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[目的]探讨人附睾分泌蛋白4(human epididymial protein 4,HE4)在卵巢癌诊断中的价值。[方法]采用酶联免疫吸附试验和化学发光法检测48例卵巢癌患者、33例卵巢良性肿瘤患者以及38例健康体检者血清HE4以及糖类抗原125(CA125)的水平。[结果]血清HE4诊断卵巢癌的ROC曲线下面积为0.921(95%CI:0.887~0.955)。HE4 86.5pmol/L为阈值时诊断敏感度为66.7%,特异性为84.5%。而血清CA125诊断卵巢癌的ROC曲线下面积为0.902(95%CI:0.857~0.947)。CA125 48.2U/ml为阈值时诊断敏感度为62.5%,特异性为81.7%。HE4与CA125联合检测诊断卵巢癌的ROC曲线下面积为0.947(95%CI:0.914~0.980)。卵巢癌Ⅲ~Ⅳ期患者血清HE4水平明显高于Ⅰ~Ⅱ期患者(P<0.001),有淋巴结转移患者血清HE4水平明显高于无淋巴结转移患者(P<0.001)。[结论]HE4可作为卵巢癌诊断的血清学标志物,且与CA125联合检测可提高卵巢癌诊断效率。
[Objective] To investigate the value of human epididymym protein 4 (HE4) in the diagnosis of ovarian cancer. [Methods] The levels of serum HE4 and carbohydrate antigen 125 (CA125) in 48 patients with ovarian cancer, 33 patients with benign ovarian tumors and 38 healthy controls were detected by enzyme-linked immunosorbent assay and chemiluminescence. [Results] The area under the ROC curve of serum HE4 in diagnosing ovarian cancer was 0.921 (95% CI: 0.887-0.9595). The diagnostic sensitivity of HE4 86.5pmol / L was 66.7% with a specificity of 84.5%. The area under the ROC curve of serum CA125 in the diagnosis of ovarian cancer was 0.902 (95% CI: 0.857-0.947). The diagnostic sensitivity and the specificity of CA125 48.2U / ml at threshold were 62.5% and 81.7% respectively. The area under the ROC curve of HE4 and CA125 in the diagnosis of ovarian cancer was 0.947 (95% CI: 0.914-0.980). The serum level of HE4 in stage Ⅲ ~ Ⅳ ovarian cancer patients was significantly higher than that in stage Ⅰ ~ Ⅱ patients (P <0.001). The serum HE4 level in patients with lymph node metastasis was significantly higher than that in patients without lymph node metastasis (P <0.001). [Conclusion] HE4 can be used as a serological marker in the diagnosis of ovarian cancer, and combined with CA125 can improve the diagnostic efficiency of ovarian cancer.