| Objective：Ovarian cancer incidence in female genital tract tumor third, second only tocervical cancer and endometrial cancer, showing a trend of rising year by year,themortality rate ranks the first place. Ovarian cancer early diagnosis is helpful to improvethe patient’s survival rate. Serum tumor markers have the advantage of simple andobjective data, in the early screening and judging the prognosis of ovarian cancer theyhave the inestimable role. Serum tumor markers CA125is epithelial ovarian cancer, andthe sensitivity and specificity are not high, with low early diagnosis for ovarian cancer.In endometriosis and ovarian benign tumor CA125is some false positives. Looking fora variety of new, high sensitivity and specificity of the serum tumor markers inAssociated with CA125in patients with ovarian cancer to make early diagnosis andimprove the survival rate is a hot spot in research of scholars both at home and abroad.Serum human epididymis protein4(the human epididymis secretory protein4, HE4) isa kind of new serum tumor markers, with high serum levels in patients in ovarianbenign tumors and normal tissues not expression or lower expression, so it may haveclinical value to the diagnosis of ovarian cancer. This article discusses HE4and CA125,CA19-9early diagnosis of ovarian cancer in clinical application.Methods: Selection of Dalian Medical University First Affiliated Hospital of obstetricsand gynecology between January2011and December2011, admitted during the periodof the clinical data of patients,.According to the postoperative pathologic divide thepatients into ovarian cancer group and ovarian benign lesions. One of34patients withovarian malignant tumor and30patients with ovarian benign lesions, and the otherselected during the same period the hospital physical examination center examination of40cases of healthy women as control group. Statistical analysis is performed withSPSS13.0software processing. The data was all expressed as mean±standard deviation(x±s). Counting material was analyzed by t test and multiple samples wereanalyzed by the analysis of variance,difference in masculine rata was analyzed by χ~2test. α=0.05.Results:1. Two kinds of HE4and CA125tumor markers in the three groups hadsignificant difference (comparing variety the mean, variance analysis and calculation ofF value is13.466,7.455, respectively, both P <0.05), but CA19-9in three groups hadno statistical significance (F value was2.401, P=2.401>0.05). The results arecompared, and two serum HE4and CA125in ovarian cancer group, average CA19-9and benign group and control group of three tumor markers were compared respectivelyhad statistical significance (P <0.05); Benign lesion group and control group of HE4and CA125and CA19-9were not statistically significant (P>0.05).(see table1);2. Ovarian cancer using chi-square test for inspection rate of positive group, the positiverate of HE4and CA19-9comparison was statistically significant (chi-square=11.569,P=11.569), the positive rate of CA125and CA19-9comparison was statisticallysignificant (chi-square=22.175, P <0.0001). Benign lesion group and the control groupof HE4in positive rate were0%. Benign group of CA125, CA19-9positive rate was10%,13.33%, positive predictive value of HE4and CA125in benign lesion group, incomparison with the positive rate of CA19-9, had statistical significance (P <0.0001),suggesting benign lesions in the serum CA125, false positive rate of CA19-9wasobviously higher than that of HE4in the false positive rate.(see table2);3. Detection of three tumor markers combined with single standard detection, there isstatistical significance, can improve the detection sensitivity, but the joint detection isnot significantly lower specific degrees;4. Serous carcinoma and endometrial carcinoma patients serum HE4average (469.91+275.6) pmol/L respectively, pmol/L (473.50+33.80), significantly higher thanmucinous carcinoma, clear cell and germ cell tumor patients average (the comparison oftwo sample mean using t test, P <0.05); Serum CA125in patients with serouscarcinoma average is (590.56+210.85) U/ml is significantly higher than other fourtypes of average tumor patients (P <0.05). Mucinous carcinoma patients serum CA19-9average is (234.29+35.87) U/ml is significantly higher than the rest of the four types ofaverage tumor patients (P <0.05);5. Ⅲ~Ⅳ stage ovarian cancer patients serum CA125and CA19-9average Ⅰ~Ⅱovarian cancer patients serum CA125and CA19-9compared average was statistically significant; Ⅲ Ⅳ stage ovarian cancer patients serum HE4and CA125positive ratewere84.61%,96.15%respectively, compared the two, no statistical significance (P>0.05).(see table6)Conclusion:1. HE4and CA125and CA19-9combined detection could improve the diagnosticefficiency of ovarian epithelial carcinoma.2. HE4can be used as a new tumor markers using in clinical diagnosis, and in thedifferential diagnosis of benign and malignant lesions in the specificity of CA125.It isan important reference index of diagnosis of ovarian cancer.3. HE4can be used to guide the histologic types of ovarian cancer classification, fordiagnosis of ovarian serous carcinoma and endometrial carcinoma may have importantsignificance. |
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