国际肿瘤学杂志
國際腫瘤學雜誌
국제종류학잡지
Journal of International Oncology
2015年
9期
657-660
,共4页
卵巢肿瘤%角蛋白质类%抗原,肿瘤相关,碳水化合物%人附睾蛋白4
卵巢腫瘤%角蛋白質類%抗原,腫瘤相關,碳水化閤物%人附睪蛋白4
란소종류%각단백질류%항원,종류상관,탄수화합물%인부고단백4
Ovarian neoplasms%Keratins%Antigens,tumor-associated,carbohydrate%human epididymis protein 4
目的 探讨血清人附睾蛋白4(HE4)、细胞角蛋白19片段(CYFRA21-1)、糖类抗原199(CA199)对卵巢恶性肿瘤诊断的意义,评价其单独及联合检测在判断卵巢癌高风险中的价值.方法 采用电化学发光免疫法(ECL)检测威海市妇幼保健院就诊的45例原发性卵巢癌、56例良性卵巢肿瘤患者及50例健康体检女性血清中HE4、CYFRA21-1、CA199水平,分析三者在卵巢癌诊断中的阳性率及符合率,比较3种指标对卵巢肿瘤的诊断价值.结果 血清HE4在恶性肿瘤组与良性肿瘤组之间、恶性肿瘤组与对照组之间差异均有统计学意义(Z=-8.61,P＜0.001;Z=-8.39,P＜0.001);CYFRA21-1在恶性肿瘤组与良性肿瘤组之间,恶性肿瘤组与对照组差异有统计学意义(Z=-8.60,P＜0.001;Z=-8.39,P＜0.001),HE4、CYRA21-1良性肿瘤组与对照组比较差异无统计学意义(Z=-1.31,P=0.189;Z=-1.29,P=0.191);CA199在良性肿瘤组与对照组比较差异有统计学意义(Z=-8.79,P＜0.001),对于恶性肿瘤两者诊断的特异性和阳性预测值都很高(HE4为99.8％、99.7％,CYFRA21-1为99.0％、96.7％),HE4、CYFRA21-1诊断的符合率也比较高,分别为93.4％、88.7％,但两者的敏感性比CA199低.CA199在卵巢良、恶性肿瘤中都会升高,只是升高的程度不同,但对卵巢癌诊断的特异性不是很高(85.8％),阳性预测值和诊断符合率也比较低(70.6％、84.1％),三者联合检测则可以提高卵巢癌诊断的敏感性(100％)及准确性(89.4％).结论 HE4、CYFRA21-1只在恶性卵巢肿瘤中升高,主要用于卵巢癌的诊断;CA199在良、恶性卵巢肿瘤中都有升高,但升高的程度不同,可用于良、恶性肿瘤的诊断与鉴别,三者联合检测则可提高卵巢癌诊断的敏感性和准确率,对于卵巢癌的早期诊断与治疗监测有重要的意义.
目的 探討血清人附睪蛋白4(HE4)、細胞角蛋白19片段(CYFRA21-1)、糖類抗原199(CA199)對卵巢噁性腫瘤診斷的意義,評價其單獨及聯閤檢測在判斷卵巢癌高風險中的價值.方法 採用電化學髮光免疫法(ECL)檢測威海市婦幼保健院就診的45例原髮性卵巢癌、56例良性卵巢腫瘤患者及50例健康體檢女性血清中HE4、CYFRA21-1、CA199水平,分析三者在卵巢癌診斷中的暘性率及符閤率,比較3種指標對卵巢腫瘤的診斷價值.結果 血清HE4在噁性腫瘤組與良性腫瘤組之間、噁性腫瘤組與對照組之間差異均有統計學意義(Z=-8.61,P＜0.001;Z=-8.39,P＜0.001);CYFRA21-1在噁性腫瘤組與良性腫瘤組之間,噁性腫瘤組與對照組差異有統計學意義(Z=-8.60,P＜0.001;Z=-8.39,P＜0.001),HE4、CYRA21-1良性腫瘤組與對照組比較差異無統計學意義(Z=-1.31,P=0.189;Z=-1.29,P=0.191);CA199在良性腫瘤組與對照組比較差異有統計學意義(Z=-8.79,P＜0.001),對于噁性腫瘤兩者診斷的特異性和暘性預測值都很高(HE4為99.8％、99.7％,CYFRA21-1為99.0％、96.7％),HE4、CYFRA21-1診斷的符閤率也比較高,分彆為93.4％、88.7％,但兩者的敏感性比CA199低.CA199在卵巢良、噁性腫瘤中都會升高,隻是升高的程度不同,但對卵巢癌診斷的特異性不是很高(85.8％),暘性預測值和診斷符閤率也比較低(70.6％、84.1％),三者聯閤檢測則可以提高卵巢癌診斷的敏感性(100％)及準確性(89.4％).結論 HE4、CYFRA21-1隻在噁性卵巢腫瘤中升高,主要用于卵巢癌的診斷;CA199在良、噁性卵巢腫瘤中都有升高,但升高的程度不同,可用于良、噁性腫瘤的診斷與鑒彆,三者聯閤檢測則可提高卵巢癌診斷的敏感性和準確率,對于卵巢癌的早期診斷與治療鑑測有重要的意義.
