目的探讨血清癌抗原125(CA125)、人附睾蛋白4(HE4)联合盆腔核磁共振成像(MR)检查对卵巢上皮性癌诊断的临床价值。方法选取2012年6月~2014年12月该院收治的卵巢肿瘤患者43例,根据肿瘤的恶性程度分为卵巢上皮性癌组23例,其中早期(Ⅰ期、Ⅱ期)10例、晚期(Ⅲ期、Ⅳ期)13例,卵巢良性肿瘤组20例;另选取同期健康志愿者20例为对照组。检测3组的血清CA125、HE4水平,同时行盆腔MR检查,对比三者单独及联合检查的灵敏度和特异度。结果卵巢上皮性癌组血清CA125、HE4水平高于卵巢良性肿瘤组和对照组,卵巢良性肿瘤组血清CA125、HE4水平高于对照组,晚期卵巢上皮性癌组的血清CA125、HE4水平高于早期卵巢上皮性癌组,差异均有统计学意义(P〈0.05)。CA125、HE4和盆腔MR对卵巢上皮性癌诊断的灵敏度、特异度、准确性均高于其他指标,差异有统计学意义(P〈0.05)。结论血清CA125、HFA-是评估卵巢上皮性癌病情进展情况的重要指标,CA125、HE4联合盆腔MR检查可提高卵巢上皮性癌诊断的灵敏度和特异性,临床有重要参考的价值。
Objective To explore the clinical value of serum cancer antigen 125 ( CA125 ), human epididymis protein4 ( HE4 ) combined with pelvic magnetic resonance imaging (MR) examination in diagnosis of epithelial ovarian cancer. Methods Forty-three ovari- an tumor patients treated in this hospital from June 2012 to December 2014 were selected and divided into ovarian epithelial cancer group (23 patients) and ovarian benign tumor group (20 patients) ; in ovarian epithelial cancer group, 10 patients of early stage (stage Ⅰ and Ⅱ ) and 13 patients of late stage ( stage Ⅲ and Ⅳ ) were included; 20 healthy women were selected as control group. The levels of serum CA125 and HE4 in the three groups were detected; MR examination was performed at the same time; the sensitivities and specificities of single detection of the three indexes and combined detection of the three indexes were compared. Results The levels of serum CA125 and HFA in ovarian epithelial cancer group were higher than those in ovarian benign tumor group and control group, the levels of serum CA125 and HFA in ovari- an benign tumor group were higher than those in control group, the levels of serum CA125 and HE4 during late stage were higher than those during early stage in ovarian epithelial cancer group, there were statistically significant differences ( P〈0. 05 ) . The sensitivity, specificity, and accuracy of combined detection were statistically significantly higher than those of single detection of the three indexes ( P〈0. 05 ) . Conclusion Serum CA125 and HE4 are the important indexes to evaluate the progress of ovarian epithelial cancer, CA125 and HFA com- bined with MR examination can improve the sensitivity and specificity in diagnosis of ovarian epithelial cancer, which has important reference value in clinical field.