CAJ | 학술논문

目的探讨血清人附睾分泌蛋白4(HE4)联合CA125水平检测在卵巢恶性肿瘤与子宫内膜异位症鉴别诊断中的价值.方法采用酶联免疫吸附试验(ELISA)检测卵巢子宫内膜异位囊肿(内异症组)46例、卵巢上皮性癌(卵巢癌组)36例、卵巢非内膜异位良性肿瘤(良性肿瘤组)60例和健康妇女(对照组)50例血清中HE4和CA125水平,结果以中位数表示.血清HFA和CA125正常值分别为0～150 pmo/L和0～35 kU/L,单独或联合检测时,其中任一指标高于正常上限即定为阳性.通过制作受试者工作特征(ROC)曲线,以曲线下面积(AUC)反映诊断的准确性;以Mann-Whitney U 检验及相关性分析探讨两项指标单独或联合检测用于诊断卵巢内异症囊肿的价值.结果 (1)HE4水平:内异症、对照、良性肿瘤组妇女血清HE4水平分别为52.4、51.0、50.0 pmoL/L,3组比较,差异无统计学意义(P>0.05),卵巢癌组患者HE4水平为507.5 pmoL/L,与其他3组分别比较,差异均有统计学意义(P<0.05).(2)CA125水平:卵巢癌、内异症、良性肿瘤及对照组妇女血清CA125水平分别为743.0、84.9、15.4、11.5 kU/L,卵巢癌组与其他3组比较,差异均有统计学意义(P<0.05).(3)单项榆测结果:卵巢癌组以内异症组为参照时,HE4和CA125笛单项检测的AUC分别0.933和0.821,其特异度为95%时的敏感度分别为79.6%和49.0%;内异症组以对照组为参照时的AUC为0.453;以良性肿瘤组为参照时的AUC为0.496.(4)联合检测结果:卵巢癌组以内异症组为参照时,HE4联合CA125检测的AUC为0.936,其特异度为95%时的敏感度为81.0%.结论 HE4水平可作为卵巢内异症囊肿的鉴别诊断依据之一,HE4联合CA125水平检测能有效鉴别卵巢内异症囊肿和卵巢恶性肿瘤.
목적 탐토혈청인부고분비단백4(HE4)연합CA125수평검측재란소악성종류여자궁내막이위증감별진단중적개치.방법 채용매련면역흡부시험(ELISA)검측란소자궁내막이위낭종(내이증조)46례、란소상피성암(란소암조)36례、란소비내막이위량성종류(량성종류조)60례화건강부녀(대조조)50례혈청중HE4화CA125수평,결과이중위수표시.혈청HFA화CA125정상치분별위0～150 pmo/L화0～35 kU/L,단독혹연합검측시,기중임일지표고우정상상한즉정위양성.통과제작수시자공작특정(ROC)곡선,이곡선하면적(AUC)반영진단적준학성;이Mann-Whitney U 검험급상관성분석탐토량항지표단독혹연합검측용우진단란소내이증낭종적개치.결과 (1)HE4수평:내이증、대조、량성종류조부녀혈청HE4수평분별위52.4、51.0、50.0 pmoL/L,3조비교,차이무통계학의의(P>0.05),란소암조환자HE4수평위507.5 pmoL/L,여기타3조분별비교,차이균유통계학의의(P<0.05).(2)CA125수평:란소암、내이증、량성종류급대조조부녀혈청CA125수평분별위743.0、84.9、15.4、11.5 kU/L,란소암조여기타3조비교,차이균유통계학의의(P<0.05).(3)단항유측결과:란소암조이내이증조위삼조시,HE4화CA125적단항검측적AUC분별0.933화0.821,기특이도위95%시적민감도분별위79.6%화49.0%;내이증조이대조조위삼조시적AUC위0.453;이량성종류조위삼조시적AUC위0.496.(4)연합검측결과:란소암조이내이증조위삼조시,HE4연합CA125검측적AUC위0.936,기특이도위95%시적민감도위81.0%.결론 HE4수평가작위란소내이증낭종적감별진단의거지일,HE4연합CA125수평검측능유효감별란소내이증낭종화란소악성종류.
Objective To investigate the value of human epididymis secretory protein 4 ( HE4 ) combined with CA125 assay in differential diagnosis of endometriosis cyst and ovarian malignant tumor.Methods The level of HE4 and CA125 were measured by enzyme-linked immunosorbent assay (ELISA) in the serum specimens of 46 cases in endometriosis cyst group,36 cases in malignant ovarian tumor group,60 cases in benign ovarian diseases and 50 women in healthy women group.Those results were shown with median level.The normal range were 0-150 pmol/L in HE4 and 0-35 kU/L,which either one was more than the threshold value defined as positive index.The sensitivity of assay was evaluated by receiver operating characteristic (ROC) curve,the relation and value of HE4 or CA125 alone and combination assay in diagnosis of endometriosis was analyzed by Mann-Whitney U test and correlation analysis.Results (1) HE4:the median levels of HE4 were 52.4,51.0,50.0 pmol/L in group of endometriosis,normal control and benign ovarian tumor,which didn't show statistical difference.However,HE4 was 507.5 pmol/L inovarian cancer group,which was significantly higher than those of 3 groups (P < 0.05 ).(2 ) CA125:there were significant different in median level of CA125 was observed as 743.0 kU/L in ovarian cancer,84.9 kU/L in endoemtriosis,15.4 kU/L in benign ovarian disease,and 11.5 kU/L in healthy women (P < 0.05).( 3 ) The single assay:when compared with that in endometriosis group,receiver operating characteristic area under the curve( ROC-AUC) were 0.933 in HE4 alone and 0.821 in CA125 alone assay in ovarian cancer group.The specificity was 95% and the sensitivity was 79.6% and 49.0%.(4) The combination assay:when compared with those in endometriosis group,the ROC-AUC was 0.936,the specificity was 95% and the sensitivity was 81.0% in ovarian cancer.Conclusions Measurement of HE4 could be used in differential diagnosis of endometriosis cyst.And the combination of HE4 and CA125 assay could discriminate ovarian endometriosis cysts from ovarian malignant tumors effectively.