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目的探讨人附睾分泌蛋白4(HE4)和鳞状细胞癌抗原(SCCAg)在子宫内膜癌的表达及两者与子宫内膜癌生物学行为的关系。方法利用酶联免疫吸附试验检测85例子宫内膜癌患者、30例子宫内膜非典型增生患者及30名健康女性(对照组)血清HE4和SCCAg含量,并对比分析两者对子宫内膜癌的临床价值。结果子宫内膜癌组血清HE4和SCCAg水平分别为(199.6±31.2)pmol/L、0.98(0.15~4.85)μg/L,明显高于子宫内膜非典型增生组[(91.6±16.8)pmol/L、0.18(0.02~1.41)μg/L,P均<0.05]和对照组[(82.5±9.7)pmol/L、0.13(0.03~1.32)μg/L,P均<0.05];HE4和SCCAg对子宫内膜癌诊断的敏感性分别为63.5%、14.1%,特异性为96.7%、100.0%;血清HE4和SCCAg水平及阳性率均随临床分期升高逐渐上升,两者在子宫内膜癌晚期的阳性率(HE4:Ⅲ期90.0%、Ⅳ期100.0%;SCCAg:Ⅲ期30.0%、Ⅳ期25.0%)明显高于早期(Ⅰ期分别为61.1%和5.6%,P均<0.05);在不同的临床病理因素中,非子宫内膜样腺癌HE4阳性率达92.0%,明显高于子宫内膜样腺癌(51.7,P<0.05),HE4在子宫内膜癌的表达与肿瘤大小、病理类型、肿瘤侵润肌层深度及肿瘤转移均有关(P均<0.05);而SCCAg在子宫内膜癌的表达仅与肿瘤转移有关(P<0.01)。结论血清HE4检测对子宫内膜癌的早期诊断及鉴别诊断有一定的临床应用价值,可作为子宫内膜癌病程监测的可靠指标。而SCCAg单独作为子宫内膜癌诊断指标尚无太大意义,仅在病程监测及判断肿瘤转移上有一定价值。
Objective To investigate the expression of human epididymal secreting protein 4 (HE4) and squamous cell carcinoma antigen (SCCAg) in endometrial carcinoma and their relationship with the biological behavior of endometrial carcinoma. Methods Serum levels of HE4 and SCCAg in 85 cases of endometrial cancer, 30 cases of endometrial dysplasia and 30 healthy women (control group) were detected by enzyme-linked immunosorbent assay (ELISA), and the relationship between endometrial carcinoma The clinical value. Results The serum levels of HE4 and SCCAg in endometrial carcinoma group were (199.6 ± 31.2) pmol / L and 0.98 (0.15-4.85) μg / L, respectively, which were significantly higher than those in the atypical hyperplasia group [(91.6 ± 16.8) pmol / L, 0.18 (0.02-1.41) μg / L, all P <0.05] and the control group [(82.5 ± 9.7) pmol / L and 0.13 The diagnostic sensitivity of endometrial carcinoma was 63.5%, 14.1%, specificity was 96.7%, 100.0% respectively. Serum HE4 and SCCAg levels and positive rates increased gradually with the clinical stage, both in endometrial carcinoma late (90.0% in HE4 stage, 100.0% in stage IV, 30.0% in stage SCCAg and 25.0% in stage Ⅳ) were significantly higher than those in stage I (61.1% and 5.6% in stage I, respectively; all P < Among the different clinicopathological factors, the positive rate of HE4 in non-endometrioid adenocarcinoma was 92.0%, which was significantly higher than that in endometrioid adenocarcinoma (51.7, P <0.05). The expression of HE4 in endometrial carcinoma was correlated with tumor size, (P <0.05). However, the expression of SCCAg in endometrial carcinoma was only associated with tumor metastasis (P <0.01). Conclusion Serum HE4 detection of endometrial cancer early diagnosis and differential diagnosis of certain clinical value, as a reliable indicator of endometrial cancer course monitoring. The SCCAg alone as a diagnostic indicator of endometrial cancer is not much significance, only in the course of disease monitoring and determine the value of tumor metastasis.