Îé°ÛÐã лºìÓ¢
£¨ÁøÖÝÊй¤ÈËÒ½Ôº ¸¾¿Æ¶þ²¡Çø£¬¹ãÎ÷ ÁøÖÝ 545005£©
ÕªÒª£ºÄ¿µÄ ̽ÌÖÈËѪÇ帽غµ°°×£´£¨HE4£©ºÍ ÈËÂѳ²°©¿¹Ô£¨CA125£©Âѳ²°©Õï¶ÏÖеÄÓ¦ÓüÛÖµ¡£·½·¨ ÊÕ¼¯78ÀýÂѳ²°©»¼ÕߺÍͬÆÚ½¡¿µÌå¼ìÕßµÄѪÇå±ê±¾£¬ÓÃÑÅÅ໯ѧ·¢¹â·ÖÎöÒÇ·Ö±ð¼ì²â¸÷×éµÄѪÇåHE4ºÍCA125ˮƽ¡£½á¹û Âѳ²°©»¼ÕßµÄѪÇåHE4ºÍCA125ˮƽÃ÷ÏÔ¸ßÓÚ¶ÔÕÕ×飻ѪÇåHE4Õï¶ÏÂѳ²°©µÄÃô¸Ð¶È¡¢ÌØÒìÐÔ¼°×¼È·¶È¾ù±ÈCA125¸ß£»ÑªÇåHE4ÔÚÂѳ²°©»¼ÕߵIJ»Í¬·ÖÆÚ±í´ï²îÒìÓÐͳ¼ÆÑ§ÒâÒ壨p<0.05£©£»HE4ºÍCA125ÁªºÏ¼ì²â¿ÉÒÔÌá¸ßÂѳ²°©Õï¶ÏµÄÃô¸Ð¶È¡¢ÌØÒì¶È¼°×¼È·¶È¡£½áÂÛHE4ºÍCA125ÁªºÏ¼ì²â¿ÉÒÔÌá¸ßÂѳ²°©µÄÕï¶ÏЧÂÊ¡£
¹Ø¼ü´Ê: ¸½Øºµ°°×4£» CA125£» Âѳ²°©£» ÁªºÏÕï¶Ï
The value of serum HE4 combined with CA125
in the diagnosis of ovarian cancer
Wu Baixiu Xie Hongying
(Liuzhou Workers' Hospital, Department of Gynecology, Liuzhou 545005, China)
Abstract: Objective To investigate the value of human serum epididymis protein 4 (HE4) and human ovarian cancer antigen (CA125) in the diagnosis of ovarian cancer. Methods Serum samples from 78 patients with ovarian cancer and healthy subjects were collected. The serum levels of HE4 and CA125 were measured by Abbott Chemiluminescence Analyzer. Results The levels of serum HE4 and CA125 in patients with ovarian cancer were significantly higher than those in the control group. The sensitivity, specificity and accuracy of serum HE4 in diagnosing ovarian cancer were higher than those in CA125. The difference of serum HE4 expression in different stages of ovarian cancer patients was statistically significant. (p<0.05); combined detection of HE4 and CA125 can improve the sensitivity, specificity and accuracy of ovarian cancer diagnosis. Conclusion Combined detection of HE4 and CA125 can improve the diagnostic efficiency of ovarian cancer.
