Diagnostic Value of Serum HE4 in Ovarian Tumor
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摘要: 目的 探讨血清HE4（human epididymis gene product 4，HE4）水平测定对卵巢恶性肿瘤的诊断价值。方法通过酶联免疫法（ELISA法）分别测定64例卵巢上皮性恶性肿瘤患者、40例卵巢良性肿瘤患者以及40例健康妇女血清HE4水平，同时检测CA125的测定值。结果卵巢上皮性恶性肿瘤患者血清HE4测定值为395.2±231.29 pmol/L，卵巢良性肿瘤患者血清HE4测定值为43.86±20.87 pmol/L，健康妇女血清HE4测定值为30.22±9.64 pmol/L。卵巢上皮性恶性肿瘤患者血清HE4水平与其他两组比较，差异有统计学意义（P<0.01），卵巢上皮性恶性肿瘤患者血清HE4水平明显高于其他两组。而卵巢良性肿瘤病变组和健康妇女组血清HE4水平比较，差异无统计学意义（P>0.05）。血清HE4测定值在148.8 pmol/L时诊断值最大，其特异性为97.5%，敏感度为86.4%，ROC曲线下的面积为0.975(95%CI 0.970~1.000 ，P<0.001)， FIGO分期、是否有远处转移及术后残余灶大小为卵巢恶性肿瘤患者生存的独立影响因素， HE4及CA125阳性或阴性、是否有淋巴结转移、腹水是否阳性、大网膜是否有转移不是卵巢恶性肿瘤患者生存的独立影响因素。结论血清HE4水平检测有助于卵巢恶性肿瘤诊断。Abstract: Objective To investigate the variation of HE4 concentration in human ovarian carcinoma and its clinicopathologic significance. Methods The serum concentration of HE4 and CA125 in 64 human ovarian carcinoma，40 ovarian benign tumor carried patients and 40 healthy control were detected by ELISA and electrochemistry irradiance methods respectively. Results The mean concentration of HE4 in 64 human ovarian carcinoma，benign tumor and healthy control was(395.2±231.29) pmol/L，(43.86±20.87) pmol/L，and (30.22±9.64) pmol/L respectively.The serum levels of HE4 were significantly higher (P<0.01)in ovarian cancer than those in benign tumor group and healthy control.But there was no significantly difference between ovarian benign tumors and healthy control(P>0.05).It would be best for diagnosis when serum concentration of HE4 was 148.8 pmol/L on ovarian carcinoma.The sensitivity and specificity of diagnosing were 86.4 %and 97.5% respectively.The HE4 assay in receiver operating characteristic-area under the curve (ROC-AUC)was 0.975 (95%CI 0.970~1.0000，P<0.001).There was not significant difference on serum concentration of HE4 in patients with or without lymph node metastasis，ascites and omentum metastasis.The independent factors of ovarian cancer survival was associated with the stage of FIGO，distant metastasis and post-operative residual lesion，but the serous HE4 contain was not independent factors for the prognosis of ovarian cancer. Conclusion It would be helpful to diagnose ovarian cancer on testing of serum HE4 contain.
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Key words:
- Ovarian carcinoma /
- HE4 /
- CA125 /
- Diagnose
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[1] Li W，Cui H，Feng J，et al.Progress in the diagnosis of ovarian cancer[J] .Zhonghua Fu Chan Ke Za Zhi，2005，40(7):496-498.[李巍，崔恒，冯捷，等.卵巢恶性肿瘤诊断的研究进展[J].中华妇产科杂志，2005，40(7):496-498.] [2] Li J，Dowdy S，Tipton T，et al.HE4 as a biomarker for ovarian and endometrial cancer management[J].Expert Revie Mol Diagn，2009，9(6):555-566. [3] Kirchhoff C，Habben I，Ivell R，et al.A major human epidi dymis specific cDNA encodes a proteinwith sequence homology to extracellular proteinase inhibitors[J].Biol Reprod，1991，45(2):350-357. [4] Kirchhoff C.Molecular characterization of epididymal proteins[J].Rev Reprod，1998，3(2):86-95. [5] Galgano MT，Hampton GM，Frierson HF Jr.Comprehensive analysis of HE4 expression in normal andmalignant human tissues[J].Mod Pathol，2006，19(6):847-853. [6] Moore RG，Brown AK，Miller MC，et al.The use of multiple novel tumor biomarkers for thedetection of ovarian carcinoma in patients with a pelvic mass[J].Gynecol Oncol，2008，108(2):402-408. [7] Kbel M，Kalloger SE，Boyd N， et al.Ovarian carcinoma subtypes are differentdisease:implications for biomarker studies[J].PloS Med，2008，5(12):e232. [8] Berry NB，Cho YM，Harrington MA，et al.Transcriptional targeting in ovarian cancer cells usingthe human epididymis protein 4 promoter[J].Gynecolo Oncol，2004，92(3):896-904. [9] Moore RG，McMeekin DS，Brown AK，et al.A noval multiple marker bioassay utilizing HE4 and CA125for the prediction of ovarian cancer in patients with a pelvic mass[J].Gynecol Oncol，2009，112(1):40-46. [10] Kamei M，Yamashita S，Tokuishi K，et al.HE4 expression can be associated with lymph nodemetastases and disease-free survival in breast cancer[J].Anticancer Res，2010，30(11):4779-4783. [11] Wang K，Gan L，Jeffrey E，et al.Monitoring gene expression profile changes in ovariancarcinomas using cDNA microarray [J].Gene，1999，229(1-2):101- 108. [12] Drapkin R，Von Horsten HH，Lin Y，et al.Human epididymis protein4（HE4）is a secretedglycoprotein that is overexpressed by serous andendometrioid ovarian carcinomas[J].Cancer Res，2005，65(6):2162-2169. [13] Montagnana M，Lippi G，Ruzzenente O，et al.The utility of serum human epididymis protein 4(HE4) in patients with a pelvic mass[J].J Clin Lab Anal，2009，23(5):331-335. [14] Nolen B，Velikokhatnaya L，Marrangoni A，et al.Serum biomarker panels for the discriminationof benign from malignant cases in patients with an adnexal mass[J].Gynecol Oncol，2010，117(3):440-445. [15] Andersen MR，Goff BA， Lowe KA，et al .Use of a symptom index， CA125， and HE4 to predictovarian cancer[J].Gynecol Oncol，2010，116(3):378-383. [16] Cheng YX，Chang XJ，Ye X，et al.Prediction of ovarian cancer in patients with pelvic massusing combined assays of HE4 and CA125 markers[J].Xian Dan Fu Chan Ke Jin Zhan，2009，18(12):261-265.[成夜霞，昌晓红，叶雪，等.血清HE4和CA125联合检测预测盆腔包块患者卵巢癌的风险[J].现代妇产科进展，2009，18(12):261-265.] [17] Xu CL，Yang YH，Wang HL，et al.The value of Serum human epididymis protein 4 epithelial in thediagnosis of ovarian cancer[J].Zhongguo Shi Yong Fu Ke Yu Chan Ke Za Zhi，2010，26(9):684-686.[徐春琳，杨艳华，王惠兰，等.血清人附睾蛋白4对卵巢上皮性癌的诊断价值[J].中国实用妇科与产科杂志，2010，26(9):684-686.] [18] Chi DS，Venkatraman ES，Masson V，et al.The ability of preoperative serum CA-125 to predictoptimal primary tumor cytoreduction in stage Ⅲ epithelial ovarian carcinoma[J].Gynecol Oncol，2000，77（2）:227-231.
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