标单独或联合检测用于诊断卵巢内异症囊肿的价值.结果 (1)HE4水平:内异症、对照、良性肿瘤组妇女血清HE4水平分别为52.4、51.0、50.0 pmoL/L,3组比较,差异无统计学意义(P>0.05),卵巢癌组患者HE4水平为507.5 pmoL/L,与其他3组分别比较,差异均有统计学意义(P<0.05).(2)CA125水平:卵巢癌、内异症、良性肿瘤及对照组妇女血清CA125水平分别为743.0、84.9、15.4、11.5 kU/L,卵巢癌组与其他3组比较,差异均有统计学意义(P<0.05).(3)单项榆测结果:卵巢癌组以内异症组为参照时,HE4和CA125笛单项检测的AUC分别0.933和0.821,其特异度为95%时的敏感度分别为79.6%和49.0%;内异症组以对照组为参照时的AUC为0.453;以良性肿瘤组为参照时的AUC为0.496.(4)联合检测结果:卵巢癌组以内异症组为参照时,HE4联合CA125检测的AUC为0.936,其特异度为95%时的敏感度为81.0%.结论 HE4水平可作为卵巢内异症囊肿的鉴别诊断依据之一,HE4联合CA125水平检测能有效鉴别卵巢内异症囊肿和卵巢恶性肿瘤.     

血清人附睾分泌蛋白4和CA125水平检测在卵巢恶性肿瘤中的诊断价值

目的 探讨血清人附睾分泌蛋白4(HE4)和CA125水平检测在卵巢恶性肿瘤诊断中的价值.方法 用酶联免疫吸附试验方法 对卵巢恶性肿瘤组(30例)、盆腔良性疾病组(110例,其中卵巢良性肿瘤45例、子宫内膜异位症和子宫腺肌病57例和盆腔炎8例)和正常组(137例)妇女血清中HFA和CA125水平进行双盲检测,结果 以中位数表示,分析两指标单独或联合检测诊断卵巢恶性肿瘤的价值.血清HF4和CA125正常值分别为0～150 pmoVL和0～35 kU/L,单独或联合检测时,其中任一指标高于正常值即定为阳性.结果 (1)卵巢恶性肿瘤组血清HE4和CA125水平分别为244 pmol/L 和601 kU/L,分别与盆腔良性疾病组(分别为32 pmoVL和22 kU/L)和正常组(分别为32 pmol/L和11 kU/L)比较,差异均有统计学意义(P<0.05).卵巢恶性肿瘤组血清HE4单项检测的阳性率为63.3%,明显低于血清CA125项榆测的阳性率(86.7%,P=0.036).(2)单项检测时,以盆腔良性疾病组作参照人群时,HE4和CA125单项检测的受试者工作特征曲线下面积(ROC-AUC)分别为0.900和0.840,其特异度为100%时的敏感度分别为70%和7%,两者比较,差异有统计学意义(P=0.000);以正常组作参照人群时,HE4和CAl25单项检测的ROC-AUC分别0.904和0.914,其特异度为100%时的敏感度分别为67%和87%,两者比较,差异有统计学意义(P=0.031).(3)联合检测时,以盆腔良性疾病组作参照人群时,HE4+CA,笛联合检测和CA125单项检测的ROC-AUC分别为0.894和0.840,其特异度为100%时的敏感度分别为50%和7%,两者比较,差异有统计学意义(P=0.000).以正常组作参照人群时,HE4+CA125联合榆测和HE4单项检测的ROC-AUC分别为0.914和0.904,其特异度为100%时的敏感度分别为87%和67%,两者比较,差异有统计学意义(P=0.031).以盆腔良性疾病组作参照人群时,HE4+CA125联合检测在特异度为100%时的敏感度(50%)虽然低于HE4单项检测(70%),但两者比较,差异无统计学意义(P=0.070).(4)以ROC曲线最左上方的点86 pmol/L、正常组95%参考值50 pmoVL和正常值的上限150 pmol/L为界值点,比较HE4单项检测对卵巢恶性肿瘤的诊断能力,结果 显示,界值点为50 pmol/L时的特异度和阳性预测值分别为95%和63%,明显低于界值点为86(分别为100%和95%)和150 pmoVL(均为100%)时的特异度和阴性预测值(P<0.01).结论 HE4单项检测诊断卵巢恶性肿瘤的特异度优于CA125单项检测,两者联合检测可以提高诊断能力.以150 pmol/L为界值点,对卵巢恶性肿瘤的诊断正确率更高,而以86 pmol/L为界值点有利于卵巢恶性肿瘤的筛查、降低漏诊率.     

