血清OPN、HE4和CA125检测对卵巢癌的临床意义

目的：探讨联合检测血清OPN、HE4和CA125对卵巢癌的临床意义。方法：选择2010年6月-2012年7月西安市中心医院妇科及陕西省肿瘤医院妇瘤科收治的35例卵巢癌患者、73例卵巢良性肿瘤患者及40例同期体检的健康妇女为研究对象,应用ELISA法检测患者手术前后血清OPN、HE4水平,电化学发光法检测患者手术前后血清CA125水平,计算3种肿瘤标志物单项以及联合检测在卵巢癌诊断中的敏感性及特异性。结果：（1）卵巢癌患者术前血清OPN、HE4和CA125水平分别为94.6±61.06ng/mL、412.3±278.62 pmol/mL和398.64±220.91 U/mL,与卵巢良性肿瘤组及正常对照组比较差异有统计学意义（P〈0.05）;（2）卵巢癌患者手术前与术后1月血清OPN、HE4和CA125水平比较,差异均有统计学意义（P〈0.05）;（3）血清OPN、HE4和CA125水平联合检测诊断卵巢癌的敏感性（94.3%）显著高于血清OPN、HE4和CA125单项指标检测（分别为37.1%、71.4%和77.1%）,联合检测与单项指标检测比较差异均有统计学意义（P〈0.05）,而血清OPN、HE4和CA125联合检测诊断卵巢癌的特异性（78.8%）稍低于血清OPN、HE4和CA125单项指标检测（分别为87.6%、100%和80.5%）,联合检测与单项指标检测的特异性比较差异无统计学意义（P〉0.05）。血清HE4单项指标检测的特异性高达100%。结论：联合检测卵巢癌患者血清OPN、HE4和CA125水平可作为诊断和评估卵巢癌预后的参考指标。

Clinical Significance of Serum OPN,HE4 and CA125 Levels in Patients with Ovarian Cancer

Objective： To study the clinical significance of serum OPN, HE4 and CA125 levels in patients with ovarian cancer.Methods：The patients from department of gynecology in the central hospital of XI＇AN city and Oncology of Gynecology in Shan Xi province carcinoma hospital were chosen from June 2010 to July 2012. According to the postoperative pathology, patients were divided into 35 patients with ovarian cancer, 73 patients with ovarian benign tumor and 40 normal healthy women, respectively. Serum levels of OPN, HE4 were detected with the enzyme-linked immunosorbent assay technique（ELISA） in patients with ovarian cancer both before and after operation. CA125 serum level was detected by an electrochemiluminescence method in patients with ovarian cancer both before and after operation. The sensitivity and specificity of the single and combined detection of these markers were calculated. Results：（1）The levels of serum OPN, HE4 and CA125 in ovarian cancer group were 94.6 ±61.06 ng/ml, 412.3±278.62 pmol/m1 and 398.64 ±220.91 U/mL, respectively. Before operation, serum OPN, HE4 and CA125 levels in ovarian cancer patients were significantly higher than those of ovarian benign tumor and healthy controls（P0.05）.（2） Serum OPN, HE4 and CA125 levels in 35 patients with ovarian cancer before operation were significantly higher than those of one month after operation（P0.05）;（3） The sensitivity of OPN, HE4 and CA125 in ovarian cancer group was 37.1 %, 71.4 % and 77.1 %, respectively. The sensitivity of the joint detection in ovarian cancer group was 94.3 %.The sensitivity of the joint detection was obviously higher than that of the single parameter detection（P0.05）. While the specificity of OPN, HE4 and CA125 in ovarian cancer group was 87.6 %, 100 % and 80.5 %, respectively. The specificity of the joint detection in ovarian cancer group was 78.8 %, slightly lower than single parameter detection. The specificity of the joint detection and single parameter detection showed no significant difference in patients with ovarian cancer group before surgery（P0.05）; However,HE4 serum level single parameter detection of specific degree was as high as 100 %. Conclusion：Serum levels of OPN, HE4 and CA125might be used as a reference index of prediction of diagnosis and evaluation in patients with ovarian cancer.