HE4、ALDH1、CD44在卵巢良恶性肿瘤鉴别诊断中的检测效能观察

摘要 目的：观察人附睾蛋白4（HE4）、乙醛脱氢酶1（ALDH1）、黏附分子CD44在卵巢良恶性肿瘤鉴别诊断中的检测效能。方法：选取2020年1月~2022年5月我院收治的100例卵巢癌患者、100例卵巢良性肿瘤患者，分为纳入恶性组与良性组，另外选取同期体检的100例健康女性作为对照组。比较三组患者血清中HE4、ALDH1及组织中CD44的表达情况，并采用受试者工作特征（ROC）曲线分析其对卵巢良恶性肿瘤的鉴别诊断价值。结果：恶性组患者的HE4、ALDH1水平及CD44阳性表达率均高于良性组与对照组（P＜0.05），良性组患者的HE4、ALDH1水平及CD44阳性表达率高于对照组（P＜0.05）。与临床分期为Ⅰ~Ⅱ期、未发生淋巴转移患者比较，临床分期为Ⅲ~Ⅳ期、发生淋巴转移的卵巢癌患者HE4、ALDH1水平及CD44阳性表达率更高（P＜0.05），Spesrman相关性分析结果显示，HE4、ALDH1水平及CD44阳性表达率均与卵巢癌患者临床分期、淋巴转移成正相关（P＜0.05）。ROC特征曲线结果显示，HE4、ALDH1、CD44鉴别卵巢良恶性肿瘤的曲线下面积（AUC）分别为0.837、0.768及0.610，采用3项指标联合（并联）鉴别卵巢良恶性肿瘤的AUC及敏感度均高于单一指标诊断（P＜0.05）。结论：卵巢恶性肿瘤患者血清中HE4、ALDH1及组织中CD44均呈现高表达，且表达水平与卵巢癌患者临床分期、淋巴转移密切相关，HE4、ALDH1联合CD44检测对卵巢良恶性肿瘤具有较高的的鉴别诊断价值。

Performance of HE4, ALDH1 and CD44 in Differential Diagnosis of Benign and Malignant Ovarian Tumors

ABSTRACT Objective: To observe the performance of human epididymis protein 4 (HE4), aldehyde dehydrogenase 1 (ALDH1) and adhesion molecule CD44 in differential diagnosis of benign and malignant ovarian tumors. Methods: 100 patients with ovarian carcinoma and 100 patients with benign ovarian tumor who were admitted to the hospital from January 2020 to May 2022 were selected, and included in the malignant group and the benign group. At the same time, 100 healthy women were selected as the control group. The expression of HE4 and ALDH1 in serum and CD44 in tissues of the three groups was compared. The value of the three parameters in differential diagnosis of benign and malignant ovarian tumors was analyzed using the receiver operating characteristic (ROC) curve. Results: The levels of HE4 and ALDH1, and CD44 positive expression rate decreased in order from the malignant group, the benign group to the control group(P<0.05). For the malignant group, the levels of HE4 and ALDH1, and CD44 positive expression rate were higher in patients with clinical stage III-IV and lymph node metastasis than those with clinical stage I-II and without lymph node metastasis (P<0.05). Spesrman correlation analysis found that the levels of HE4 and ALDH1, and CD44 positive expression rate were positively correlated with clinical stage and lymph node metastasis in patients with ovarian carcinoma(P<0.05). ROC curve analysis results showed that the area under the curve(AUC) values of HE4, ALDH1, and CD44 in differential diagnosis of benign and malignant ovarian tumors were 0.837, 0.768, and 0.610, respectively. The AUC and sensitivity of combined diagnosis with the three indicators were higher than those of single diagnosis (P<0.05). Conclusion: The expression of HE4 and ALDH1 in serum and CD44 in tissues of patients with malignant ovarian tumors is high. The expression level is closely related to clinical stage and lymph node metastasis of ovarian carcinoma. The combination of HE4, ALDH1 and CD44 is of high value in the differential diagnosis of benign and malignant ovarian tumors.