血清肿瘤标记物CA125、HE4、CEA联合检测在卵巢癌诊疗中的价值

摘要/Abstract

摘要： 目的探讨血清肿瘤标记物糖类抗原 125（CA125）、人附睾蛋白4（HE4）、癌胚抗原（CEA）联合检测在卵巢癌（OC）诊断、指导治疗及预后评估中的价值。方法选取2018年1月—2019年6月在日照市人民医院首次诊治的103例OC患者为研究对象（OC组）,其中63例OC患者术前进行新辅助化疗,化疗有效组45例、无效组18例。同时选取同期来医院就诊的52例卵巢良性病变患者为良性对照组,所有入选人群均有血清CA125、HE4、CEA检查资料。结果 OC组的血清CA125、HE4、CEA水平高于对照组,差异有统计学意义（P<0.05）;OC组临床高分期（Ⅲ~Ⅳ）的血清CA125、HE4、CEA水平高于临床低分期（Ⅰ~Ⅱ）水平,差异有统计学意义（P<0.05）;新辅助化疗前有效组、无效组血清CA125、HE4、CEA水平比较,差异无统计学意义（P>0.05）,新辅助化疗后无效组血清标记物水平与化疗前比较,差异无统计学意义（P>0.05）,有效组化疗后血清标记物水平低于化疗前,差异有统计学意义（P<0.05）;受试者工作特征（ROC）曲线显示血清CA125、HE4、CEA联合检测诊断OC的曲线下面积（AUC）为0.910、敏感度为91.26%,高于各单项检测,差异有统计学意义（P<0.05）;血清CA125、HE4、CEA高水平表达组的5年无事件发生率低于低水平表达组,差异有统计学意义（P<0.05）。结论血清CA125、HE4、CEA联合检测可提高OC诊断价值,根据其表达水平可指导临床制订治疗方案及评估预后。

关键词: 卵巢癌, 糖类抗原125, 人附睾蛋白4, 癌胚抗原, 联合检测

Abstract: Objective To investigate the value of combined detection of serum tumor marker carbohydrate antigen 125 (CA125), human epididymis protein 4 (HE4) and carcinoembryonic antigen (CEA) in the diagnosis, treatment and prognosis of ovarian cancer (OC). Methods A total of 103 OC patients diagnosed and treated for the first time in Rizhao People's Hospital from January 2018 to June 2019 were selected as the study subjects (OC group), among which 63 OC patients received neoadjuvant chemotherapy before surgery, 45 patients in the effective chemotherapy group and 18 patients in the ineffective chemotherapy group. At the same time, 52 patients with benign ovarian lesions who came to the hospital during the same period were selected as the benign control group, all of whom had serum CA125, HE4 and CEA examination data. Results The serum levels of CA125, HE4 and CEA in OC group were higher than those in control group, and the difference was statistically significant (P<0.05). The levels of serum CA125, HE4 and CEA in OC group with clinical high stage (Ⅲ~Ⅳ) were higher than those in clinical low stage (Ⅰ~Ⅱ), and the difference was statistically significant (P<0.05). There was no statistically significant difference in serum CA125, HE4 and CEA levels between the effective group and the ineffective group before neoadjuvant chemotherapy (P>0.05). There was no statistically significant difference in serum marker levels between the ineffective group after neoadjuvant chemotherapy and before chemotherapy (P>0.05). Serum marker levels in the effective group after chemotherapy were lower than those before chemotherapy. The difference was statistically significant (P<0.05). Receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) of the combined detection of serum CA125, HE4 and CEA was 0.910 and the sensitivity was 91.26%, which was higher than that of each single detection, and the difference was statistically significant (P<0.05). The 5-year incident-free rate of serum CA125, HE4 and CEA in high expression group was lower than that in low expression group, and the difference was statistically significant (P<0.05). Conclusion The combined detection of serum CA125, HE4 and CEA can improve the diagnostic value of OC, and can guide the clinical formulation of treatment and prognosis evaluation according to the expression level.

Key words: ovarian cancer, carbohydrate antigen 125, human epididymal protein 4, carcinoembryonic antigen, combined detection

中图分类号:

胡永超, 张荣华, 康从利. 血清肿瘤标记物CA125、HE4、CEA联合检测在卵巢癌诊疗中的价值[J]. 中华养生保健, 2025, 43(11): 180-184.

HU Yong-chao, ZHANG Rong-hua, KANG Cong-li. Value of Combined Detection of Serum Tumor Markers CA125, HE4 and CEA in the Diagnosis and Treatment of Ovarian Cancer[J]. ZHONGHUA YANGSHENG BAOJIAN, 2025, 43(11): 180-184.

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