血清糖链多肽抗原125和人附睾分泌蛋白4检测在子宫内膜癌中的应用价值

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摘要目的探讨血清糖链多肽抗原125（CA125）、人附睾分泌蛋白4（HE4）在子宫内膜癌（EC）中的应用价值。方法选取2015年1月～2016年9月我院收治的52例EC患者作为Ⅰ组，选取同期的53例子宫内膜息肉患者作为Ⅱ组，选取同期的54例健康体检者为Ⅲ组，分别检测三组的血清CA125和HE4水平，比较各组间的差异以及EC患者不同分期之间的差异，同时分析其在EC诊断中的价值。结果Ⅰ组的CA125、HE4水平显著高于Ⅱ组和Ⅲ组，差异有统计学意义（P＜0.05）。Ⅱ组的 HE4水平高于Ⅲ组，差异有统计学意义（P＜0.05）。Ⅱ组和Ⅲ组的CA125水平比较，差异无统计学意义（P＞0.05）。Ⅰ组Ⅰ期的CA125水平与Ⅱ组和Ⅲ组比较，差异无统计学意义（P＞0.05）。Ⅰ组Ⅰ期的HE4水平高于Ⅱ组和Ⅲ组，差异有统计学意义（P＜0.05）。在不同病理组织学分级、FIGO分期和Ⅲ期淋巴结是否转移的比较中，随着肿瘤恶性程度的升高，CA125、HE4水平呈递增趋势，差异有统计学意义（P＜0.05）。在Ⅰ期肌层浸润程度中，仅有HE4水平比较差异有统计学意义（P＜0.05）。CA125、HE4与EC成正相关，相关系数为0.44、0.69，HE4更密切。以CA125＞35 U/ml、HE4＞104 pmol/L为临界值，CA125的灵敏度和特异度为59.6%、84.1%，HE4为46.2%、99.1%；约登指数分别为0.44、0.45。采用ROC曲线分析HE4，结果显示，HE4在74 pmol/L时曲线下面积最大，灵敏度和特异度为78.8%、88.8%，约登指数为0.68。将两项指标联合检测诊断EC，并不能显著提高诊断准确性。结论血清CA125和HE4均可作为EC检测的标志物，对预测肿瘤恶性程度有一定意义，其中HE4的诊断准确率及预测价值更高，尤其在肿瘤早期。

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	温东瑜
	熊小琴
	辛玉宏

关键词 ：糖链多肽抗原125, 人附睾分泌蛋白4, 子宫内膜癌

Abstract：ObjectiveTo explore the application value of serum carbohydrate antigen-125 (CA-125)and human epididymis secretory protein 4 (HE4)detection in endometrial carcinoma (EC).Methods52 cases of EC in our hospital from January 2015 to September 2016 were selected as groupⅠ,and 53 patients with endometrial polyps in the same period were selected as groupⅡ,and 54 healthy persons in the same period were selected as groupⅢ.The levels of serum CA125 and HE4 were detected in three groups respectively.The difference in the each group and the difference in the different stages of EC were compared.The value of EC in the diagnosis of the patients was analyzed.ResultsThe level of CA125 and HE4 in groupⅠ was higher than that in groupⅡ and groupⅢ,with significant difference (P＜0.05).The level of HE4 in groupⅡ was higher than that in groupⅢ,with significant difference (P＜0.05).There was no significant difference in the level of CA125 between groupⅡ and groupⅢ (P＞0.05).There was no significant difference in the level of CA125 between stageⅠof groupⅠand groupⅡ,groupⅢ(P＞0.05).The level of HE4 in stageⅠof groupⅠ was higher than that in groupⅡ and groupⅢ,with significant difference (P＜0.05).In the comparison of different pathological grading,FIGO staging and whether to transfer of lymph node metastasis in stageⅢ,with the increase of malignancy,CA125 and HE4 levels increased,the difference was statistically significant(P＜0.05).In the myometrial invasion in stageⅠ,only the level of HE4 was statistically significant(P＜0.05).CA125,HE4 and EC were positively correlated,the correlation coefficient was 0.44,0.69,HE4 was more closely.With CA125＞35 U/ml and HE4＞74 pmol/L as the diagnostic critical value,the sensitivity and specificity of CA125 were 59.6%,84.1%,46.2%for HE4,99.1%.Youden index were 0.44,0.45 respectively.The results using ROC curve analysis HE4 showed that the maximum area under the curve of HE4 was 74 pmol/L,the sensitivity and specificity was 78.8%,88.8%respectively,Youden index was 0.68.The combined detection of two indexes in the diagnosis of EC could not significantly improve the diagnostic accuracy.ConclusionCA125 and HE4 can be used as detection markers for EC,which have certainly significance in predicting the degree of malignancy,and HE4 is better in diagnostic accuracy and predictive value,especially in the early stage.

Key words： Carbohydrate antigen-125 Human epididymis secretory protein 4 Endometrial carcinoma

作者简介: 温东瑜（1983-），女，本科，主治医师，研究方向：妇科肿瘤

引用本文:

温东瑜;熊小琴;辛玉宏. 血清糖链多肽抗原125和人附睾分泌蛋白4检测在子宫内膜癌中的应用价值[J]. 中国当代医药, 2017, 24(2): 57-60.
WEN Dong-yu;XIONG Xiao-qin;XIN Yu-hong. Application value of serum carbohydrate antigen-125 and human epididymis secretory protein 4 detection in endometrial carcinoma. 中国当代医药, 2017, 24(2): 57-60.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2017/V24/I2/57

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