目的探讨血清人附睾蛋白4(human epididymis protein 4,HE4)和糖链抗原125(carbohydrate,antigen 125,CA125)在卵巢癌诊断中的价值。方法卵巢癌患者42例(卵巢癌组),卵巢良性肿瘤患者42例(良性肿瘤组),采用电化学发光法检测2组血清HE4和CA125水平,比较不同分期卵巢癌患者血清HE4和CA125水平;统计卵巢癌组血清HE4和CA125阳性率,计算血清HE4、CA125单独及联合诊断卵巢癌的准确性、灵敏性和特异性等。结果卵巢癌组CA125水平[(236.14±96.23)u/mL],HE4水平[(346.53±125.67)pmol/L]均高于良性肿瘤组[(32.61±18.59)u/mL、(58.91±29.56)pmol/L](P<0.05);卵巢癌Ⅰ+Ⅱ期患者血清CA125[(61.28±36.21)u/mL]低于Ⅲ期[(424.87±98.65)u/mL]和Ⅳ期[(531.56±194.24)u/mL](P<0.05),Ⅲ期与Ⅳ期差异无统计学意义(P>0.05);卵巢癌Ⅰ+Ⅱ期患者血清HE4[(89.25±45.95)pmol/L]低于Ⅲ期[(321.79±78.69)pmol/L]和Ⅳ期[(768.72±67.83)pmol/L],且Ⅲ期低于Ⅳ期,差异均有统计学意义(P<0.05);卵巢癌组血清HE4阳性36例,CA125阳性33例,HE4+CA125阳性38例,HE4和CA125联合诊断卵巢癌的灵敏性(90.47%)、特异性(97.62%)、阳性预测值(97.44%)、阴性预测值(91.11%)和准确性(96.34%)均高于单独检测HE4(85.71%、95.24%、94.74%、86.96%,90.48%)和CA125(78.57%,57.14%、64.71%、72.73%、65.86%)(P<0.05)。结论与卵巢良性肿瘤患者比较,卵巢癌患者血清HE4、CA125水平明显增高,且其增高水平与卵巢癌临床分期有一定关系;HE4和CA125联合检测诊断卵巢癌的效能优于单独检测血清HE4和CA125。