Key words: epididymis protein 4; CA125; ovarian cancer; joint diagnosis
Âѳ²°©ÊÇÒ»ÖÖ·¢²¡ÂʺÍËÀÍöÂʽϸߵĸ¾¿Æ¶ñÐÔÖ×ÁöÖ®Ò»£¬·¢²¡Âʽö´ÎÓÚ×Ó¹¬¾±°©ºÍ×Ó¹¬Ìå°©£¬Âѳ²¶ñÐÔÖ×ÁöÖÐÒÔÂѳ²ÉÏÆ¤°©×î¶à¼û£¬ÆäËÀÍöÂÊÊǸ÷À฾¿ÆÖ×ÁöµÄÊ×룬¶ÔÅ®ÐÔÉúÃü½¡¿µÔì³ÉÑÏÖØÍþв¡£ÓÉÓÚÂѳ²Ìå»ý½ÏС£¬Éî¾ÓÅèǻ֮ÄÚ£¬ÓÖȱ·¦µäÐ͵ÄÁÙ´²Ö¢×´£¬Òò´ËÄÑÒÔÔçÆÚ·¢ÏÖ£¬Ä¿Ç°ÁÙ´²·¢ÏÖµÄÂѳ²°©´ó¶àÊýÒÑÀ©É¢µ½Å踹ǻÆ÷¹Ù£¬Òò´ËÔçÆÚÕï¶ÏÂѳ²°©ÏÔµÃÓÈÎªÖØÒª¡£CA125ÊÇ´«Í³µÄÖ×Áö±êÖ¾Îµ«ÊÇÆäÔÚÕï¶ÏÂѳ²°©·½ÃæÈÔÓÐÒ»¶¨¾ÖÏÞÐÔ£¬Ö÷Òª±íÏÖÔÚCA125ÔÚÂѳ²½¬ÒºÐÔ°©¼°Î´·Ö»¯°©ÖеÄÑôÐÔÂʽϸߣ¬¶øÔÚð¤ÒºÐÔ°©ÖеÄÑôÐÔÂʽϵͣ»ÁíÍâһЩÁ¼ÐÔ¼²²¡ÖÐCA125Ò²»áÉý¸ß,±ÈÈçÅèÇ»Ñ×Ö¢¡¢Âѳ²ÄÒÏÙÁö¡¢×Ó¹¬ÄÚĤÒìλ֢µÈ£¬Òò´ËCA125Ó¦ÓõÄÃô¸ÐÐÔ¼°ÌØÒìÐÔÊܵ½ÏÞÖÆ[1]¡£¸½Øºµ°°×4(HE4)ÊÇÒ»ÖÖеÄÖ×Áö±êÖ¾ÎҲ³£ÓÃÓÚÕï¶ÏÂѳ²°©¡£±¾ÎÄÖ÷Ҫ̽ÌÖÁªºÏѪÇåHE4ºÍCA125ÔÚÂѳ²°©Õï¶ÏÖеÄÓ¦ÓüÛÖµ¡£
1¡¢²ÄÁϺͷ½·¨
1.1¡¢Ò»°ã×ÊÁÏ
ÊÕ¼¯±¾Ôº2018Äê2Ôµ½2018Äê10ÔÂÃÅÕPסԺµÄ»¼Õß×ÊÁÏ£¬¹²ÊÕ¼¯µ½Ê×·¢µÄÂѳ²°©»¼Õß78Àý£¬¾ùΪ½ÓÊܹý»¯·ÅÁƺÍÄÚ·ÖÃÚÖÎÁÆ£¬Åųý¸ßѪѹ¡¢ÌÇÄò²¡µÈ»ù´¡¼²²¡¡£°´ÕÕ¸ù¾ÝÃÀ¹ú°©Ö¢Ñо¿Î¯Ô±»áÓë¹ú¼Ê¿¹°©ÁªÃËÁªºÏÖÆ¶¨µÄ²¡Àíѧ·ÖÆÚ±ê×¼,ÆäÖТñ-¢òÆÚ41Àý£¬¢ó-¢ôÆÚ37Àý£¬Æ½¾ùÄêÁäΪ53.8¡À7.9Ëê¡£ÁíÍâѡȡͬÆÚÌå¼ìÈËÔ±80Àý×÷Ϊ¶ÔÕÕ×é¡£
1.2¡¢·½·¨
¹Û²ì×éºÍ¶ÔÕÕ×é¾ùÓÚÇ峿¿Õ¸¹³éÈ¡¾²ÂöѪ5mL£¬¾²Ö¹30·ÖÖÓºó£¬ÓÃÀëÐÄ»úÒÔ3000r/minÀëÐÄ10min£¬·ÖÀë³öÉϲãѪÇ壬ÖÃ-80¡æ±ùÏä±£´æ±¸Óá£CA125ºÍHE4µÄ¼ì²âÒÇÆ÷ΪÑÅÅàÈ«×Ô¶¯»¯Ñ§·¢¹â·ÖÎöÒÇi2000£¨ÃÀ¹ú£©£¬ÊÔ¼ÁºÐ¼°Ð£×¼Æ·¾ùΪÔ×°ÅäÌ×ʹÓã¬ÒÇÆ÷µÄ²Ù×÷¾ù°´ÕÕÖÆÔìÉÌÌṩµÄ±ê×¼»¯²Ù×÷³ÌÐò½øÐвÙ×÷£¬ÆäÖÐCA125µÄ²Î¿¼·¶Î§Îª0 - 35U/mL£¬HE4µÄ²Î¿¼·¶Î§ÊÇ£ºÎ´¾ø¾Å®ÐÔ<70 pmol/L£¬¾ø¾Å®ÐÔ<140 pmol/L£¬³¬¹ý¶ÔÓ¦µÄ²Î¿¼·¶Î§ÉÏÏßÅжÏΪÑôÐÔ¡£Ê×ÏȱȽϹ۲ì×éÓë¶ÔÕÕ×éµÄCA125ºÍHE4µÄˮƽÊÇ·ñ´æÔÚ²îÒ죬Æä´ÎÁªºÏCA125ºÍHE4ÒÔÌá¸ßÕï¶ÏЧÂÊ¡£
1.3¡¢ ͳ¼ÆÑ§´¦Àí
ËùÓÐÊý¾Ý×ÊÁϲÉÓà SPSS 25.0 ͳ¼ÆÑ§Èí¼þ½øÐд¦Àí£¬Êý¾Ý²ÉÓþùÖµ¡À±ê×¼²î±íʾ£¬¼ÆÁ¿×ÊÁÏÐÐt¼ìÑé,¼ÆÊý×ÊÁÏÓÿ¨·½¼ìÑ飬ÒÔP <0.05 Ϊ²îÒìÓÐͳ¼ÆÑ§ÒâÒå¡£
2 ¡¢½á ¹û
2.1¹Û²ì×éÓë¶ÔÕÕ×éѪÇå HE4ÓëCA125 µÄˮƽ±È½Ï
¹Û²ì×éµÄѪÇåHE4ºÍCA125ˮƽ¾ùÃ÷ÏÔ¸ßÓÚ¶ÔÕÕ×飬²îÒìÓÐͳ¼ÆÑ§ÒâÒå¡£HE4ÔÚ¹Û²ì×é¢ñ-¢òÆÚÓë¢ó-¢ôÆÚÖ®¼ä²îÒìÓÐͳ¼ÆÑ§ÒâÒ壬¶øCA125ÔÚ¹Û²ì×é¢ñ-¢òÆÚÓë¢ó-¢ôÆÚÖ®¼ä²îÒìÎÞͳ¼ÆÑ§ÒâÒ壬½á¹û¼û±í 1¡£
±í 1¹Û²ì×éÓë¶ÔÕÕ×éѪÇå HE4ÓëCA125 µÄˮƽ±È½Ï(`X¡ÀS)
×é±ð |
n |
CA125£¨U/mL£© |
CA125 |
HE4£¨pmol/L£© |
HE4 |
t |
p |
t |
p |
¶ÔÕÕ×é |
80 |
10.23¡À8.66 |
8.43 |
0.02 |
15.41¡À8.66 |
17.26 |
<0.001 |
¹Û²ì×é |
78 |
68.65¡À18.63 |
138.26¡À21.32 |
¢ñ-¢òÆÚ |
41 |
64.25¡À14.26 |
1.26 |
0.14 |
96.32¡À17.24 |
12.24 |
<0.001 |
¢ó-¢ôÆÚ |
37 |
71.41¡À19.26 |
157.33¡À29.66 |
2.2 HE4ÓëCA125 Õï¶ÏÂѳ²°©µÄÕï¶ÏÐÔÄܱȽÏ
HE4µÄÌØÒìÐÔ±ÈCA125¸ß£¨87.50 VS 83.75£¬%£©£¬HE4µÄÃô¸Ð¶È±ÈCA125¸ß£¨88.46 VS 80.77£¬%£©£¬HE4Õï¶ÏµÄ׼ȷ¶È±ÈCA125¸ß£¨87.97 VS 82.23£¬%£©£¬ÁªºÏÕï¶ÏµÄÌØÒìÐÔ¡¢Ãô¸Ð¶ÈºÍ׼ȷ¶È×î¸ß£¬½á¹û¼û±í 2¡£