목적 탐토혈청인부고단백4(HE4)、세포각단백19편단(CYFRA21-1)、당류항원199(CA199)대란소악성종류진단적의의,평개기단독급연합검측재판단란소암고풍험중적개치.방법 채용전화학발광면역법(ECL)검측위해시부유보건원취진적45례원발성란소암、56례량성란소종류환자급50례건강체검녀성혈청중HE4、CYFRA21-1、CA199수평,분석삼자재란소암진단중적양성솔급부합솔,비교3충지표대란소종류적진단개치.결과 혈청HE4재악성종류조여량성종류조지간、악성종류조여대조조지간차이균유통계학의의(Z=-8.61,P＜0.001;Z=-8.39,P＜0.001);CYFRA21-1재악성종류조여량성종류조지간,악성종류조여대조조차이유통계학의의(Z=-8.60,P＜0.001;Z=-8.39,P＜0.001),HE4、CYRA21-1량성종류조여대조조비교차이무통계학의의(Z=-1.31,P=0.189;Z=-1.29,P=0.191);CA199재량성종류조여대조조비교차이유통계학의의(Z=-8.79,P＜0.001),대우악성종류량자진단적특이성화양성예측치도흔고(HE4위99.8％、99.7％,CYFRA21-1위99.0％、96.7％),HE4、CYFRA21-1진단적부합솔야비교고,분별위93.4％、88.7％,단량자적민감성비CA199저.CA199재란소량、악성종류중도회승고,지시승고적정도불동,단대란소암진단적특이성불시흔고(85.8％),양성예측치화진단부합솔야비교저(70.6％、84.1％),삼자연합검측칙가이제고란소암진단적민감성(100％)급준학성(89.4％).결론 HE4、CYFRA21-1지재악성란소종류중승고,주요용우란소암적진단;CA199재량、악성란소종류중도유승고,단승고적정도불동,가용우량、악성종류적진단여감별,삼자연합검측칙가제고란소암진단적민감성화준학솔,대우란소암적조기진단여치료감측유중요적의의.
Objective To investigate the diagnosis significance of human epididymis (HE4),cytokeratin-19-fragment (CYFRA21-1),carbohydrate antigen 199 (CA199) on the malignant ovarian tumor,and to evaluate the value of individual and combined detection in judging high risk ovarian cancer.Methods The serum HE4,CYFRA21-1,CA199 levels of 45 patients with primary ovarian cancer,56 patients with benign ovarian tumor and 50 healthy check-up women in our hospital were detected by electrochemiluminescence immunoassay (ECL).The positive rates and coincidence rates of them were analyzed and the diagnostic value of them were compared.Results HE4 and CYFRA21-1 levels of ovarian cancer group were significantly higher compared with the benign tumor group and healthy control group and the differences were statistically significant (Z=-8.61,P＜0.001;Z=-8.39,P＜0.001;Z=-8.60,P＜0.001;Z=-8.39,P＜0.001),however there is no difference between benign tumor group andcontrol group(Z =-1.31,P =0.189;Z =-1.29,P =0.191).The difference of CA199 between benign tumor group and control group was statistically significant (Z =-8.79,P ＜ 0.001).For the malignant tumors,the specificity and positive predictive value of HE4 (99.8％,99.7％),CYFRA21-1 (99.0％,96.7％) were very high and the diagnostic accordance rates were relatively high (93.4％,88.7％),but the sensibilities of them were lower compared with CA199.CA199 was increased both in benign and malignant ovarian tumors with different degrees,but the specificity was not very high (85.8％),and the positive predictive value and the diagnosis accordance rate were low (70.6％,84.1％).The combined detection of HE4,CYFRA 21-1 and CA199 could improve the sensitivity and of the diagnosis of ovarian cancer (100％) and accuracy (89.4％).Conclusions HE4 and CYFRA21-1 only increas in malignant ovarian tumors,and they are mainly used for the diagnosis of ovarian cancer;CA199 level is increased both in benign and malignant ovarian tumors,but the extent is different and it can be used for distinguishing and diagnosing of benign and malignant ovarian tumors.Combining the three indexes can improve the sensitivity and accuracy of the diagnosis of ovarian cancer,and has an important significance for the early diagnosis and treatment of ovarian cancer.
