人附睾蛋白 4 浓度在慢性肾脏病中的升高。

Elevated human epididymis protein 4 concentrations in chronic kidney disease.

机构信息

Department of Laboratory Medicine, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary.

出版信息

Ann Clin Biochem. 2012 Jul;49(Pt 4):377-80. doi: 10.1258/acb.2011.011258. Epub 2012 Jun 11.

DOI:10.1258/acb.2011.011258

PMID:22688735

Abstract

BACKGROUND

Human epididymis protein 4 (HE4) has recently become an available tumour biomarker for detecting ovarian cancer along with the standard cancer antigen 125 (CA125). However, it is unknown if the levels of HE4 and CA125 may be altered in subjects who have impaired renal function with no ovarian disorders.

METHODS

In 113 female patients at different stages of chronic kidney disease (CKD) with no ovarian and lung cancer and 68 subjects with normal renal and ovarian function, HE4 and CA125 concentrations were analysed by using chemiluminescent microparticle immunoassay (Architect®, Abbott) and electrochemiluminescent immunoassay (Modular E170®, Roche), respectively. Renal function was evaluated by measuring serum creatinine and urea concentrations (Cobas Integra-800®, Roche). Estimated glomerular filtration rate (eGFR in mL/min/1.73 m2) was calculated by the 4v-MDRD formula.

RESULTS

Significantly increased HE4 concentrations (P<0.0001) were found in individuals with differently decreased eGFR values (<90 mL/min/1.73 m2) compared with clinical controls. CA125 serum concentration was higher than normal in subjects with CKD3 (eGFR=30-59 mL/min/1.73 m2), but significant elevation (P=0.006) in CA125 concentrations was seen only in those who had severe renal failure (CKD4-5; eGFR<30 mL/min/1.73 m2). These tendencies were independent of age in our study cohort, and seemed to be more evident among women in premenopausal status.

CONCLUSIONS

HE4 concentrations may be elevated in CKD patients with no ovarian and lung cancer. Thus, HE4 results should be interpreted cautiously in women with renal disorders.

摘要

背景

人附睾蛋白 4（HE4）最近已成为一种可用于检测卵巢癌的肿瘤标志物，与标准肿瘤标志物癌抗原 125（CA125）一起使用。然而，目前尚不清楚在没有卵巢疾病但肾功能受损的患者中，HE4 和 CA125 的水平是否会发生改变。

方法

在 113 名患有不同阶段慢性肾脏病（CKD）的女性患者（无卵巢和肺癌）和 68 名肾功能和卵巢功能正常的受试者中，使用化学发光微粒子免疫分析（Architect®，雅培）和电化学发光免疫分析（Modular E170®，罗氏）分别分析 HE4 和 CA125 浓度。通过测量血清肌酐和尿素浓度（Cobas Integra-800®，罗氏）来评估肾功能。通过 4v-MDRD 公式计算估计肾小球滤过率（eGFR，以 mL/min/1.73 m2 计）。

结果

与临床对照相比，eGFR 值不同程度降低（<90 mL/min/1.73 m2）的个体 HE4 浓度显著升高（P<0.0001）。在 CKD3 期（eGFR=30-59 mL/min/1.73 m2）患者中，CA125 血清浓度高于正常值，但仅在患有严重肾衰竭（CKD4-5；eGFR<30 mL/min/1.73 m2）的患者中观察到 CA125 浓度的显著升高（P=0.006）。在我们的研究队列中，这些趋势与年龄无关，并且在绝经前的女性中似乎更为明显。