CAJ | 학술논문

目的探讨血清人附睾蛋白(HE)4、糖类抗原(CA)125及CA19-9联合检测在早期子宫内膜癌中的临床应用价值.方法选取206例早期子宫内膜癌(子宫内膜癌组)及118例子宫肌瘤(子宫肌瘤组)患者,采用酶联免疫吸附法检测血清HE4水平,应用化学发光法检测血清CA125及CA19-9水平,比较各组血清HE4、CA125及CA19-9的阳性率,并比较147例子宫内膜癌患者手术前后血清HE4、CA125及CA19-9水平的变化.结果子宫内膜癌组血清HE4及CA19-9明显高于子宫肌瘤组[76.57(56.92～ 104.60) pmol/L比56.75(48.33～68.91) pmol/L、13.26(6.07 ～ 25.90) kU/L比7.64(3.76 ～ 16.45) kU/L],差异有统计学意义(P=0.000),两组血清CA125比较差异无统计学意义(P=0.106).子宫内膜癌组血清HE4和HE4+ CA125+ CA19-9检测阳性率明显高于血清CA125、CA19-9、CA125+ CA19-9检测,差异有统计学意义(P＜0.01).子宫内膜癌组血清HE4、CA19-9、HE4+CA125、HE4+ CA19-9、HE4+ CA125+ CA19-9检测阳性率明显高于子宫肌瘤组,差异有统计学意义(P＜0.01).147例子宫内膜癌患者术后血清HE4、CA125及CA19-9水平显著低于术前,差异有统计学意义(P＜0.01).结论血清HE4对早期子宫内膜癌的诊断价值优于CA125及CA19-9,联合检测能提高诊断阳性率,血清HE4、CA125及CA19-9亦有助于早期子宫内膜癌的疗效评价.
목적 탐토혈청인부고단백(HE)4、당류항원(CA)125급CA19-9연합검측재조기자궁내막암중적림상응용개치.방법 선취206례조기자궁내막암(자궁내막암조)급118례자궁기류(자궁기류조)환자,채용매련면역흡부법검측혈청HE4수평,응용화학발광법검측혈청CA125급CA19-9수평,비교각조혈청HE4、CA125급CA19-9적양성솔,병비교147례자궁내막암환자수술전후혈청HE4、CA125급CA19-9수평적변화.결과 자궁내막암조혈청HE4급CA19-9명현고우자궁기류조[76.57(56.92～ 104.60) pmol/L비56.75(48.33～68.91) pmol/L、13.26(6.07 ～ 25.90) kU/L비7.64(3.76 ～ 16.45) kU/L],차이유통계학의의(P=0.000),량조혈청CA125비교차이무통계학의의(P=0.106).자궁내막암조혈청HE4화HE4+ CA125+ CA19-9검측양성솔명현고우혈청CA125、CA19-9、CA125+ CA19-9검측,차이유통계학의의(P＜0.01).자궁내막암조혈청HE4、CA19-9、HE4+CA125、HE4+ CA19-9、HE4+ CA125+ CA19-9검측양성솔명현고우자궁기류조,차이유통계학의의(P＜0.01).147례자궁내막암환자술후혈청HE4、CA125급CA19-9수평현저저우술전,차이유통계학의의(P＜0.01).결론 혈청HE4대조기자궁내막암적진단개치우우CA125급CA19-9,연합검측능제고진단양성솔,혈청HE4、CA125급CA19-9역유조우조기자궁내막암적료효평개.
Objective To investigate the application value of combined detection of serum human epididymis protein 4 (HE4),cancer antigen 125 (CA125) and cancer antigen 19-9 (CA 19-9) in early endometrial carcinoma.Methods Two hundred and six patients with early endometrial carcinoma (endometrial carcinoma group) and 118 patients with uterine fibroids (uterine fibroids group) were selected.Serum level of HE4 was measured by enzyme linked immunosorbent assay (ELISA),and serum levels of CA 125 and CA 19-9 were measured by chemiluminescence immunoassay(CLIA).The positive rates of serum HE4,CA125 and CA19-9 in the 2 groups were compared.The changes between pre-and post-operative in the serum levels of serum HE4,CA125 and CA19-9 were compared in 147 endometrial carcinoma patients.Results The serum levels of HE4 and CA19-9 in endometrial carcinoma group were significantly higher than those in uterine fibroids group [76.57 (56.92-104.60) pmol/L vs.56.75 (48.33-68.91) pmol/L,13.26(6.07-25.90) kU/L vs.7.64(3.76-16.45) kU/L],there were statistical differences (P =0.000),there was no statistical difference in serum level of CA125 between the 2 groups (P=0.106).In endometrial carcinoma group,the positive rates of serum HE4 and HE4 + CA125 + CA19-9 were significantly higher than the positive rates of serum CA125,CA19-9,CA125+CA19-9,there were statistical differences (P ＜ 0.01).The positive rates of serum HE4,CA19-9,HE4 +CA125,HE4 +CA19-9 and HE4 +CA125 +CA19-9 in endometrial carcinoma group were significantly higher than those in uterine fibroids group,there were statistical differences (P ＜ 0.01).The serum levels of HE4,CA125 and CA19-9 in post-operative in 147 endometrial carcinoma patients were significantly lower than those in pre-operative,there were statistical differences (P ＜ 0.01).Conclusion The diagnostic value of serum HE4 in early endometrial carcinoma is better than CA125 and CA19-9,while combined detection of serum HE4,CA125 and CA19-9 can raise the positive rate and be helpful for therapeutic effect evaluation.