Dong Chunhua, Liu Ping, Li Chao
Chunhua Dong, Department of Gynaecology, Binzhou People's Hospital, Shandong, 256610, China.
Ping Liu, Office of Binzhou People's Hospital, Library of Binzhou People's Hospital, Binzhou People's Hospital, Shandong, 256610, China.
Pak J Med Sci. 2017 Jul-Aug;33(4):1013-1017. doi: 10.12669/pjms.334.12755.
To investigate the clinical significance of human epididymal secretory protein E4 (HE4) in combination with cancer antigen 125 (CA125) in the diagnosis of endometrial cancer.
One hundred and fifty patients with endometrial cancer who were admitted to Binzhou People's Hospital, Shandong, China, between June 2013 and July 2014, were enrolled and set as an endometrial cancer group; another one hundred patients with benign uterine diseases and one hundred healthy females were also enrolled. The serum was collected from the subjects for the detection of HE4 level. The level of CA125 was detected using electrochemiluminescence assay (ELISA). Receiver Operating Characteristic (ROC) curve was drawn to analyze the cutoff points of HE4 and CA125 levels for the diagnosis of endometrial cancer. The diagnostic efficacy based on the detection of the two indexes separately and jointly was evaluated.
The area under curve (AUC) for diagnosis of endometrial cancer based on HE4 was superior to that based on CA125 (0.819 vs 0.757). The optimal diagnosis cutoff point of HE4 and CA125 on the ROC curves was 92.21 pmol/L and 31.32KU/L, respectively. The sensitivity, Youden index, coincidence rate and negative predicted value of diagnosing endometrial cancer with HE4 in combination with CA125 (73.2%, 0.641, 83.5% and 83.4%) were significantly higher than those of diagnosing endometrial cancer with the two indexes separately. The ROC-AUC value of serum HE4 and CA125 was 0.749 and 0.528 respectively, much lower than that of HE4 in combination with CA125 (0.794; P<0.05).
Serum HE4 and CA125 are the ideal marker combination for the diagnosis of endometrial cancer. HE4 combined with CA125 is beneficial to the diagnosis of endometrial cancer; hence it is worth promotion in clinical practice.
探讨人附睾分泌蛋白E4(HE4)联合癌抗原125(CA125)在子宫内膜癌诊断中的临床意义。
选取2013年6月至2014年7月在中国山东省滨州市人民医院收治的150例子宫内膜癌患者,设为子宫内膜癌组;另选取100例子宫良性疾病患者和100例健康女性。采集受试者血清检测HE4水平,采用电化学发光免疫分析法(ELISA)检测CA125水平。绘制受试者工作特征(ROC)曲线,分析HE4和CA125水平对子宫内膜癌诊断的截断点。评估单独及联合检测这两项指标的诊断效能。
基于HE4诊断子宫内膜癌的曲线下面积(AUC)优于基于CA125的(0.819对0.757)。ROC曲线上HE4和CA125的最佳诊断截断点分别为92.21 pmol/L和31.32KU/L。HE4联合CA125诊断子宫内膜癌的灵敏度、约登指数、符合率及阴性预测值(73.2%、0.641、83.5%和83.4%)显著高于单独使用这两项指标诊断子宫内膜癌时。血清HE4和CA125的ROC-AUC值分别为0.749和0.528,远低于HE4联合CA125时的(0.794;P<0.05)。
血清HE4和CA125是诊断子宫内膜癌的理想标志物组合。HE4联合CA125有助于子宫内膜癌的诊断,值得在临床实践中推广。