【摘要】：目的：探討血清人附睪蛋白4(HE4)與糖類抗原CA125及ROMA指數(shù)在卵巢癌婦女中的診斷價值。方法：采用微粒子化學發(fā)光法檢測184例上皮性卵巢癌患者血清標本HE4和CA125,并結合絕經(jīng)狀態(tài)計算出ROMA指數(shù)；以132例卵巢良性疾病和107例健康體檢者作為對照組。結果：1.HE4檢測水平在絕經(jīng)前后患者中均為惡性組高于健康對照組和卵巢良性疾病組,但對照組與良性疾病組無統(tǒng)計學差異。而CA125的檢測水平在三組的比較中,差異均有統(tǒng)計學意義(P0.05)。2.HE4的診斷特異度及陽性預測值高于CA125,將其聯(lián)合檢測診斷靈敏度、診斷特異度分別為92.39%和81.06%,并且診斷符合率為87.66%均高于單項檢測。3.在病理分期中HE4在Ⅰ期+Ⅱ期中的陽性率高于CA125,CA125在Ⅲ期+Ⅳ期中的陽性率高于HE4,兩者聯(lián)合檢測在Ⅰ期+Ⅱ期中的陽性率為92.68%；4.HE4、CA125單獨檢測及聯(lián)合檢測,陽性率在絕經(jīng)前后、維族與漢族之間無明顯差異；年齡因素除CA125的陽性率在≤45歲與45歲中無統(tǒng)計學意義外,另外兩者的陽性率均有統(tǒng)計學差異。5.聯(lián)合檢測HE4與CA125用Fisher判別分析判別卵巢癌正確率分別為絕經(jīng)前組78.82%(67/85),絕經(jīng)后組79.80%(79/99)。6.絕經(jīng)前組中ROMA指數(shù)診斷靈敏度、特異度分別為90.59%、89.06%；絕經(jīng)后組中ROMA指數(shù)的靈敏度、特異度分別為91.92%、86.76%,兩組之間差異無統(tǒng)計學意義x2=0.26,P=0.83。7.CA125、HE4、ROMA指數(shù)的曲線下面積在絕經(jīng)前后組中均為HE4與ROMA的曲線下面積大于CA125。結論：1.CA125對卵巢良惡性疾病的區(qū)分不如HE4好,HE4應用于上皮性卵巢癌可降低漏診率提高早期診斷能力,將其聯(lián)合檢測對卵巢癌的診斷價值更高。2.ROMA指數(shù)適合用于評估上皮性卵巢癌的風險性,從而提高診斷率。
[Abstract]:Aim: to investigate the diagnostic value of serum human epididymal protein 4 (HE4), carbohydrate antigen CA125 and ROMA index in women with ovarian cancer. Methods: the serum HE4 and CA125, were measured by microparticle chemiluminescence in 184 patients with epithelial ovarian cancer and the ROMA index was calculated in combination with menopause status, and the control group consisted of 132 benign ovarian diseases and 107 healthy controls. Results: the level of 1.HE4 was higher in the malignant group than that in the healthy control group and the benign ovarian disease group before and after menopause, but there was no significant difference between the control group and the benign disease group. 2. The diagnostic specificity and positive predictive value of HE4 were higher than those of CA125, and the sensitivity of combined detection of CA125 was higher than that of HE4 in the comparison of the three groups (P0.05). 2. The diagnostic specificity and positive predictive value of HE4 were higher than that of CA125,. The specificity of diagnosis was 92.39% and 81.06% respectively, and the diagnostic coincidence rate of 87.66% was higher than that of single detection. 3. The positive rate of HE4 in stage 鈪，

本文編號：2435829