血清癌抗原125联合人血清附睾蛋白4对卵巢恶性肿瘤的检测价值

[摘要] 目的 探讨人血清附睾蛋白4（HE4）和癌抗原125（CA125）在卵巢恶性肿瘤诊断中的检测价值。 方法 选择59例卵巢恶性病变患者（恶性病变组）、87例良性病变患者（良性病变组）及61例体检健康妇女（健康对照组），采用化学发光免疫法及酶联免疫法测定其血清CA125与HE4水平，并进行分析。 结果 卵巢癌恶性病变组的CA125与HE4水平均显著高于健康对照组和卵巢良性病变组，差异有统计学意义（P < 0.05）；CA125与HE4联合检测的灵敏度（88.14%）明显高于单项检测的CA125（79.66%）或HE4（57.63%），联合检测的阴性预测值（89.86%）明显高于单独检测的CA125（83.78%）和HE4（76.19%）。 结论 血清CA125与HE4联合检测可提高卵巢恶性肿瘤的灵敏度、诊断及治疗水平。

[关键词] 卵巢恶性肿瘤；癌抗原125；人血清附睾蛋白4

[中图分类号] R730.43 [文献标识码] A [文章编号] 1673-7210（2012）07（a）-0091-03

Testing value of carcinoembryonic antigen 125 and human epididymis gene protein 4 for malignant tumor of ovary

XU Huigen1 YUAN Chunlei2

1.Department of Laboratory Medicine, Torch Development Zone Hospital of Zhongshan City, Guangdong Province, Zhongshan 528437, China；2.Department of Laboratory Medicine, the Affiliated Bo'ai Hospital of Southern Medical University in Zhongshan City, Guangdong Province, Zhongshan 528403, China

[Abstract] Objective To discuss the testing value of carcinoembryonic antigen 125 (CA125) and human epididymis gene protein 4 (HE4) for malignant tumor of ovary. Methods Chose 59 patients with malignant tumor of ovary (malignant change group), 87 patients with benign lesion (benign lesion group), 61 health people (health control group), used the chemiluminescence immunoassay and euzymelinked immunosorbent assay to check the level of the CA125 and HE4 of their blood, and were analyzed. Results The level of the CA125 and HE4 content in the malignant tumor of ovary group were higher than those of the benign lesion group and the health group, there were statistical significance between them(P < 0.05). The sensitiveness of CA125 combined with HE4 (88.14%) is higher than the singleness checking CA125 (79.66%) or HE4(57.63%), negative predicted value of checking together (89.86%) is higher than the singleness checking CA125 (83.78%) or HE4 (76.19%). Conclusion combined check CA125 and HE4 can be improve the sensitiveness , diagnoses and treatment in the malignant tumor of ovary patient.

[Key words] Malignant tumor of ovary; Carcinoembryonic antigen 125; Human epididymis gene protein 4

在世界范围内的生殖系统恶性肿瘤中，卵巢癌的死亡率较高。该疾病由于发病时的症状不明显，导致诊断时已是晚期的发生率高达75%以上，因此争取不到最好的治疗时间，以致达到5年生存期的患者不足30%[1]。早发现、早诊断、早治疗是提高患者生活质量和生存率的关键。由于卵巢恶性肿瘤诊断缺乏特异的肿瘤标志物，故临床上常通过肿瘤标志物联合检测以提高对卵巢恶性肿瘤的敏感性[2]。目前用于诊断卵巢癌的诊断指标仅有癌抗原125（CA125）被广泛使用，但是该指标不单只有患者患卵巢癌时才会升高，其在子宫内膜异位症、盆腔炎症等妇科良性疾病中也有升高的现象，所以在诊断卵巢癌时单独用CA125是难以确诊的，即特异性不高，故在诊断中寻找一种灵敏性和特异性较强的标志物来配合检查，有利于提高卵巢癌的诊断水平。人血清附睾蛋白4（human epididymis gene protein 4，HE4）是一种新的肿瘤标志物，它在子宫内膜异位症、盆腔炎症及正常组织中的含量不高，但在卵巢癌中的含量比较高，并且应用于诊断卵巢癌的研究在国外早已有报道[3]。笔者通过联合检测血清CA125与HE4水平对卵巢恶性肿瘤进行早期诊断，并与卵巢良性病变、健康妇女进行比较，现总结分析报道如下：