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目的:探讨新肿瘤标记物血清人附睾分泌蛋白4(HE4)和CA125联合检测鉴别妇科盆腔肿块患者卵巢癌的诊断价值。方法:将诊断为妇科盆腔肿块拟行手术的108例患者和40例健康体检妇女采用酶联免疫吸附法(ELISA法)测定HE4含量、电化学发光法测定CA125含量。结果:卵巢癌组患者血清HE4、CA125水平明显高于盆腔良性肿块组患者(良性组)及健康妇女(对照组),差异有统计学意义(P<0.05),良性组血清HE4水平与健康妇女(对照组)比较差异无统计学意义(P>0.05),而同组血清CA125水平与对照组比较差异有统计学意义(P<0.05);良性组和对照组血清HE4的阳性率均为0,而良性组血清CA125为30.1%,良性组中HE4的阳性率与同组血清CA125阳性率比较差异有统计学意义(P<0.01);HE4+CA125联合检测卵巢癌的敏感度、特异度分别为91.4%、80.5%,与单一指标检测敏感度进行比较差异有统计学意义(P<0.05)。结论:HE4是一种较理想的卵巢癌肿瘤标志物,其血清水平对妇科盆腔肿块良恶性疾病的鉴别诊断具有一定的应用价值,与CA125联合检测可以提高盆腔肿块患者中卵巢癌的鉴别诊断价值。
OBJECTIVE: To investigate the diagnostic value of the combination of HE4 and CA125 in the detection of ovarian cancer in gynecologic pelvic masses. Methods: The HE4 content was determined by enzyme - linked immunosorbent assay (ELISA) in 108 patients and 40 healthy women who were diagnosed as gynecologic pelvic masses. The content of CA125 was determined by electrochemiluminescence. Results: The levels of serum HE4 and CA125 in ovarian cancer patients were significantly higher than those in benign pelvic masses and healthy women (control group), the difference was statistically significant (P <0.05). The serum levels of HE4 in benign group were significantly higher than those in healthy women (P <0.05), while the serum CA125 levels in the same group were significantly different from those in the control group (P <0.05). The positive rates of serum HE4 in the benign and control groups were all 0 , While the serum CA125 in benign group was 30.1%. The positive rate of HE4 in benign group was significantly higher than that in the same group (P <0.01). The sensitivity and specificity of HE4 + CA125 in detecting ovarian cancer (91.4%, 80.5%, respectively). The difference was statistically significant (P <0.05). Conclusion: HE4 is an ideal tumor marker of ovarian cancer. The serum level of HE4 is of value in the differential diagnosis of benign and malignant pelvic masses in gynecology. Combined with CA125 can improve the differential diagnosis of ovarian cancer in pelvic masses .