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目的探讨血清人附睾分泌蛋白E4(human epididymal secretory protein E4,HE4)与癌抗原125(CA125)联合检测对子宫内膜癌诊断的临床价值。方法选择2011年12月至2012年12月80例子宫内膜癌患者(子宫内膜癌组),同期60例子宫良性疾病患者(子宫良性疾病组)和60例健康体检女性(对照组),抽取血清后通过ELISA法检测其中HE4水平,采用电化学发光免疫分析法检测其中CA125水平。结果子宫内膜癌组患者血清HE4、CA125水平高于子宫良性疾病组和对照组,差异均有统计学意义(P<0.05)。子宫内膜癌组HE4+CA125联合检测的敏感度高于HE4、CA125单独检测,且HE4单独检测敏感度高于CA125,但HE4比CA125、HE4+CA125联合检测具有更高的特异度,差异均有统计学意义(P<0.05)。HE4、CA125在子宫内膜癌Ⅲ~Ⅳ期的阳性率[62.50%(15/24)、45.83%(11/24)]明显高于I~Ⅱ期的阳性率[32.14%(18/56)、12.50%(7/56)],差异均有统计学意义(P<0.01)。结论血清HE4和CA125联合检测有助于子宫内膜癌的诊断;HE4在敏感度与特异度方面优于CA125;HE4和CA125在子宫内膜癌中的阳性率与病理分期有关。
Objective To investigate the clinical value of combined detection of serum human epididymal secretory protein E4 (HE4) and cancer antigen 125 (CA125) in the diagnosis of endometrial cancer. Methods Eighty patients with endometrial cancer (endometrial carcinoma), 60 patients with uterine benign disease (benign uterine disease) and 60 healthy women (control group) were enrolled in this study from December 2011 to December 2012. The level of HE4 was detected by ELISA after the serum was extracted, and the level of CA125 was detected by electrochemiluminescence immunoassay. Results The serum levels of HE4 and CA125 in patients with endometrial carcinoma were significantly higher than those in patients with benign uterine disease and controls (P <0.05). The sensitivity of HE4 + CA125 detection in endometrial carcinoma group was higher than that of HE4 and CA125 alone, and the sensitivity of HE4 alone was higher than that of CA125, but the specificity of HE4 was higher than that of CA125 and HE4 + CA125 There was statistical significance (P <0.05). The positive rates of HE4 and CA125 in stage Ⅲ ~ Ⅳ of endometrial carcinoma were significantly higher than those in stage Ⅰ ~ Ⅱ [62.50% (15/24), 45.83% (11/24)] [32.14% (18/56) , 12.50% (7/56)], the differences were statistically significant (P <0.01). Conclusion The combination of serum HE4 and CA125 is helpful for the diagnosis of endometrial carcinoma. HE4 is superior to CA125 in sensitivity and specificity. The positive rate of HE4 and CA125 in endometrial carcinoma is related to the pathological stage.