血清人附睾蛋白4在卵巢癌临床转归中的关系

目的围手术期及化疗期间人附睾蛋白4（HE4）血清水平的变化,与卵巢癌的疗效和无瘤进展生存时间（PFS）的关系尚不清楚,本文通过检测卵巢上皮性癌不同时期的HE4水平,探讨其与卵巢癌临床转归的关系。方法 取2005年11月至2009年12月间北京大学人民医院诊治并随访完整的卵巢上皮性癌患者（n=100）的血清样本,采用酶联免疫吸附试验法,测定患者不同时期的血清HE4水平。中位随访时间为17个月（3~55个月）。结果本研究共检测了100例患者共559份血清的HE4水平。在有连续性资料的73例患者中,初治疗效为完全缓解组与未完全缓解组相比,化疗期间HE4下降更迅速,差异有统计学意义。单因素分析主要显示了首次化疗前HE4水平与PFS明显相关：首次化疗前HE4水平≤150 pmol/L组的中位PFS较HE4〉150pmol/L组延长（34 vs 17.5个月,P=0.001）。多因素分析显示,首次化疗前HE4水平未降至正常是晚期卵巢癌患者PFS的独立危险因素。首次化疗前HE4水平与残余瘤灶大小呈中度相关（r=0.458,P〈0.001）。结论手术前后及化疗期间HE4变化情况有助于判断初治效果;首次化疗前HE4水平一定程度上反映了手术的满意程度,是晚期卵巢癌的PFS的相对独立影响因素。     

国产人附睾分泌蛋白4（HE4）ELISA试剂盒与CA_（125）联合诊断上皮性卵巢癌的研究

目的评价人附睾分泌蛋白4（HE4）ELISA试剂盒与CA125联合诊断卵巢癌的意义;方法两种（HE4）ELISA法检测上皮性卵巢癌114例。对照组为盆腔包块疑似样本59例,其他妇科良性疾病30例,肺癌、结直肠癌及乳腺癌患者45例,孕妇血清30例,正常人血清100例。实验组检测CA125。结果 HE4_义翘和HE4_康乃格试剂盒诊断卵巢癌敏感性为74.6%和70.2%,联合CA125诊断敏感性为73.2%和68.8%;在早期和晚期卵巢癌的诊断中,HE4_义翘试剂盒敏感性为66.7%和79%,HE4_康乃格试剂盒敏感性为48.1%和79%;HE4_义翘联合CA125敏感性为66.7%和77.2%,HE4_康乃格联合CA125敏感性为48%和77.2%。两试剂盒在各组数据中有强的相关性,相关系数为0.963。结论 HE4_义翘试剂盒在早期诊断卵巢癌方面较好。     

Prognostic value of serum HE4 in patients with advanced ovarian,fallopian tube,and peritoneal carcinoma

In this study, the prognostic value of serum HE4 was investigated in patients with advanced ovarian, fallopian tube, and peritoneal carcinoma. Serum HE4 and CA125 levels were measured in both patients and controls, and the response of treatment and the detection of recurrence were evaluated by serum HE4 and CA125 levels in the patients. The results showed that the levels of serum HE4 and CA125 were significantly higher in advanced patients than those seen in benign disease controls (p < 0.001). Compared with CA125, HE4 had higher specificity, but lower sensitivity. Furthermore, serum HE4 was closely associated with the response of treatment and recurrence, the effective response rate for therapy treatment showed by HE4 was higher than CA125, and a serum HE4 level was correlated with a sensitivity of 82.8% and a specificity of 99%, a positive predictive value (PPV) of 97.7%, and a negative predictive value (NPV) of 77.9% to show the presence of recurrence; the accuracy of HE4 for recurrence prediction after treatment was 88.6%. Our study indicated that serum HE4 levels are effective for diagnosis, evaluating the response of treatment and predicting recurrence in patients with advanced ovarian, fallopian tube, and peritoneal carcinoma.     

Evaluation of ovarian cancer remission markers HE4, MMP7 and Mesothelin by comparison to the established marker CA125

Objective

Evaluate and compare the effectiveness of CA125, HE4, Mesothelin and MMP7 marker levels to monitor ovarian cancer patients after surgery and chemotherapy. Evaluate the lead time of a rise of marker levels before recurrence.

Methods

The study consists of 23 patients with advanced stage ovarian/fallopian tube cancer. Blood was drawn after front line surgery and chemotherapy treatment and at 3 month intervals thereafter. One patient had chemoresistant disease, two patients remained in remission and 20 patients had recurring disease and were used for marker evaluation.

Results

In five patients HE4 was the only marker to elevate before recurrence with a lead time of up to 4½ months including one patient who did not have a CA125 response at all. In a further two patients, HE4 increased before CA125 did. In four of these seven patients, HE4 levels were consistently at or above threshold during remission when both CA125 and imaging results were negative. MMP7 elevated before recurrence in one patient who was negative for the other markers. Mesothelin elevated in two patients who were also positive for CA125 and HE4.

