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目的探讨血清人附睾分泌蛋白4(HE4)在卵巢恶性肿瘤中的诊断价值。方法采用酶联免疫吸附试验及化学发光方法检查75例卵巢恶性肿瘤患者、100例卵巢良性肿瘤患者及50名健康者血清HE4及糖类抗原125(CA125)水平。比较各组间血清HE4和CA125水平、HE4和CA125的阳性率,卵巢恶性肿瘤患者不同临床分期、有无淋巴结转移和不同病理分化程度之间血清HE4和CA125水平和阳性率。结果卵巢恶性肿瘤组血清HE4、CA125水平及阳性率明显高于健康组,差异均有统计学意义(P<0.05),卵巢良性肿瘤组血清HE4水平与健康组相比差异无统计学意义(P>0.05),血清CA125水平与健康组相比差异有统计学意义(P<0.05);卵巢恶性肿瘤组血清HE4水平及表达阳性率明显高于良性肿瘤组,差异有统计学意义(P<0.05),卵巢恶性肿瘤组CA125表达水平高于卵巢良性肿瘤组,差异有统计学意义(P<0.05),卵巢恶性肿瘤组CA125表达阳性率与卵巢良性肿瘤组相比差异无统计学意义(P>0.05);晚期、有淋巴结转移、分化程度低的卵巢恶性肿瘤患者血清HE4水平及HE4阳性率较早期、无淋巴结转移、分化程度高的卵巢恶性肿瘤患者高,差异有统计学意义(P<0.05),而血清CA125水平及阳性率差异无统计学意义(P>0.05)。血清HE4对卵巢恶性肿瘤检测的灵敏度、特异度、阳性预测者、阴性预测值及准确率均高于CA125。结论 HE4是对卵巢恶性肿瘤诊断良好的肿瘤标志物,通过对血清HE4检测可以提高对卵巢恶性肿瘤诊断的准确率,血清HE4水平及阳性率与卵巢恶性肿瘤临床分期、有无淋巴结转移及病理分化程度有关。
Objective To investigate the diagnostic value of serum human epididymal secretory protein 4 (HE4) in ovarian cancer. Methods Serum levels of HE4 and carbohydrate antigen 125 (CA125) in 75 patients with ovarian cancer, 100 patients with benign ovarian tumor and 50 healthy controls were examined by enzyme-linked immunosorbent assay and chemiluminescence. The serum levels of HE4 and CA125, positive rates of HE4 and CA125, serum clinical levels of HE4 and CA125 and their positive rates in different clinical stages, with or without lymph node metastasis and different pathological differentiation were compared between groups. Results The serum level of HE4 and CA125 and the positive rate in ovarian cancer group were significantly higher than those in healthy group (P <0.05). There was no significant difference in serum HE4 level between benign ovarian tumor group and healthy group (P > 0.05). The serum level of CA125 in ovarian cancer group was significantly higher than that in benign tumor group (P <0.05), the level of serum CA125 was significantly higher than that in healthy group (P <0.05) ), The expression level of CA125 in ovarian cancer group was higher than that in benign ovarian tumor group (P <0.05), the positive rate of CA125 in ovarian cancer group was not significantly different from benign ovarian tumor group (P> 0.05). In the late stage, the serum HE4 level and the positive rate of HE4 in patients with lymph node metastasis and low differentiation were higher than those in early stage without lymph node metastasis and high degree of differentiation (P <0.05 ), While the serum CA125 level and positive rate difference was not statistically significant (P> 0.05). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of serum HE4 in ovarian cancer were higher than those of CA125. Conclusions HE4 is a good tumor marker for the diagnosis of ovarian cancer. HE4 detection can improve the accuracy of diagnosis of ovarian cancer, serum HE4 level and positive rate of ovarian cancer clinical stage, with or without lymph node metastasis and pathological differentiation Degree related.