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目的:探讨血清人附睾上皮分泌蛋白4(HE4)和癌抗原(CA125)单独或联合检测对卵巢癌的诊断价值。方法:分别应用酶联免疫吸附试验和电化学发光技术测定经病理确诊的卵巢癌患者112例、盆腔良性疾病患者68例及健康对照者80例血清肿瘤标志物HE4、CA125的含量水平,并计算各项目的灵敏性、特异性、准确性、阳性及阴性预测值等诊断性能指标。结果:①卵巢癌组HE4和CA125水平明显高于其他2组,差异有统计学意义(P<0.01);健康对照组和良性疾病组比较HE4差异无统计学意义(P>0.05);CA1252组差异有统计学意义(P<0.01)。②以卵巢良性疾病作参照,单独检测血清HE4水平对卵巢癌诊断的敏感性为57.8%,低于单独检测CA125的75.3%;但其特异性为97.0%,高于CA125的85.5%。以二者其中之一高于参考值即视为阳性时,联合检测HE4和CA125对卵巢癌诊断的敏感性为94.6%,特异性可达85.0%。结论:HE4单项检测诊断卵巢癌的特异性优于CA125单项检测,两者联合检测可以提高诊断。
Objective: To investigate the diagnostic value of serum human epididymal epithelial secretory protein 4 (HE4) and cancer antigen (CA125) in ovarian cancer. Methods: The levels of serum tumor markers HE4 and CA125 in 112 patients with ovarian cancer, 68 patients with pelvic benign disease and 80 healthy controls were determined by enzyme-linked immunosorbent assay (ELISA) and electrochemiluminescence (CL) respectively. The project sensitivity, specificity, accuracy, positive and negative predictive value and other diagnostic performance indicators. Results: ① The levels of HE4 and CA125 in ovarian cancer group were significantly higher than those in the other two groups (P <0.01), while there was no significant difference between healthy control group and benign disease group (P> 0.05); CA1252 group The difference was statistically significant (P <0.01). (2) According to benign ovarian disease, the sensitivity of detecting serum HE4 alone to the diagnosis of ovarian cancer was 57.8%, lower than that of detecting CA125 alone 75.3%; but its specificity was 97.0%, higher than that of CA125 85.5%. When both of them were considered as positive, the detection of HE4 and CA125 was 94.6% and the specificity was 85.0%. Conclusion: The specificity of single detection of HE4 in ovarian cancer is better than single detection of CA125, and the combination of both can improve the diagnosis.