Conclusions

HE4 can predict ovarian cancer recurrence earlier than CA125 and it can be elevated in patients that do not express CA125 at sufficient levels to make a clinical decision. MMP7 and Mesothelin have lower potential as markers for ovarian cancer recurrence to complement CA125. A failure of HE4 levels to normalize at completion of standard therapy may indicate a poor prognosis.     

联合检测人附睾蛋白4与血清CA125用于诊断卵巢上皮性癌的诊断价值

目的:研究人附睾蛋白4(HE4)在卵巢上皮性癌患者血清及尿液中的表达水平,探讨其联合血清CA125用于卵巢上皮性癌诊断的临床应用价值。方法:采用酶联免疫吸附法(ELISA法)检测50例卵巢上皮性癌患者、38例卵巢良性肿瘤患者和40例正常人血清及尿液中的HE4水平和血清CA125水平。结果:卵巢癌患者组血清及尿液中的HE4水平明显高于卵巢良性肿瘤组及正常对照组,差异均有统计学意义(P<0.05),血清及尿液HE4水平在卵巢良性肿瘤组及正常对照组之间差异无统计学意义(P>0.05)。血清HE4检测卵巢上皮性癌的灵敏度、特异度分别为58.0%、87.2%,与血清CA125联合检测其灵敏度、特异度提高至86.0%、89.7%;尿液HE4检测卵巢上皮性癌的灵敏度、特异度分别80.0%、91.0%,与血清CA125联合检测其灵敏度、特异度可达90.0%、94.9%;联合检测血清HE4、尿液HE4和血清CA125的灵敏度和特异度高达94.0%、94.9%。结论:联合检测血清及尿液HE4与血清CA125可显著提高卵巢上皮性癌的诊断率。     

IOTA SR与CA125、HE4、ROMA、RMI1、GI-RADS对卵巢良恶性肿瘤的诊断价值比较

目的探讨糖链多肽抗原125(CA125)、人附睾蛋白4(HE 4)、恶性肿瘤风险算法(ROMA)、恶性风险指数1(RMI1)、国际卵巢肿瘤分析简单规则(IOTA SR)、妇科影像报告与数据系统(GI-RADS)在卵巢良恶性肿瘤鉴别诊断中的价值。方法选取2019年7月至2020年7月于锦州医科大学附属第一医院83例行附件手术并经术后病理检查确诊的卵巢肿瘤患者,术前行常规检查、血清CA 125、血清HE 4及妇科超声检查,计算ROMA值、RMI1值,根据超声结果进行IOTA SR评分及GI-RADS评分。使用推荐的临界值计算每种方法的敏感度、特异度、阳性预测值、阴性预测值和约登指数,计量资料构建受试者工作特征(ROC)曲线及计算曲线下面积(AUC)。结果卵巢恶性肿瘤组与卵巢良性肿瘤组相比,血清CA125、血清HE4、ROMA、RMI1水平显著升高,且均具有统计学意义(P<0.05)。对于卵巢良恶性肿瘤诊断,敏感度:CA125>ROMA>IOTA SR>RMI1>HE4=GI-RADS,特异度:HE4>IOTA SR>ROMA>GI-RADS>RMI1>CA125,约登指数:IOTA SR>ROMA>HE4>RMI1=GI-RADS>CA125,AUC:ROMA>RMI1>HE4>CA125,CA125约登指数明显低于其余各组,且差异有统计学意义(P<0.05),IOTA SR、ROMA、HE4、RMI1、GI-RADS各组间约登指数有差异,但差异无统计学意义(P>0.05)。结论IOTA SR在卵巢良恶性肿瘤的鉴别诊断中有较高的敏感度与特异度,诊断效能较高。     

Evaluation of HE4 as an extrabiomarker to CA125 to improve detection of ovarian carcinoma: is it time for a step forward?

Purpose

To evaluate human epididymis protein 4 (HE4) as an extrabiomarker to cancer antigen 125 (CA125) to improve the detection of ovarian carcinoma.

Methods

Sixty patients with ovarian carcinoma, 50 patients with benign ovarian tumors and 30 healthy women were included in the present study. Serum concentration of HE4 was assayed using ELISA technique, while CA125 was assayed using chemiluminescent enzyme immunoassay.

Results

The median CA125 and HE4 serum values were significantly higher among ovarian cancer patients when compared with healthy control However, the median serum levels of CA125 but not HE4 were significantly higher among patients with benign ovarian tumors as compared to healthy women. Based on the receiver operator characteristics curve analysis, HE4 had higher sensitivities than CA125 for the detection of ovarian cancer at 90, 95 and 98 % specificities and the combination of both markers yielded a higher sensitivity than either alone. However, CA125 but not HE4 had higher sensitivities for the detection of benign ovarian tumors at the same specificities. In addition, a positive correlation was observed between HE4 and CA125 among patients with ovarian carcinoma.

