HE4、CA125联合D-二聚体检测对卵巢癌的诊断价值

石慧; 胡建国

doi:10.13898/j.cnki.issn.1000-2200.2020.04.027

HE4、CA125联合D-二聚体检测对卵巢癌的诊断价值

石慧,
胡建国

Diagnostic value of the detection of HE4, CA125 combined with D-dimer in ovarian cancer

摘要

摘要:
目的探究人附睾蛋白4（HE4）、糖类抗原125（CA125）结合D-二聚体的测定在卵巢癌诊断中的运用价值。
方法选取经病理确诊为卵巢恶性肿瘤122例（卵巢癌组）为观察对象，另外选取经影像学诊断为卵巢良性肿瘤的病人113例（良性肿瘤组）及同期健康体检女性121名作为对照。分别测定各组血HE4、CA125及D-二聚体的水平，分析比较各项目间的差异以及三项指标分开和协同检测的诊断意义。
结果血CA125和HE4水平卵巢癌组>良性肿瘤组>健康对照组（P < 0.05~P < 0.01），血D-二聚体水平卵巢癌组>良性肿瘤组和健康对照组（P < 0.01），良性肿瘤组和健康对照组差异无统计学意义（P>0.05）；不同临床分期的卵巢癌病人中血D-二聚体、CA125、HE4水平差异有统计学意义（P < 0.01）；随着卵巢癌恶性程度的增高，病人血CA125、HE4指标水平也不断升高，血D-二聚体Ⅲ期和Ⅳ期> Ⅱ期> Ⅰ期，差异均有统计学意义（P < 0.05~P < 0.01），Ⅲ期和Ⅳ期差异无统计学意义（P>0.05）；在卵巢癌诊断上，血D-二聚体、CA125、HE4单独检测时，灵敏度分别为80.33%、81.97%、63.93%。三项指标联合检测时，灵敏度可达94.26%。D-二聚体、CA125、HE4三者联合监测诊断早期卵巢癌（Ⅰ~Ⅱ期）和卵巢癌（Ⅰ~Ⅳ期）时的AUC分别为0.913和0.959，均比各指标单独检测时明显提升。
结论血清D-二聚体、CA125和HE4联合监测，显著提升了卵巢癌诊断的灵敏度和诊断效能，且三项指标表达水平与卵巢癌临床分期有关。

Abstract:
ObjectiveTo explore the value of the detection of carbohydrate antigen 125(CA125), human epididymis protein 4(HE4) combined with D-dimer in the diagnosis of ovarian malignant tumor.
MethodsA total of 122 ovarian malignant tumor patients diagnosed by pathology, 113 benign ovarian tumor patients diagnosed by imaging findings and 121 healthy females at the same tine were divided into the ovarian cancer group, benign ovarian tumor group and control group, respectively.The serum concentrations of HE4, CA125 and D-dimer in three groups were determined, the differences of which among three groups were compared, and the diagnostic significance of the separation and synergy of three indicators was analyzed.
ResultsThe serum levels of CA125 and HE4 in ovarian cancer group, benign tumor group and control group gradually decreased in turn(P < 0.05 to P < 0.01).The differences of the serum level of D-dimer level in ovarian cancer group was higher than that in benign tumor group and control group(P < 0.01), and the difference of which between the benign tumor group and control group was not statistically significant(P>0.05).The differences of the serum levels of D-dimer, CA125 and HE4 in ovarian cancer patients with different clinical stages were statistically significant(P < 0.01).With the increasing of ovarian malignant degree, the serum levels of CA125 and HE4 increased.The serum levels of D-dimer in patients with stages Ⅲ and Ⅳ, Ⅱ, and Ⅰ ovarian cancer gradually decreased, the differences of the serum levels of D-dimer among above patients were statistically significant(P < 0.05 to P < 0.01), and the difference of which between the stage Ⅲ and Ⅳ patients was not statistically significant(P>0.05).In the diagnosis of ovarian cancer, the sensitivities of the detection of D-dimer, CA125 and HE4 were 80.33%, 81.97% and 63.93%, respectively.The sensitivity of the combined detection of three indexes was 94.26%.The AUC of the combined detection of three indexes in the diagnosis of the stageⅠtoⅡ and stageⅠto Ⅳ ovarian cancer were 0.913 and 0.959, respectively, which was significantly higher than that of the single indicator detection.
ConclusionThe combined detection of serum CA125, D-dimer and HE4 can significantly improve the sensitivity and diagnostic efficiency of ovarian cancer, and the expression levels of three indicators are related to the clinical stage of ovarian cancer.

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