CAJ | 학술논문

背景与目的:目前对子宫内膜癌的早期筛查及疾病监测仍缺少有效的肿瘤监测指标.本文旨在探讨肿瘤标志物CA125及人附睾分泌蛋白4(human? epididymis? protein?4,HE4)单项或联合检测对诊断子宫内膜癌患者的临床意义.方法:选择80例具有肿瘤标志物检测结果的子宫内膜癌患者和27例子宫良性肿瘤患者的临床资料进行回顾性分析.结果:子宫内膜癌患者血清HE4水平为(92.32±7.60)pmol/L,子宫良性肿瘤患者血清HE4水平为(58.88±3.01)pmoL/L;以上2组CAl25水平分别为(30.05±5.24)、(34.32±8.16)U/mL.子宫内膜癌患者血清HE4水平明显高于子宫良性肿瘤患者,差异有统计学意义(P<0.01),而CA125水平差异无统计学意义(P>0.05).HE4和CA125单项检测的ROC-AUC值分别为0.731和0.503,差异有统计学意义(P<0.001).两项指标联合检测的ROC-AUC值为0.758,与单项指标检测相比,差异有统计学意义(P<0.001).特异度为95%的情况下, CA125单项检测的灵敏度为10%,HE4单项检测的灵敏度为32.5%,而联合检测的灵敏度为33.8%.结论:HE4是检测子宫内膜癌肿瘤较理想的标志物,其血清水平对子宫体肿瘤的良恶性辅助诊断及鉴别诊断具有一定的应用价值,联合CA125检测可以提高对子宫内膜癌的诊断率.
배경여목적:목전대자궁내막암적조기사사급질병감측잉결소유효적종류감측지표.본문지재탐토종류표지물CA125급인부고분비단백4(human? epididymis? protein?4,HE4)단항혹연합검측대진단자궁내막암환자적림상의의.방법:선택80례구유종류표지물검측결과적자궁내막암환자화27례자궁량성종류환자적림상자료진행회고성분석.결과:자궁내막암환자혈청HE4수평위(92.32±7.60)pmol/L,자궁량성종류환자혈청HE4수평위(58.88±3.01)pmoL/L;이상2조CAl25수평분별위(30.05±5.24)、(34.32±8.16)U/mL.자궁내막암환자혈청HE4수평명현고우자궁량성종류환자,차이유통계학의의(P<0.01),이CA125수평차이무통계학의의(P>0.05).HE4화CA125단항검측적ROC-AUC치분별위0.731화0.503,차이유통계학의의(P<0.001).량항지표연합검측적ROC-AUC치위0.758,여단항지표검측상비,차이유통계학의의(P<0.001).특이도위95%적정황하, CA125단항검측적령민도위10%,HE4단항검측적령민도위32.5%,이연합검측적령민도위33.8%.결론:HE4시검측자궁내막암종류교이상적표지물,기혈청수평대자궁체종류적량악성보조진단급감별진단구유일정적응용개치,연합CA125검측가이제고대자궁내막암적진단솔.
?Background and purpose:To date, there is no good marker for screening or disease monitoring of endometrial carcinoma. The present study aimed to investigate the significance of human epididymis protein 4 (HE4) as a tumor marker combined with CA125 in diagnosis of endometrial carcinoma patients.?Methods:Serum levels of HE4 and CA125 were examined in 80 patients with endometrial carcinoma. Twenty-seven patients with benign uterus disease were used as controls. Results:Serum levels of HE4 in endometrial carcinoma group were significantly higher than those in the benign uterus disease group (92.32±7.60 pmol/L vs 58.88±3.01 pmol/L, P<0.0001), while the difference of these CA125 levels have no statistical meaning (30.05±5.24 U/mL vs 34.32±8.16 U/mL, P>0.05). The receiver operating characteristic area under the curve (ROC-AUC) were 0.731, 0.503 and 0.758, the sensitivity were 32.5%, 10% and 33.8% when the specificity was 95% in HE4 alone, CA125 alone and HE4+CA125 combined detection in endometrial cancer group. Conclusion:HE4 is an ideal tumor marker and it has certain values in accessory diagnosis and differential diagnosis of endometrial cancer. The clinical value can be improved by combined detection of HE4 and CA125.