血清CA125、HE4和影像学检查在上皮性卵巢癌术后复发诊断中的应用价值

发布时间：2018-11-24 12:34

【摘要】：背景与目的:人附睾蛋白4(human epididymis protein 4,HE4)是一种新型上皮性卵巢癌(epithelial ovarian cancer,EOC)的血清免疫标志物。本研究旨在评价其与卵巢最常用的血清标志物—糖类抗原125(cancer antigen-125,CA125)和腹、盆腔CT/MRI检查对卵巢癌术后复发的诊断价值。方法:回顾性分析EOC术后复发患者92例,其中二次手术48例,化疗44例。统计治疗前血清CA125、HE4和腹、盆腔CT/MRI检查诊断的灵敏度,并与手术病理和临床随访结果进行对照。结果:血清CA125和HE4的灵敏度分别为58.7%和61.9%。两者差异无统计学意义(P0.05);联合两者的灵敏度为80.4%,较单一应用显著提高(P0.05)。腹、盆腔CT/MRI的灵敏度为88.0%,显著高于血清CA125和HE4(P0.01)。与两者联用相比,差异无统计学意义(P0.05)。三者联合应用的灵敏度最高(97.8%),显著高于血清CA125和HE4联用(P0.01),以及单用腹、盆腔CT/MRI(P0.05)。结论:血清HE4对于EOC术后复发的检出与CA125同样有效,两者联合应用可显著提高诊断的灵敏度。与腹、盆腔影像学检查三者联用的灵敏度最高,是EOC术后监测较佳的策略。
[Abstract]:Background & AIM: human epididymal protein 4 (human epididymis protein 4 (HE4) is a novel serum immunomarker for epithelial ovarian cancer (epithelial ovarian cancer,EOC). The purpose of this study was to evaluate the diagnostic value of serum antigens 125 (cancer antigen-125,CA125) and abdominal and pelvic CT/MRI in the diagnosis of postoperative recurrence of ovarian cancer. Methods: 92 cases of recurrence after EOC were analyzed retrospectively, including 48 cases of secondary operation and 44 cases of chemotherapy. The diagnostic sensitivity of serum CA125,HE4, abdominal and pelvic CT/MRI before treatment was statistically analyzed and compared with the results of surgical pathology and clinical follow-up. Results: the sensitivity of serum CA125 and HE4 were 58.7% and 61.9%, respectively. There was no significant difference between the two groups (P0.05), and the sensitivity of combination was 80.4, which was significantly higher than that of single application (P0.05). The sensitivity of abdominal and pelvic CT/MRI was 88.0 and significantly higher than that of serum CA125 and HE4 (P0.01). There was no significant difference between the two groups (P0.05). The sensitivity of the combined treatment was the highest (97.8%), which was significantly higher than the combination of serum CA125 and HE4 (P0.01), and the single use of abdominal and pelvic CT/MRI (P0.05). Conclusion: serum HE4 is as effective as CA125 in detecting recurrence after EOC. In combination with abdominal and pelvic imaging, the sensitivity of these three methods is the highest and is a better strategy for monitoring after EOC.
【作者单位】：上海市第八人民医院妇产科;复旦大学附属肿瘤医院妇瘤科复旦大学上海医学院肿瘤学系;复旦大学附属肿瘤医院放射诊断科复旦大学上海医学院肿瘤学系;
【分类号】：R737.31

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