中文摘要：

目的探讨血清人附睾分泌蛋白-4（HE4）、分泌性白细胞蛋白酶抑制因子（SLPI）以及CA125联合检测对上皮性卵巢癌早期诊断的价值,以期能建立一种特异、敏感的早期诊断卵巢癌的方法。方法选取56例卵巢癌患者为卵巢癌组,同期住院的卵巢良性肿瘤患者50例为卵巢良性肿瘤组,同期门诊体检的健康妇女30例为对照组。使用酶联免疫吸附（ELISA）双抗体夹心法检测血清中HE4、SLPI的浓度,电化学发光法检测血清CA125浓度。比较各组HE4、SLPI以及CA125的水平,并比较单项、两两联合、3项联合检测时的阳性率。结果卵巢癌组的3项指标均明显高于其他2组（均P〈0.05）;Ⅰ-Ⅱ期卵巢癌患者HE4、SLPI的阳性率显著高于良性肿瘤组（P〈0.05）,而CA125差异无统计学意义;CA125对浆液性囊腺癌诊断敏感性最高（93.10%）,HE4对浆液性囊腺癌、子宫内膜样腺癌诊断敏感性较高（分别为96.60%、90.90%）,SLPI对不同病理类型的卵巢癌诊断敏感性差异无统计学意义。两两联合检测时,HE4＋CA125对卵巢癌的敏感度和阳性率均为最高;3项联合检测时敏感度最高、约登指数最大。结论 CA125对晚期上皮性卵巢癌敏感,但早期诊断率低。HE4、SLPI在早期上皮性卵巢癌即升高,可以成为提高上皮性卵巢癌早期诊断率的肿瘤标志物。CA125＋HE4＋SLPI联合检测可提高上皮性卵巢癌的诊断率。

英文摘要：

Objective To study the values of combined detection of serum human epididymis protein-4 （HE4）,secretory leukocyte protease inhibitor （SLPI） and CA125 in the early diagnosis of ovarian cancer, and to establish a specific and sensitive method for the early diagnosis of ovarian cancer. Methods The levels of HE4 and SLPI were measured by ELISA and the levels of CA125 were detected by ECLIA in 56 cases of ovarian cancer, 50 cases of benign tumor and 30 healthy controls. The serum levels of HE4, SLPI and CA125 were compared among the three groups and the positive rates were compared among one, two and threeqndex detection. Results The serum levels of HE4, SLPI and CA125 in ovarian cancer group were significantly higher than those inother groups （all P〈0.05）. The positive rates of HE4 and SLPI detection in stage Ⅰ-Ⅱ ovarian epithelial carcinoma were significantly higher than those in benign ovarian tumor （P〈 0. 05）. There were no significant differences inthe positive rates of CA125 detection between the two groups. The diagnostic sensitivity of serum CA125 was highest for serous carcinoma（93.10%）, but the diagnostic sensitivity of serum HE4 was relatively higher for serous carcinoma and endo- metrial carcinoma（96. 6% and 90.90%,respectively）. There were no significant differences in the diagnostic sensitivity of serum SLPI among different pathological types of ovarian cancer. Combined HE4 and CA125 detection had the highest positive rates for ovarian cancer. Combined CA125, HE4 and SLPI detection had higher sensitivity and the highest Youden index for ovarian cancer. Conclusion Serum CA125 is the most sensitive marker for advanced epithelial ovarian cancer,but it has low early diagnostic rate. Serum levels of HE4 and SLPI increase in early stage of ovarian cancer and can be regarded as the markers for early diagnosis of ovarian cancer. The combined detection of CA125, HE4 and SLPI can improve the diagnostic rate of ovarian cancer.