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目的探讨血清人附睾蛋白4(HE4)联合CA125和CA199的检测在卵巢恶性肿瘤筛查中的临床意义。方法选取2015年12月至2016年12月间南京市溧水区人民医院收治的74例卵巢肿瘤患者,根据肿瘤良恶性不同分为恶性肿瘤组39例和良性肿瘤组35例,选取同期健康受试者35例为健康组。采用电化学发光法检测3组受试者血清中的HE4、CA125和CA199水平,观察3组中各肿瘤标志物水平,以及3种肿瘤标志物联合检测的诊断效率。结果恶性肿瘤组中血清HE4、CA125和CA199平均水平显著高于良性肿瘤组和健康组,差异均有统计学意义(均P<0.05);良性肿瘤组和健康组比较,差异无统计学意义(P>0.05)。卵巢癌组血清HE4和CA125的敏感性和Youden指数均较CA199标志物高,差异均有统计学意义(均P<0.05)。与CA125相比,CA199和HE4的特异性较高,差异均有统计学意义(均P<0.05)。血清HE4、CA125和CA199联合检测卵巢恶性肿瘤的敏感性显著高于3指标单项检测,差异均有统计学意义(均P<0.05)。结论血清HE4、CA125和CA199联合检测对提高卵巢恶性肿瘤的诊断率有重要意义,其中HE4的检测有助于卵巢良恶性的诊断,是卵巢癌诊断的重要参考指标。
Objective To investigate the clinical significance of serum human epididymal protein 4 (HE4) combined with CA125 and CA199 in the screening of malignant ovarian tumors. Methods Seventy-four patients with ovarian tumors admitted to Lishui District People’s Hospital of Nanjing from December 2015 to December 2016 were divided into 39 cases of malignant tumor group and 35 cases of benign tumor group according to different benign and malignant tumors. 35 cases were healthy group. The levels of HE4, CA125 and CA199 in sera of three groups were detected by electrochemiluminescence. The levels of tumor markers in each group and the diagnostic efficiency of three kinds of tumor markers were detected. Results The average levels of serum HE4, CA125 and CA199 in malignant tumor group were significantly higher than those in benign tumor group and healthy group (all P <0.05). There was no significant difference between benign tumor group and healthy group P> 0.05). The ovarian cancer serum HE4 and CA125 sensitivity and Youden index were higher than CA199 markers, the differences were statistically significant (P <0.05). Compared with CA125, the specificity of CA199 and HE4 were higher, the differences were statistically significant (all P <0.05). Serum HE4, CA125 and CA199 combined detection of ovarian cancer was significantly higher than the sensitivity of the three indicators of a single test, the differences were statistically significant (P <0.05). Conclusions The combined detection of serum HE4, CA125 and CA199 is of great significance in the diagnosis of ovarian cancer. The detection of HE4 is helpful for the diagnosis of benign and malignant ovarian and is an important reference for the diagnosis of ovarian cancer.