摘要
目的探讨血清糖类抗原125(CA125)、血清糖类抗原153(CA153)及血清人附睾蛋白4(HE4)联合检测对子宫内膜癌的诊断价值。方法回顾性分析84例子宫内膜癌患者(内膜癌组)、70例子宫内膜增生患者(内膜增生组)的临床资料及同期72例健康体检女性的体检资料(对照组)。比较3组受试者的血清CA125、CA153、HE4水平及阳性率。以病理检查结果为金标准,计算并比较肿瘤标志物(CA125、CA153、HE4)单项、两项及三项联合诊断子宫内膜癌的灵敏度、特异度、准确率和约登指数,并比较不同子宫内膜癌病理分期患者的CA125、CA153、HE4水平及阳性率。结果内膜癌组患者的血清CA125、CA153、HE4水平及阳性率均高于内膜增生组及对照组,差异均有统计学意义(P﹤0.05)。CA125+CA153+HE4联合诊断子宫内膜癌的灵敏度高于CA125、CA153、HE4、CA125+CA153、CA125+HE4、CA153+HE4诊断,差异均有统计学意义(P﹤0.05);CA125+CA153+HE4三项联合诊断子宫内膜癌的准确率明显高于CA125、CA153、CA125+CA153诊断,差异均有统计学意义(P﹤0.01);在单项、两项联合、三项联合诊断中,CA125+CA153+HE4三项联合诊断子宫内膜癌的约登指数最高。Ⅲ～Ⅳ期子宫内膜癌患者的血清CA125、CA153、HE4水平均高于Ⅰ～Ⅱ期患者,差异均有统计学意义(P﹤0.05);Ⅲ～Ⅳ期子宫内膜癌患者的血清CA125、HE4的阳性率均高于Ⅰ～Ⅱ期患者,差异均有统计学意义(P﹤0.05)。结论术前检测血清CA125、CA153、HE4水平,可为临床医师评估子宫内膜癌患者的病理分期提供参考;CA125+CA153+HE4三项联合诊断子宫内膜癌的灵敏度、约登指数高于单项肿瘤标志物诊断和两项联合诊断。
Objective To research and investigate the diagnostic value of combined detection of carbohydrate antigen 125(CA125),carbohydrate antigen 153(CA153)and human epididymal protein 4(HE4)in endometrial carcinoma.Method The clinical data of 84 patients with endometrial carcinoma(endometrial carcinoma group)and 70 patients with endometrial hyperplasia(endometrial hyperplasia group)were retrospectively analyzed,and the physical examination results of 72 healthy women(control group)were collected.The serum levels of CA125,CA153 and HE4,and the positive rate of single tumor markers among three groups were compared.Based on the pathological examination results as the gold standard,the sensitivity,specificity,accuracy rate and Jordan index of single,two and three combined tumor markers(CA125,CA153,HE4)in the diagnosis of endometrial carcinoma were calculated and compared,and the levels and positive rates of CA125,CA153 and HE4 in patients with different pathological stages of endometrial carcinoma were compared.Result The positive rates and levels of serum CA125,CA153 and HE4 in the endometrial carcinoma group were higher than those in the endometrial hyperplasia group and the control group,and the differences were statistically significant(P<0.05).The diagnostic sensitivity for endometrial carcinoma of CA125+CA153+HE4 combined detection were significantly higher than those of CA125,CA153,HE4,CA125+CA153,CA125+HE4 and CA153+HE4(P<0.05).The diagnostic accuracy rate for endometrial carcinoma of CA125+CA153+HE4 combined detection was significantly higher than those of serum CA125,CA153 and CA125+CA153,and the differences were statistically significant(P<0.01).Among the single,two and three combined tumor markers detections,CA125+CA153+HE4 had the highest Jordan index for diagnosis of endometrial carcinoma.The serum levels of CA125,CA153 and HE4 in patients with advanced(III-IV)endometrial carcinoma were significantly higher than those in patients with early stage(I-II)endometrial carcinoma(P<0.05);and the positive rates of CA12
作者
屈洁
刘果艳
王晓琴
QU Jie;LIU Guoyan;WANG Xiaoqin(Laboratory Department,the First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,Shaanxi,China;Laboratory Department,the Second People’s Hospital of Wuxi,Wuxi 214002,Jiangsu,China)
出处
《癌症进展》
2018年第15期1903-1906,共4页
Oncology Progress
关键词
子宫内膜癌
肿瘤标志物
人附睾蛋白4
联合检测
endometrial carcinoma
tumor marker
human epididymal protein 4
combined detection