±í2 HE4¡¢CA125¡¢TSGF Õï¶ÏÐÔÄÜ±È½Ï Àý( % )
ÐÔÄÜ |
CA125 |
HE4 |
ÁªºÏÕï¶Ï |
¿¨·½ |
P |
ÌØÒìÐÔ |
83.75(67/80) |
87.50(70/80) |
95.0(76/80) |
25.14 |
0.000 |
Ãô¸Ð¶È |
80.77(63/78) |
88.46(69/78) |
93.59(73/78) |
17.26 |
0.001 |
׼ȷ¶È |
82.23(130/158) |
87.97(139/158) |
94.30(149/158) |
40.21 |
0.000 |
3¡¢ ÌÖÂÛ
Âѳ²°©µÄ·¢²¡ÂÊÖðÄêÌá¸ß£¬Ô¤ºóÉú´æ½Ï²î£¬¶øÇÒÔçÆÚÖ¢×´²»µäÐÍ£¬³£ÒÔ¸¹²¿°ü¿é¡¢¸¹Ë®¡¢¸¹ÕÍ¡¢³öѪ¡¢ÅèÇ»ÌÛÍ´µÈ·ÇÌØÒìÐԵıíÏÖÊÕÖÎÈëÔº£¬Òò´ËÔçÆÚ·¢ÏÖ²¢¼°Ê±È·ÕïÂѳ²°©ÏÔµÃÓÈÎªÖØÒª¡£Ä¿Ç°Õï¶ÏÂѳ²°©Ö÷ÒªÒÀ¾Ý¾Òõ³¬Éù¼ì²é£¬ÊµÊ©ÆðÀ´Ïà¶Ô¸´ÔÓ£¬¶øÑªÇåѧµÄ¼ì²é¾ÍÏԵýÏΪ¼òµ¥£¬Ä¿Ç°Õï¶ÏÂѳ²°©±È½ÏÈÈÃŵÄѪÇå±êÖ¾ÎïÊÇCA125ºÍHE4¡£CA125ÊÇÂѳ²°©Ïà¶Ô±È½ÏÌØÒìÐÔµÄÖ×Áö±êÖ¾ÎÆäÔÚÕï¶ÏÂѳ²°©µÄÌØÒìÐÔºÍÃô¸Ð¶È¶¼·Ç³£¸ß[2-3]£¬Âѳ²°©Ö÷ÒªÀ´Ô´ÓÚÉÏÆ¤×éÖ¯£¬Ò²ÓÐһЩÀ´Ô´ÓÚ¼äÒ¶×éÖ¯¡¢Åßϸ°û×éÖ¯µÈ£¬CA125¶Ô¼äÒ¶×éÖ¯ÒÔÍâµÄÆäËû×éÖ¯²¢²»Ãô¸Ð£¬Ãô¸Ð¶ÈºÍÌØÒìÐÔÏà¶Ô½ÏµÍ¡£ÁíÍâÒ²ÓÐһЩÎÄÏ×±¨µÀCA125ÔÚ¸ÎÓ²»¯ºÍÀà·çʪ¹Ø½ÚÑ׵ȼ²²¡Ò²ÓÐÒ»¶¨³Ì¶ÈµÄÉý¸ß£¬²¢ÇÒÓë¼²²¡µÄ»î¶¯³Ì¶ÈÒÔ¼°Ô¤ºóÅжÏÓÐÒ»¶¨µÄÏà¹ØÐÔ[4-5]¡£HE4ÊÇʱϱȽÏÈÈÃŵÄÖ×Áö±ê¼ÇÎÓÐÎÄÏ×Ö¸³öHE4ÊÇÉÏÆ¤ÐÔÂѳ²°©µÄÁ¼ºÃÖ×Áö±êÖ¾Îï,ÓëÖ×ÁöµÄÁ¼¡¢¶ñÐÔ¼ø±ð¼°ÁÙ´²ÌØÕ÷ÓÐÃÜÇеĹØÏµ,¶ÔÉÏÆ¤ÐÔÂѳ²°©»¼ÕßµÄÔçÆÚÕï¶Ï¼°Ô¤ºóÓÐÒ»¶¨µÄ¼ÛÖµ[6]£¬HE4Ò²¿ÉÔÚÆäËûÖ×Áö£¬±ÈÈç´ó³¦°©¡¢·Î°©µÈÖ×ÁöÒ²ÓÐÒ»¶¨µÄ±í´ï[7-8]¡£
