血管内皮生长因子、糖类抗原125及人附睾蛋白4联合检测在卵巢癌诊断中的价值

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摘要目的探讨血管内皮细胞生长因子（VEGF）联合糖类抗原125（CA125）以及人附睾蛋白4（HE4）在卵巢癌诊断中的应用价值。方法选取2017年1月至2019年6月泰安市泰山区人民医院收治的60 例卵巢癌患者作为卵巢癌组，选取2017年1月至2019年6月泰安市泰山区人民医院收治的60 例卵巢良性疾病患者作为卵巢良性疾病组，并选择2017年1月至2019年6月在泰安市泰山区人民医院门诊健康体检的60 例健康女性作为正常对照组。检测三组的血清VEGF、CA125 及HE4 的水平，比较卵巢癌患者、卵巢良性疾病患者及健康女性的血清VEGF、CA125 及HE4 水平，采用受试者工作特征（ROC）曲线分析三项指标单独检测和联合检测对卵巢癌的诊断价值。结果卵巢癌组的VEGF、CA125、HE4 水平高于对照组和卵巢良性疾病组，差异有统计学意义（P＜0.001）。卵巢良性疾病组的VEGF 水平高于正常对照组，差异有统计学意义（P＜0.001）。卵巢良性疾病组的CA125、HE4 水平与对照组比较，差异无统计学意义（P＞0.05）。卵巢癌Ⅳ期患者的血清CA125、VEGF 和HE4 水平高于卵巢癌Ⅰ～Ⅱ期及Ⅲ期患者，差异有统计学意义（P＜0.05）。卵巢癌Ⅲ期患者的血清CA125、VEGF 和HE4 水平高于卵巢癌Ⅰ～Ⅱ期患者，差异有统计学意义（P＜0.05）。VEGF、CA125、HE4 诊断卵巢癌的灵敏度分别为85.00%、73.33%、65.00%，特异度分别为79.17%、68.33%、89.17%。在VEGF、CA125、HE4 单项检测中，VEGF 对卵巢癌的诊断效能最高。 VEGF、CA125、HE4 三项联合检测的灵敏度和特异度分别为71.67%、91.67%。 CA125 和HE4 联合检测的灵敏度和特异度分别为83.33%和72.50%。三项联合检测的诊断效能高于单独检测和CA125+HE4 两项联合检测。在卵巢癌早期诊断（Ⅰ～Ⅱ期）诊断中，VEGF、CA125、HE4 三项联合的灵敏度、特异度分别为84.60%、93.00%；CA125 和HE4两项联合检测的灵敏度、特异度分别为81.50%、76.80%。三项联合检测早期卵巢癌的诊断效能高于CA125+HE4两项联合检测。结论联合检测血清VEGF、CA125、HE4 对卵巢癌的诊断、病情评估以及预后判断，特别是早期卵巢癌诊断具有重要价值。

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	刘学博

关键词 ：血管内皮细胞生长因子, 糖类抗原, 人附睾蛋白4, 卵巢癌

Abstract：Objective To investigate the clinical value of combined detection of vascular endothelial growth factor(VEGF), carbohydrate antigen 125 (CA125) and human epididymis protein 4 (HE4) in the diagnosis of ovarian cancer.Methods From January 2017 to June 2019, 60 ovarian cancer patients admitted to Taishan District People′s Hospital of Tai′an City were selected as the ovarian cancer group. From January 2017 to June 2019, 60 patients with benign ovarian diseases admitted to Taishan District People′s Hospital of Tai′an City were selected as the benign ovarian diseases group, and 60 healthy women who underwent health check-up from January 2017 to June 2019 at Taishan District People′s Hospital of Tai′an City were selected as the control group. The serum levels of VEGF, CA125 and HE4 were measured, the serum levels of VEGF, CA125 and HE4 were compared among ovarian cancer patients, benign ovarian disease patients and healthy women, the receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of three separate and combined tests for ovarian cancer. Results The levels of VEGF, CA125 and HE4 in ovarian cancer group were higher than those in control group and benign ovarian disease group, and the differences were statistically significant (P＜0.001). The level of VEGF in benign ovarian disease group was higher than that in normal control group, the difference was statistically significant (P＜0.001). There were no statistically significant differences in the CA125 and HE4 levels between benign ovarian disease group and control group (P＞0.05). The serum levels of CA125,VEGF and HE4 in patients with stage Ⅳovarian cancer were higher than those in patients with stage Ⅰ-Ⅱand Ⅲovarian cancer, and the differences were statistically significant (P＜0.05). Serum levels of CA125, VEGF and HE4 in patients with stage Ⅲovarian cancer were higher than those in patients with stage Ⅰ-Ⅱovarian cancer, and the differences were statistically significant (P＜0.05). The sensitivity of VEGF, CA125 and HE4 to ovarian cancer were 85.00%,73.33%, 65.00% respectively. The specificity of VEGF, CA125 and HE4 to ovarian cancer were 79.17%, 68.33% and 89.17% respectively. In VEGF, CA125 and HE4 single test, the diagnostic efficacy of VEGF in ovarian cancer was the highest. The sensitivity and specificity of three combined tests among VEGF, CA125 and HE4 were 71.67% and 91.67% respectively. The test′s sensitivity and specificity of CA125 combined with HE4 were 83.33% and 72.50% respectively. The diagnostic efficacy of three combined tests was higher than that of single test and CA125+HE4 test. The sensitivity and specificity of three combined tests among VEGF, CA125 and HE4 were 84.60% and 93.00% respectively, and the sensitivity and specificity of CA125 combined with HE4 were 81.50% and 76.80% respectively. The diagnostic efficacy of three combined tests was higher than that of CA125+HE4. Conclusion The combined determination of CA125 and serum HE4 and VEGF improves the diagnosis of ovarian epithelial cancer, especially for early ovarian cancer diagnosis.

Key words： Vascular endothelial growth factor Carbohydrate antigen 125 Human epididymis protein 4 Ovarian cancer

引用本文:

刘学博. 血管内皮生长因子、糖类抗原125及人附睾蛋白4联合检测在卵巢癌诊断中的价值[J]. 中国当代医药, 2022, 29(16): 35-38转48.
LIU Xuebo. Value of combined detection of vascular endothelial growth factor, carbohydrate antigen 125 and human epididymis protein 4 in the diagnosis of ovarian carcinoma. 中国当代医药, 2022, 29(16): 35-38转48.

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