血清HE4、CA125和CA724检测在卵巢恶性肿瘤诊断中的应用

目的通过检测卵巢恶性肿瘤患者血清人附睾蛋白4(HE4)、CA125和CA724水平,探讨这三项检测在卵巢恶性肿瘤诊断中的临床价值。方法采用电化学发光免疫法(ECL)检测CA125和CA724水平,以ELISA法检测HE4水平。测定36例卵巢恶性肿瘤组患者、59例卵巢良性疾病患者及70名健康体检人群血清三项水平并进行比较。结果卵巢恶性肿瘤组患者血清HE4、CA125和CA724水平显著高于良性疾病组和健康体检组(P0.05),其中良性疾病组CA125和CA724水平高于健康体检组(P0.05),但是良性疾病组HE4水平与健康体检组比较差异无统计学意义(P0.05);卵巢恶性肿瘤组患者血清HE4、CA125、CA724单独检测的灵敏度分别为69.4%、83.3%、58.3%,而这三项联合检测的灵敏度为91.7%,明显高于三项单独检测(P0.05)。当以卵巢良性疾病组作为参照人群时,HE4、CA125、CA724单独检测的特异性分别为96.6%、62.7%、81.4%,而这三项联合检测的特异性为61.0%。结论 HE4在诊断卵巢恶性肿瘤上具有高度特异性的肿瘤标志物,区分良性或恶性肿瘤时应选择HE4检测;卵巢肿瘤疾病的筛查是可选择HE4、CA125、CA724和三项联合检测以提高诊断的敏感性。

Clinical Significance of Detecting Serum HE4, CA125 and CA724 Levels in Diagnoses of Ovarian Malignancies

Objective To study the value of detecting serum HE4, CA125 and CA724 in diagnosis of ovarian malignancies. Methods The serum CA125 and CA724 levels were determined by ECL and serum HFA levels was determined by ELISA in 36 patients with ovarian malignancies, 59 patients with benign ovarian disease and 70 healthy controls. Results The serum levels of HE4, CA125 and CA724 in ovarian malignancies group were significantly higher than that of in other two groups （P 〈 0.05 ）. The diagnostic sensitivity of HFA, CA125 and CA724 for ovarian malignancies was 69.4% , 83.3% and 58.3% respectively, and the detection sensitivity of three indexes combined detection was 91.7%. The sensitivity of three indexes combined detection was higher than that of the single detection （ P 〈 0.05 ）. The diagnostic specificity of HE4, CA125, CA724 alone and their combined detection for ovarian malignancies was 96.6%, 62.7%, 81.4% and 61.0% respectively when patients with benign ovarian disease as reference. Conclusion The specificity of HE4 assay was higher than oth- ers assay in the diagnosis of ovarian malignancies. The combined detection of HE4, CA125 and CA724 could improve the diagnostic sensitivity and specificity of ovarian malignancies.