肿瘤标志物联检在卵巢癌早期诊断中的研究

目的探讨肿瘤标志物人附睾蛋白4（HE4）、糖类抗原125（CA125）及癌胚抗原（CEA）]联合检测在卵巢癌早期诊断中的应用价值。方法对47例卵巢癌患者（卵巢癌组,FIGO临床分期Ⅰ期6例、Ⅱ期12例、Ⅲ期14例、Ⅳ期15例）、63例良性卵巢疾病患者（良性病变组）及78例健康体检育龄妇女（对照组）进行HE4、CA125及CEA检测,观察各组HE4、CA125、CEA血清水平变化及异常率;比较不同FIGO临床分期HE4、CA125、CEA血清水平的变化;对3种肿瘤标志物单独检测和联合检测对卵巢癌诊断的效果进行方法学评价。结果卵巢癌组的HE4、CA125及CEA血清水平及异常率均明显高于良性病变组及对照组（均P〈0.05）,良性病变组与对照组比较差异均无统计学意义（均P〉0.05）;FIGO临床Ⅲ—Ⅳ期卵巢癌组HE4、CA125及CEA血清水平明显高于FIGO临床Ⅰ—Ⅱ期卵巢癌组（均P〈0.001）。3种肿瘤标志物单独检测以HE4及CA125 2项指标较好;3种肿瘤标志物联合检测对灵敏度、诊断符合率、约登指数及阴性预测值均有不同程度的提升。结论 HE4、CA125及CEA联合检测对卵巢癌的防治有重要的临床意义。

Combined Detection of Tumor Markers for Early Diagnosis of Ovarian Cancer

Objective To explore the value of combined detection of tumor markers in early di-agnosis of ovarian cancer.Methods Serum levels of human epididymis protein 4 （HE4）,carbohy-drate antigen 125 （CA 125）and carcinoembryonic antigen （CEA）were detected in 47 patients with ovarian cancer （ovarian cancer group,including FIGO Ⅰ in 6,FIGO Ⅱ in 12,FIGO Ⅲ in 14 and FIGOⅣ in 15）,63 patients with benign ovarian diseases （benign lesion group）and 78 health-y subjects （control group）.Serum HE4,CA125 and CEA levels and abnormal rates were com-pared among the three groups.Moreover,serum HE4,CA125 and CEA levels were compared a-mong different FIGO stages.The efficacies of separate and combined detection of the three tumor markers were evaluated in the three groups.Results Compared with ovarian cancer group,serum HE4,CA125 and CEA levels and abnormal rates significantly decreased in benign lesion group and control group（all P〈0.05）,but there were no significant differences between the two groups （all P〉0.05）.Compared with FIGO Ⅰ-Ⅱ,serum HE4,CA125 and CEA levels significantly in-creased in FIGO Ⅲ-Ⅳ（P〈0.001）.The indicators for HE4 or CA125 were better than those for CEA.Compared with separate detection,the sensitivity,diagnostic coincidence rate,Youden’s in-dex and negative predictive value were improved by combined detection of the three tumor mark-ers.Conclusion The combined detection of HE4,CA125 and CEA has an important clinical sig-nificance in the prevention and treatment of ovarian cancer.