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目的:探讨联合检测血清OPN、HE4和CA125对卵巢癌的临床意义。方法:选择2010年6月-2012年7月西安市中心医院妇科及陕西省肿瘤医院妇瘤科收治的35例卵巢癌患者、73例卵巢良性肿瘤患者及40例同期体检的健康妇女为研究对象,应用ELISA法检测患者手术前后血清OPN、HE4水平,电化学发光法检测患者手术前后血清CA125水平,计算3种肿瘤标志物单项以及联合检测在卵巢癌诊断中的敏感性及特异性。结果:(1)卵巢癌患者术前血清OPN、HE4和CA125水平分别为94.6±61.06ng/mL、412.3±278.62 pmol/mL和398.64±220.91 U/mL,与卵巢良性肿瘤组及正常对照组比较差异有统计学意义(P<0.05);(2)卵巢癌患者手术前与术后1月血清OPN、HE4和CA125水平比较,差异均有统计学意义(P<0.05);(3)血清OPN、HE4和CA125水平联合检测诊断卵巢癌的敏感性(94.3%)显著高于血清OPN、HE4和CA125单项指标检测(分别为37.1%、71.4%和77.1%),联合检测与单项指标检测比较差异均有统计学意义(P<0.05),而血清OPN、HE4和CA125联合检测诊断卵巢癌的特异性(78.8%)稍低于血清OPN、HE4和CA125单项指标检测(分别为87.6%、100%和80.5%),联合检测与单项指标检测的特异性比较差异无统计学意义(P>0.05)。血清HE4单项指标检测的特异性高达100%。结论:联合检测卵巢癌患者血清OPN、HE4和CA125水平可作为诊断和评估卵巢癌预后的参考指标。
Objective: To investigate the clinical significance of combined detection of serum OPN, HE4 and CA125 in ovarian cancer. Methods: From June 2010 to July 2012, 35 patients with ovarian cancer, 73 patients with benign ovarian tumors and 40 healthy women who underwent gynecology in Xi’an Central Hospital and Shaanxi Provincial Cancer Hospital were enrolled in this study. Serum levels of OPN and HE4 were detected by ELISA before and after surgery. The levels of serum CA125 in patients before and after operation were detected by electrochemiluminescence. The sensitivity and specificity of three kinds of tumor markers and their combined detection in the diagnosis of ovarian cancer were calculated. Results: (1) The serum levels of OPN, HE4 and CA125 in preoperative ovarian cancer patients were 94.6 ± 61.06ng / mL, 412.3 ± 278.62 pmol / mL and 398.64 ± 220.91 U / mL respectively, which were significantly higher than those in benign ovarian tumor group and normal control group (P <0.05); (2) The levels of serum OPN, HE4 and CA125 in patients with ovarian cancer before operation and one month after operation were significantly different (P <0.05); (3) Serum OPN The sensitivity of combined detection of HE4 and CA125 in the diagnosis of ovarian cancer was significantly higher than that of serum OPN, HE4 and CA125 (37.1%, 71.4% and 77.1%, respectively). The combined detection was significantly different from the single index (P <0.05). The specificity of combined detection of OPN, HE4 and CA125 in ovarian cancer (78.8%) was slightly lower than that of OPN, HE4 and CA125 (87.6%, 100% And 80.5% respectively). There was no significant difference in the specificity between the combined test and single test (P> 0.05). Serum HE4 single index detection of specificity up to 100%. Conclusion: The combined detection of serum OPN, HE4 and CA125 levels in patients with ovarian cancer can be used as a reference index for diagnosis and assessment of prognosis of ovarian cancer.