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目的:探讨CA125、HE4、CA724、CEA联合检测在卵巢癌早期诊断中的价值。方法:以2011年4月～2012年4月因盆腔肿块就诊的156例疑似卵巢癌患者为研究对象,采用电化学发光法测定血清CA125、HE4、CA724、CEA值。同时选取体检中心同期进行健康体检的70位女性作为健康对照组,观察比较人群血清学肿瘤标志物表达的差异。结果:最终经病理确认,研究组中60例为卵巢癌,80例为卵巢良性疾病,16例因状态未知而未纳入后期分析。卵巢癌组的血清CA125、HE4、CA724、CEA水平显著高于卵巢良性疾病组和健康对照组(P<0.05);除外CA125,卵巢良性疾病组与对照组间其余各指标无显著性差异(P<0.05)。CA125、HE4、CA724、CEA单一指标检测卵巢癌的灵敏度分别为60%、73%、48%、20%,特异度分别为40%、90%、80%、70%。4项指标联合检测卵巢癌的灵敏度为89%,特异度为86%。结论:CA125、HE4、CA724、CEA联合检测模式是筛选特异性较高的指标,能提高检测的灵敏度,同时保持较高的特异度,是卵巢癌早期诊断的可行模式。
Objective: To investigate the value of combined detection of CA125, HE4, CA724 and CEA in the early diagnosis of ovarian cancer. Methods: From April 2011 to April 2012, 156 cases of suspected ovarian cancer patients treated by pelvic masses were studied. The levels of serum CA125, HE4, CA724 and CEA were measured by electrochemiluminescence. At the same time, 70 healthy women who took physical examinations in the same period were selected as healthy control group to observe the difference of serum tumor markers among the population. Results: The final confirmed by pathology, the study group of 60 cases of ovarian cancer, 80 cases of benign ovarian disease, 16 cases because of unknown status but not included in the post-analysis. Serum levels of CA125, HE4, CA724 and CEA in ovarian cancer group were significantly higher than those in benign ovarian disease group and healthy control group (P <0.05), except CA125, benign ovarian disease group and control group, there was no significant difference (P <0.05). The sensitivity of detecting single tumor markers of CA125, HE4, CA724 and CEA were 60%, 73%, 48%, 20% and 40%, 90%, 80% and 70% respectively. Four indicators of joint detection of ovarian cancer sensitivity was 89%, specificity was 86%. Conclusion: The combined detection of CA125, HE4, CA724 and CEA is a highly specific screening index, which can improve the sensitivity of detection and maintain the high specificity. It is a feasible model for the early diagnosis of ovarian cancer.