| 崔彭华,张玉娟,邵雪斋,王会民,申兴彬.人附睾蛋白4与糖类抗原125在子宫内膜癌诊治中的临床价值[J].,2018,(12):2334-2338 |
| 人附睾蛋白4与糖类抗原125在子宫内膜癌诊治中的临床价值 |
| The Clinical Value of Human Epididymal Protein 4 and Carbohydrate Antigen 125 in the Diagnosis and Treatment of Endometrial Carcinoma |
| 投稿时间：2017-11-11 修订日期：2017-12-06 |
| DOI：10.13241/j.cnki.pmb.2018.12.028 |
| 中文关键词: 子宫内膜癌的 人附睾蛋白4 糖类抗原125 诊断 预后 |
| 英文关键词: Endometrial carcinoma Human epididymal protein 4 Carbohydrate antigen 125 Diagnosis Prognosis |
| 基金项目:河北省人口和计划生育委员会科技研究计划项目（2012-A25）；承德市科技支撑计划项目（2013-2044） |
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| 中文摘要: |
| 摘要 目的：探讨人附睾蛋白4(HE4)与糖类抗原125(CA-125)在子宫内膜癌(EC)诊治中的临床价值。方法：选择60例EC患者、60例功能失调性子宫出血(DUB)患者为研究对象(分别记为EC组、DUB组)，以同期体检健康的60名女性为对照(NC组)。采用酶联免疫吸附法(ELISA)、电化学发光法(ECLA)分别检测三组受检者的血清HE4、CA-125水平并比较，绘制ROC曲线评价两指标单项及联合检测对EC的诊断效能。结果：EC组血清HE4[(141.16±46.43)pmol/L]、CA-125[(33.14±7.52)U/mL]水平均明显高于DUB组和NC组(P＜0.05)，DUB组血清CA-125水平[(19.05±7.20)U/mL]明显高于NC组(P＜0.05)，而HE4水平与NC组无显著差异(P＞0.05)。术前，ECⅢ期患者的血清HE4[(172.04±18.66) pmol/L]和CA-125[(45.05±4.11)U/mL]水平均明显高于Ⅱ期和Ⅰ期患者(P＜0.05)；ECⅠ期的HE4阳性率(67.9%)明显高于CA-125阳性率(P＜0.05)；HE4、CA-125诊断EC的临界值分别为65.42 pmol/L和25.53 U/mL；单独检测HE4、CA-125诊断EC的敏感性分别为97.5%、78.3%，特异性分别为95.0%、98.3%，曲线下面积(AUC)分别为0.993、0.954；二者联合检测诊断EC的敏感性、特异性及AUC分别99.2%、95.0%和0.995；与术前比，EC患者术后血清HE4[(45.13±8.06)pmol/L]、CA-125[(11.22±5.50)U/mL]水平均显著降低(P＜0.05)。结论：血清HE4水平监测对EC的诊断、术前评估及疗效评判具有重要的参考价值，其与CA-125联合检测可提高EC诊断的准确性。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the clinical value of human epididymal protein 4 (HE4) and carbohydrate antigen 125 (CA-125) in the diagnosis and treatment of endometrial carcinoma (EC). Methods: 60 cases of patients with EC (EC group) and 60 cases of patients with dysfunctional uterine bleeding (DUB) (DUB group) were selected for the present study. 60 cases of healthy women were enrolled as the normal control (NC group). Enzyme linked immunosorbent assay (ELISA) and electrochemiluminescence (ECLA) were performed for detecting the levels of serum HE4 and CA-125, respectively. The differences of serum HE4 and CA-125 levels among the three groups were compared, and ROC curve was drawn to evaluate the diagnostic efficacy of single and combined detection of two in- dex on EC. Results: The levels of serum HE4 [(141.16±46.43) pmol/L] and CA-125 [(33.14±7.52) U/mL] in the group EC were signifi- cantly higher than those in the group DUB and group NC (P< 0.05). Compared with the NC group, the level of serum CA-125 [(19.05±7.20) U/mL] in the group DUB was significantly higher (P<0.05), but there was no significant difference of HE4 level between them (P>0.05). The levels of serum HE4 [(172.04±18.66) pmol/L] and CA-125 [(45.05±4.11) U/mL] in EC patients with stage Ⅲ were sig- nificantly higher than those in EC patients with stage Ⅱand stage Ⅰ (P<0.05). The positive rates of HE4 in EC stage I (67.9%) was sig- nificantly higher than that of CA-125 (P<0.05). The critical values of HE4 and CA-125 for EC diagnosis were 65.42 pmol/L and 25.53 U/mL, respectively. The sensitivity of HE4 and CA-125 for EC diagnosis were 97.5% and 78.3%, respectively. The specificity were 95.0% and 98.3%, respectively. The area under the curve (AUC) were 0.993 and 0.954, respectively. The sensitivity, specificity and AUC of HE4 and CA-125 combined detection for EC diagnosing were 99.2%, 95.0% and 0.995, respectively. Compared with the preoperative, the levels of serum HE4 [(45.13±8.06) pmol/L] and CA-125 [(11.22±5.50) U/mL] in the postoperative EC patients were significantly lower (P<0.05). Conclusion: A monitoring of serum HE4 level had important reference value for the diagnosis, preoperation and efficacy evaluation of EC, and its combined detection with CA-125 can improve the accuracy of EC diagnosis. |
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