±¾Ñо¿·¢ÏÖHE4Õï¶ÏÂѳ²°©µÄÃô¸Ð¶ÈºÍÌØÒìÐÔ¾ù±ÈCA125µÄ¸ß£¬Á½ÕßÁªºÏ¼ì²â¿ÉÒÔÌá¸ßÂѳ²°©µÄÕï¶ÏЧÂÊ¡£ÁíÍâÒ²·¢ÏÖCA125ÔÚÂѳ²°©¢ñ-¢òÆÚÓë¢ó-¢ôÆÚÖеıí´ïÎÞ²îÒ죬¶øHE4ÔÚÂѳ²°©¢ñ-¢òÆÚÓë¢ó-¢ôÆÚÖеıí´ï²îÒìÓÐͳ¼ÆÑ§ÒâÒ壬ÌáʾHE4ÔÚÂѳ²°©µÄ·ÖÆÚ±ÈCA125ÓÐÒ»¶¨µÄÓÅÔ½ÐÔ¡£µ±È»±¾Ñо¿Ò²ÓÐһЩ²»×ãÖ®´¦£¬±ÈÈç±ê±¾Á¿Ïà¶Ô½ÏÉÙ£¬Ö»ÊÇÊÕ¼¯ÎÒÃÇÒ½ÔºµÄ»¼ÕßÐÅÏ¢½øÐзÖÎö£¬Î´À´ÐèÒª´óÑù±¾ºÍ¶àÖÖÁªºÏ£¬ÒÔ¸ü¼ÓÃ÷È·HE4ºÍCA125ÔÚÂѳ²°©ÖеÄÓ¦ÓüÛÖµ¡£
×ÜÖ®£¬CA125ºÍHE4ÔÚÂѳ²°©µÄÕï¶ÏÖÐÓÐÖØÒªµÄÒâÒ壬Á½ÕßµÄÁªºÏ¼ì²â¿ÉÒÔÌá¸ßÂѳ²°©µÄÕï¶ÏЧÂÊ¡£
²Î¿¼ÎÄÏ×
[1]¹Ë¿¡½Ü,Àäö©,ҦѧȨµÈ.ÉÏÆ¤ÐÔÂѳ²°©»¼ÕßѪÇåIGF-1¡¢IGF-2¼°CA125¼ì²âµÄÁÙ´²¼ÛÖµ[J].½ËÕÒ½Ò©,2008,34(11):1183-1184.
[2]Ö£ºìÔÆ,ÓÚÆæ,É긴½ø, µÈ.ѪÇåHE4¡¢CA125ºÍCA199ÁªºÏ¼ì²â¶ÔÂѳ²°©ÔçÆÚÕï¶ÏµÄÁÙ´²Ñо¿[J].¹ú¼Ê¼ìÑéҽѧÔÓÖ¾,2017,(19):2680-2682.
[3]·¶æ¿,Ф¹â¾ü,ñã¹úÇ¿, µÈ.Ö×Áö±êÖ¾ÎïHE4¡¢CA125¡¢CA199¡¢CA153¡¢AFPÔÚÂѳ²°©ÔçÆÚÕï¶ÏÖеÄÓ¦ÓüÛÖµ[J].¹ú¼Ê¼ìÑéҽѧÔÓÖ¾,2017,(19):2718-2719,2722.
[4]ÍõÓ¢.CA125Éý¸ßÔÚ¸ÎÓ²»¯»¼ÕßÖеÄÁÙ´²¼ÛÖµ[J].ËÄ´¨Ò½Ñ§,2012,(2):322-323.
[5]³ÂËØÔÆ,Îâ´ºÁú,Àî¿¡, µÈ.Àà·çʪ¹Ø½ÚÑ×»¼Õß CA125Éý¸ßÏà¹ØÒòËØ[J].ÖлªÁÙ´²ÃâÒߺͱä̬·´Ó¦ÔÓÖ¾,2015,(1):26-30.
[6]µ³Çïºì,²Ü¾²,ÕÅ»¶»¶, µÈ.HE4ÔÚÉÏÆ¤ÐÔÂѳ²°©Öеıí´ïÇé¿ö¼°ÆäÓëÁÙ´²ÌØÕ÷¼°Ô¤ºóµÄ¹ØÏµ·ÖÎö[J].°©Ö¢½øÕ¹,2018,(5):629-631,635.
[7]κÃ÷,ÍõÔ°Ô°,ÕÅÐË, µÈ.´ó³¦°©»¼ÕßѪÇåHE4¡¢DKK-1ˮƽ±ä»¯¼°ÆäÒâÒå[J].ɽ¶«Ò½Ò©,2018,(27):26-29.
[8]Íõ¾²¾»,Íõ·¼,ÕÅ˧.ѪÇåTK1¡¢CRP¡¢HE4¡¢CEA»ùÏßˮƽÓë·Î°©Ô¤ºó¹ØÏµµÄ³²Ê½²¡Àý¶ÔÕÕÑо¿[J].ÁÙ´²·Î¿ÆÔÓÖ¾,2018,(2):224-227.