Conclusion

HE4 is a valuable marker for ovarian cancer diagnosis and when combined with CA125, they had a higher sensitivity at a set specificity, thus providing a more accurate predictor of ovarian cancer than either alone.     

血清miR-222、HE4及CA125水平联合ROMA指数对上皮性卵巢癌的诊断价值

目的:探讨血清miR-222、血清人附睾蛋白4(HE4)及糖类抗原125(CA125)水平联合ROMA指数对上皮性卵巢癌(EOC)的诊断价值。方法:选取2016年1月至2019年12月海南西部中心医院收治的120例EOC患者、100例上皮性卵巢良性肿瘤患者和50例正常健康女性作为研究对象。实时定量PCR法检测miR-222表达水平,化学发光法测定血清HE4及CA125水平,并计算ROMA指数。应用受试者工作特征(ROC)曲线分析血清miR-222、HE4及CA125水平联合ROMA指数对EOC的诊断价值。Pearson相关分析EOC患者血清miR-222水平与HE4、CA125及ROMA指数的相关性。结果:EOC组血清miR-222、HE4、CA125水平及ROMA指数均明显高于良性组和对照组(P<0.001)。Ⅲ~Ⅳ期EOC患者的血清miR-222、HE4、CA125水平及ROMA指数均明显高于Ⅰ~Ⅱ期(P<0.001)。ROC曲线显示,血清miR-222、HE4、CA125水平及ROMA指数诊断EOC的最佳截断值分别为1.21、193.62pmol/L、165.73U/ml、35.60%,四项联合诊断EOC的曲线下面积(0.970,95%CI0.913~0.998)最大,其敏感度和特异度为99.5%和88.2%。相关分析显示,EOC患者血清miR-222水平与HE4、CA125及ROMA指数均呈正相关(r=0.830、P<0.001,r=0.772、P<0.001,r=0.884、P<0.001)。结论:EOC患者血清miR-222、HE4及CA125水平明显升高,联合ROMA指数对EOC诊断具有较高的价值。     

人附睾蛋白4与癌抗原125在卵巢癌二元论模型中的应用

目的：探讨血清人附睾蛋白4（HE4）、CA125对上皮性卵巢癌（EOC）二元论模型的应用价值。方法：选取2012年2月-2013年4月间因盆腔包块或卵巢囊肿住院拟行手术的患者,包括妇科炎症65例,子宫内膜异位症（EMs）509例,卵巢良性肿瘤887例,卵巢交界性上皮瘤73例,EOC 132例（Ⅰ型78例,Ⅱ型54例）,以及正常妇女71例。采用电化学发光法检测其血清HE4、CA125水平,并评估其应用价值。结果：EOC患者血清HE4和CA125水平与国际妇产科联盟（FIGO）分期呈正相关（rs分别为0.534,0.541,均P=0.000）;各期Ⅱ型EOC HE4、CA125表达水平高于同期Ⅰ型EOC,高级浆液性癌高于低级浆液性癌,各期EOC HE4表达水平高于妇科良性疾患各组（P＜0.05）;Ⅰ期EOC患者血清CA125表达与妇科炎症、EMs组差异无统计学意义（均P＞0.05）,Ⅱ、Ⅲ期Ⅰ型EOC患者血清CA125表达与EMs组差异无统计学意义（均P＞0.05）。 HE4、CA125检测EOC的受试者工作曲线下面积（ROC-AUC）分别为0.877,0.786;准确度为90.0%,70.5%;敏感度67.4%,69.7%;特异度92.1%,72.6%;约登指数0.595,0.403。结论：HE4单项检测EOC的特异度优于CA125,单独血清HE4及其与CA125联合检测对EOC早期诊断、分期、病理分型及预后评估都有一定意义,可以作为诊断EOC的重要指标。     

Tumour-associated antigen CA 125 in patients with ovarian cancer

The serum levels of antigen CA 125 expressed by epithelial ovarian carcinoma were measured in 27 postmenopausal women with ovarian tumours and in 16 controls. Increased serum levels of CA 125 were found in nine (75%) out of 12 patients with ovarian cancer; in three with stage I disease levels were not elevated. No significant difference was found in the concentration of CA 125 detected in peripheral or ovarian venous blood. Decreased antigen levels were found 6-30 weeks after radical operation and cytostatic chemotherapy in the ovarian cancer group. The results indicate the value of measuring CA 125 as a tumour marker in the follow-up of ovarian cancer.