摘要
目的:探讨血清人附睾分泌蛋白4(HE4)、组织特异性抗原(TPS)和CA125联检在卵巢癌诊断中的应用价值。方法:采用EIA、ELISA和ECLIA分别检测卵巢癌患者(n=30)、卵巢良性疾病患者(n=30)和健康对照者(n=31)的血清HE4、TPS和CA125血清水平。结果:卵巢癌组与卵巢良性疾病组、健康对照组、卵巢良性疾病组+健康对照组比较,血清HE4、TPS和CA125的水平都有显著统计学差异(P<0.01)。HE4在64.28pmol/L时约顿指数最大(0.667),敏感性为70.0%,特异性为96.7%,ROC-AUC为0.878;TPS在63.20U/L时约顿指数最大(0.469),敏感性为63.3%,特异性为83.6%,ROC-AUC为0.761;CA125在48.86U/ml时约顿指数最大(0.602),敏感性为73.3%,特异性为86.9%,ROC-AUC为0.836;HE4+CA125联检后敏感性为93.3%,特异性为82.0%,ROC-AUC为0.938;HE4+CA125+TPS联检后敏感性为93.3%,特异性为86.9%,ROC-AUC为0.941;HE4与CA125、HE4+CA125、HE4+CA125+TPS比较ROC-AUC无显著差异,HE4和CA125联检后其ROC-AUC增大为0.938,与CA125、TPS二个单项指标相比,P值均<0.05,与HE4、CA125、TPS三个指标联检后的ROC-AUC值0.941比较P>0.05,不存在统计学差异。结论:血清HE4是卵巢癌诊断的良好指标,HE4和CA125联检是理想的组合方式,兼顾了敏感性和特异性,提高了对卵巢癌的诊断能力。
Objective To study the diagnostic value of combined measurement of serum human epididymis secretory protein4（HE4）,tissue polypeptide specific antigen（TPS）and CA125 in patients with ovarian cancer.Methods Serum levels of HE4（with EIA）,TPS（with ELISA）and CA125（with ECLIA）were detected in 30 patients with ovarian cancer,30 patients with benign ovarian diseases and 31 controls.Results Serum levels of HE4,TPS and CA125 in patients with ovarian cancer were significantly higher than those in patients with benign ovarian diseases and the controls（P〈0.01）.The Yonden index（0.667）of HE4 was biggest at 64.28pmol/L,the sensitivity and the specificity was 70.0% and 96.7% respectively,and the receiver operating characteric-area under the curve（ROC-AUC）was 0.878.The Yonden index（0.469）of TPS was the biggest at 63.20U/L,the sensitivity and the specificity was 63.3% and 83.6% respectively and the ROC-AUC was 0.761.The Yonden index（0.537）of CA125 was the biggest at 48.86U/ml,the sensitivity and the specificity was 73.3% and 86.9% respectively and the ROC-AUC was 0.836.The sensitivity and the specificity of combined detection of HE4 and CA125 was 93.3% and 82.0% respectively and the ROC-AUC was 0.938.The sensitivity and the specificity of combined detection of HE4,CA125 and TPS was 93.3% and 86.9% respectively and the ROC-AUC was 0.941.The ROC-AUC of HE4 was not significantly different from that of CA125,HE4＋CA125 and HE4＋CA125＋TPS.The ROC-AUC of the combination of HE4 and CA125 increased to 0.938 which was significantly higher than that of CA125 or TPS alone（P〈0.05）,but was only slightly and insignificantly lower the ROC-AUC 0.941 of the combination of HE4,CA125 and TPS（P〈0.05）.Conclusion HE4 as a novel surum tumor marker,is a good indicator in the dignosis of ovarian cancer.Combined detection of HE4 and CA125 would be most desirable as shown from the above study of the ROC-AUCs of various combinations.
出处
《放射免疫学杂志》
CAS
2010年第4期409-411,共3页
Journal of Radioimmanology
