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分别用ELISA法和电化学发光法测定手术前的69例卵巢癌患者和52卵巢良性肿瘤患者及60例健康体检者的HE4和CA125的血清水平,并以卵巢良性肿瘤+健康人为参照绘制ROC曲线,分析HE4和CA125在不同临界点时对卵巢癌的诊断能力,评价HE4和CA125的诊断价值。临床回顾卵巢癌患者临床分期和病理学参数,以单变量统计分析治疗前HE4和CA125水平与卵巢癌临床病理特征的相关性。结果显示卵巢癌组HE4的中位水平为233.40 pmol/L,CA125中位数水平为88.37 U/ml,与卵巢良性肿瘤组和正常对照组比较,差异有非常显著意义(P<0.01)。以良性肿瘤+健康人为参照人群,HE4和CA125单项检测的受试者工作特征曲线下面积分别为0.906和0.758,当HE4的阳性临界点为150 pmol/L时,其敏感性和特异性分别为68.12%和100%,当HE4的阳性临界值为75 pmol/L时,其敏感性和特异性分别为79.71%和94.64%。HE4和CA125的表达水平和阳性率与患者临床分期及病理特征显著相关。尤其在FIGOⅠ期卵巢癌患者,高分化卵巢癌患者以及卵巢子宫内膜样癌患者中,HE4的表达阳性率显著高于CA125,差异有统计学意义(P<0.05)。由此可见HE4作为卵巢癌的肿瘤标志物,具有比CA125更好的鉴别诊断和早期诊断价值,术前HE4和CA125的检测可辅助判断卵巢癌患者临床病理特征,提高术后生存率。
The serum levels of HE4 and CA125 in 69 ovarian cancer patients, 52 ovarian benign tumor patients and 60 healthy volunteers before surgery were measured by ELISA and electrochemiluminescence. The ROC curves were drawn with reference to benign ovarian tumors and healthy individuals , Analyze the diagnostic ability of HE4 and CA125 in ovarian cancer at different critical points, and evaluate the diagnostic value of HE4 and CA125. The clinical stage and pathological parameters of patients with ovarian cancer were retrospectively analyzed. The correlation between the levels of HE4 and CA125 before treatment and the clinicopathological features of ovarian cancer was analyzed by univariate analysis. The results showed that the median level of HE4 in ovarian cancer group was 233.40 pmol / L, and the median CA125 level was 88.37 U / ml, which was significantly different from that in benign ovarian tumor group and normal control group (P <0.01). The benign tumor + healthy human reference population, HE4 and CA125 single test subjects under the area under the working curve were 0.906 and 0.758, respectively, when HE4 positive critical point of 150 pmol / L, the sensitivity and specificity were 68.12% and 100%. The sensitivity and specificity of HE4 were 79.71% and 94.64% when the positive cutoff value was 75 pmol / L. The expression level and positive rate of HE4 and CA125 were significantly correlated with clinical stage and pathological features. Especially in patients with FIGO stage I ovarian cancer, patients with well-differentiated ovarian cancer and patients with ovarian endometrial carcinoma, the positive rate of HE4 expression was significantly higher than that of CA125, the difference was statistically significant (P <0.05). This shows that HE4 as a tumor marker of ovarian cancer has better differential diagnosis and early diagnosis value than CA125. The detection of HE4 and CA125 before surgery can help to determine the clinicopathological features of patients with ovarian cancer and improve the postoperative survival rate.