摘要
目的探讨人附睾蛋白4(HE4)和糖类抗原19-9(CA19-9)联合检测在卵巢癌临床诊断和病理分型中应用价值。方法选取2015年9月至2017年2月万州区人民医院妇产科诊治的64例卵巢癌患者为受试对象,并以同期就诊的64例卵巢良性肿瘤患者为对照人群,利用酶联免疫吸附测定(ELISA)检测患者血清CA19-9和HE4的水平,以ROC曲线评价其诊断价值,并对不同病理分型患者CA19-9和HE4水平进行比较。结果 CA19-9最佳诊断临界值为37.9U/L;血清CA19-9≥37.9U/L预测卵巢癌阳性的特异度为88.16%,灵敏度为76.59%;HE4最佳诊断临界值为55.74pmol/L;血清HE4≥55.74pmol/L指示卵巢癌阳性的特异度为90.64%,灵敏度为82.91%;良性卵巢肿瘤患者CA19-9与HE4水平明显低于卵巢癌患者,差异均有统计学意义(P<0.05);CA19-9与HE4联合检测诊断卵巢癌的特异度与单独检测比较,差异无统计学意义(P>0.05),但灵敏度明显高于单独检测(P<0.05);卵巢上皮型肿瘤患者CA19-9和HE4水平较卵巢非上皮型肿瘤者高(P<0.05);此外,黏液型、透明细胞肿瘤、子宫内膜样肿瘤和移行细胞肿瘤的卵巢癌患者CA19-9和HE4水平均显著低于浆液型卵巢癌患者(P<0.05)。结论联合检测血清CA19-9与HE4可提高卵巢癌临床诊断灵敏度,且对肿瘤病理分型具有积极的辅助指导作用。
Objective To investigate the clinical value of combined detection of human epididymal protein 4(HE4)and carbohydrate antigen 19-9(CA19-9)in clinical diagnosis and pathological typing of ovarian cancer.Methods The 64 cases of ovarian cancer from September 2015 to February 2017 in our hospital were selected as the subjects,and 64 patients with ovarian benign tumor were enrolled as the control group.The serum levels of CA19-9 and HE4 were determined by enzyme linked immunosorbent assay(ELISA).The diagnostic value was evaluated by ROC curve,and the contents of CA19-9 and HE4 in different pathological types were compared.Results The best diagnostic critical value of CA19-9 was 37.9 U/L.The positive prediction of ovarian cancer specificity was 88.16%and the sensitivity was 76.59%when the level of serum CA19-9 more than 37.9 U/L;The best diagnostic critical value of HE4 was 55.74 pmol/L.The positive prediction of ovarian cancer specificity was 90.64%and the sensitivity was 82.91%when the level of serum HE4 more than 55.74 pmol/L;The levels of CA19-9 and HE4 in patients with benign ovarian tumors were significantly lower than those in patients with ovarian cancer(P<0.05).The specificity of combined detection of CA19-9 and HE4 in diagnosis of ovarian cancer was not statistically significant as compared with that of individual detection(P>0.05),but the sensitivity was higher than that of individual detection(P<0.05).The content of CA19-9 and HE4 in epithelial ovarian tumor patients were higher than non-epithelial tumors(P<0.05).In addition,The levels of CA19-9 and HE4 in mucinous type,clear cell tumor,endometrioid tumor and transitional cell tumor in patients with ovarian cancer were significantly lower than those in serous ovarian cancer(P<0.05).Conclusion The combined detection of serum CA19-9 and HE4 can significantly improve the sensitivity of clinical diagnosis of ovarian cancer,and has a positive auxiliary guiding role in pathological classification of tumor.
作者
方友琴
方友华
林开健
陈艳
FANG Youqin;FANG Youhua;LIN Kaijian;CHEN Yan(Department of Obstetrics and Gynecology,Wanzhou People′s Hospital of Chongqing,Chongqing 404100,China;Department of Respiratory,the Fifth People′s Hospital of Chongqing,Chongqing 400062,China;Department of Nursing,Wanzhou People′s Hospital of Chongqing,Chongqing 404100,China)
出处
《检验医学与临床》
CAS
2018年第8期1108-1111,共4页
Laboratory Medicine and Clinic
基金
重庆市万州区科委项目(WZStc-042017064)
关键词
卵巢癌
糖类抗原19-9
人附睾蛋白4
病理分型
ovarian cancer
carbohydrate antigen 19-9
human epididymal protein 4
pathological classification
作者简介
方友琴,女,副主任医师,主要从事卵巢癌方面的临床诊断研究。;通信作者,E-mail:454260070@qq.com.
