HE4 评估与 CA125 比较在卵巢癌诊断和治疗反应评估中的意义。
Significance of HE4 estimation in comparison with CA125 in diagnosis of ovarian cancer and assessment of treatment response.
机构信息
Clinical Pathology Department, Faculty of Medicine, Sohag University, Sohag, Egypt.
出版信息
Diagn Pathol. 2013 Jan 23;8:11. doi: 10.1186/1746-1596-8-11.
BACKGROUND
Human epididymis protein 4 (HE4) is a novel and specific biomarker for ovarian cancer. The aim of this study is to evaluate a new tumor marker, HE4, in comparison with CA125 in diagnosis of epithelial ovarian cancer (EOC) and benign gynecological diseases.
METHODS
CA125 and HE4 serum levels were determined in 30 patients with epithelial ovarian cancer (21 serous, 6 endometrioid and 3 mucinous tumors), 20 patients with benign gynecological diseases (8 patients with ovarian cyst, 5 patients with endometriosis, 4 patients with fibroid and 3 patients with pelvic inflammatory disease) and 20 healthy women. CA125 and HE4 cut-offs were 35 U/ml and 150 pmol/l, respectively.
RESULTS
Serum HE4 and CA125 concentrations were significantly higher in the ovarian cancer patients compared with those seen in patients with benign disease or in the healthy controls (p = 0.001 and p < 0.001 respectively). In the receiver operating characteristic analysis (ROC), the area under the curve (AUC) values for HE4 was 0.96 (95% confidence interval, 0.9-1.0) and CA125 was 0.82 (95% confidence interval, 0.7-0.94). Compared to CA125, HE4 had higher sensitivity (90% vs. 83.3%), specificity (95% vs. 85%), PPV (93.1% vs. 80.7%) and NPV (92.7% vs. 87.2%), the combination of HE4 + CA125 the sensitivity and PPV reached 96.7% and 97% respectively.
CONCLUSION
Measuring serum HE4 concentrations along with CA125 concentrations may provide higher accuracy for detecting epithelial ovarian cancer.
VIRTUAL SLIDES
The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1060413168685759.
背景
人附睾蛋白 4（HE4）是一种新型的卵巢癌特异性标志物。本研究旨在评估一种新的肿瘤标志物 HE4，与 CA125 联合用于诊断上皮性卵巢癌（EOC）和良性妇科疾病。
方法
检测 30 例上皮性卵巢癌（21 例浆液性癌，6 例子宫内膜样癌，3 例黏液性癌）、20 例良性妇科疾病（8 例卵巢囊肿、5 例子宫内膜异位症、4 例子宫肌瘤、3 例盆腔炎）和 20 例健康女性的血清 CA125 和 HE4 水平。CA125 和 HE4 的截断值分别为 35 U/ml 和 150 pmol/L。
结果
卵巢癌患者的血清 HE4 和 CA125 浓度明显高于良性疾病患者和健康对照组（p=0.001 和 p<0.001）。在受试者工作特征分析（ROC）中，HE4 的曲线下面积（AUC）值为 0.96（95%置信区间，0.9-1.0），CA125 的 AUC 值为 0.82（95%置信区间，0.7-0.94）。与 CA125 相比，HE4 的敏感性（90% vs. 83.3%）、特异性（95% vs. 85%）、PPV（93.1% vs. 80.7%）和 NPV（92.7% vs. 87.2%）更高，HE4+CA125 的联合检测敏感性和 PPV 分别达到 96.7%和 97%。
结论
同时检测血清 HE4 和 CA125 浓度可能为检测上皮性卵巢癌提供更高的准确性。
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