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分别在ARCHITECT i2000_(SR)化学发光免疫分析仪(微粒子化学发光法)和E170电化学发光免疫分析仪(电化学发光法)上测定术前85例子宫内膜癌患者和100例健康体检者的HE4和CA125血清水平,绘制ROC曲线并确立HE4最佳诊断临界值,分析HE4和CA125单项和联合检测的诊断指标,进而评价术前HE4单项及联合CA125检测在子宫内膜癌的早期诊断价值。临床回顾子宫内膜癌患者预后相关因素,以单变量统计分析治疗前HE4和CA125与子宫内膜癌预后因素的相关性。结果显示术前子宫内膜癌组HE4和CA125血清水平与正常对照组比较,差异有统计学意义(P<0.01)。HE4和CAl25单项检测的工作特征曲线下面积分别为0.797和0.746,以约登指数确定HE4的临界参考值为69.45 pmol/L,在100%特异性下,HE4单项和联合CA125检测的敏感性分别为50.59%和58.82%,均显著高于CA125(28.24%)。HE4和CA125均与患者FIGO分期、附件受侵、阴道和(或)宫旁受侵和盆腔或(和)腹主动脉旁淋巴结转移显著相关;HE4和CA125的阳性率随着子宫内膜癌的分期、恶性程度和播散范围的升高而升高。HE4在绝经妇女及早期内膜癌的阳性率显著高于CA125(P<0.01)。由此可见HE4作为子宫内膜癌的肿瘤标志物,具有比CA125更好的早期诊断价值,术前HE4和CA125的联合检测可辅助判断子宫内膜癌患者预后,提高术后生存率。
85 cases of endometrial cancer patients and 100 cases of healthy subjects were measured on ARCHITECT i2000_ (SR) chemiluminescence immunoassay (particle chemiluminescence) and E170 electrochemiluminescence immunoassay (electrochemiluminescence) HE4 and CA125 serum levels, draw the ROC curve and establish the HE4 optimal diagnostic threshold, analyze the diagnostic indicators of HE4 and CA125 single and combined detection, and then evaluate the preoperative diagnosis of HE4 single and combined CA125 in the early diagnosis of endometrial cancer. Clinical factors related to the prognosis of patients with endometrial cancer were retrospectively analyzed. The correlation between the prognostic factors of HE4 and CA125 and the prognosis of endometrial carcinoma was analyzed by univariate analysis. The results showed that the serum levels of HE4 and CA125 in preoperative endometrial cancer group were significantly different from those in normal control group (P <0.01). The area under the working characteristic curve of single detection of HE4 and CAl25 were 0.797 and 0.746 respectively. The critical reference value of HE4 determined by Youden index was 69.45 pmol / L. The sensitivity of single HE4 and combined CA125 detection at 100% specificity was 50.59% and 58.82%, which were significantly higher than CA125 (28.24%). Both HE4 and CA125 were significantly associated with FIGO staging, accessory invasion, vaginal and / or paravaginal invasion and pelvic or (and) paraaortic lymph node metastasis. The positive rates of HE4 and CA125 were associated with endometrial cancer Staging, the degree of malignancy and the spread of the rise and increase. The positive rate of HE4 in menopausal women and early endometrial cancer was significantly higher than that in CA125 (P <0.01). This shows that HE4 as a tumor marker of endometrial cancer has a better early diagnosis value than CA125. The combined detection of HE4 and CA125 before surgery can help determine the prognosis of patients with endometrial cancer and improve the postoperative survival rate.