CA125、CA199、HE4水平联合检测对子宫内膜异位症的诊断及预后评估价值

Diagnostic and prognostic value of combined detection of CA125, CA199 and HE4 in endometriosis

摘要:

目的 分析糖类抗原125（CA125）、糖类抗原199（CA199）及人附睾上皮分泌蛋白4（HE4）水平对子宫内膜异位症（EMs）的诊断和预后评估价值。方法 选取2021年2月—2024年3月在连云港第二人民医院接受检查的122例EMs患者（EMs组）和92例非EMs患者（非EMs组）。比较EMs组与非EMs组临床资料、不同EMs分期患者的CA125、CA199、HE4水平；进行多因素逐步Logistic回归分析，并绘制受试者工作特征（ROC）曲线；比较预后良好组与预后不良组HE4、CA125、CA199水平。结果 EMs组CA125、CA199、HE4、NLR、Fib水平均高于非EMs组（P 0.05）。EMs Ⅳ期HE4、CA125、CA199水平均高于Ⅲ期、Ⅱ期、Ⅰ期（P 0.05）。多因素逐步Logistic回归分析结果显示：CA125水平高［O^R=1.103（95% CI：1.052，1.156）］、CA199水平高［O^R=1.270（95% CI：1.141，1.413）］、HE4水平高［O^R=1.157（95% CI：1.081，1.239）］、NLR水平高［O^R=1.352（95% CI：1.174，1.558）］、Fib水平高［O^R=1.908（95% CI：1.371，2.656）］均为发生EMs的危险因素（P 0.05）。ROC曲线结果表明：CA125、CA199、HE4联合检测诊断EMs的AUC为0.893，敏感性为89.3%（95% CI：0.825，0.942），特异性为88.0%（95% CI：0.796，0.939）。预后不良组HE4、CA125、CA199水平均高于预后良好组（P 0.05）。结论 CA125、CA199、HE4与EMs患者临床分期相关，三者联合检测EMs诊断效能更高，且CA125、CA199、HE4与EMs患者预后不良有关。

Abstract:

Objective To analyze the diagnostic and prognostic value of carbohydrate antigen 125 (CA125), CA199 and human epididymis protein 4 (HE4) levels in endometriosis (EMs).Methods A total of 122 patients with EMs (EMs group) and 92 patients without EMs (non-EMs group) who underwent examination at Lianyungang Second People's Hospital between February 2021 and March 2024 were selected. Clinical data were compared between the EMs group and the non-EMs group, and levels of CA125, CA199 and HE4 were compared among EMs patients at different stages. The multivariable stepwise logistic regression analysis was performed, and the receiver operating characteristic (ROC) curves were plotted. The levels of HE4, CA125 and CA199 were compared between the favorable-prognosis group and the poor-prognosis group.Results The levels of CA125, CA199, HE4, NLR and Fib in the EMs group were all higher than those in the non-EMs group (P 0.05). The levels of HE4, CA125 and CA199 in stage IV EMs were all higher than those in stages III, II and I EMs (P 0.05). Results of multivariable stepwise logistic regression analysis showed that high levels of CA125 [O^R = 1.103 (95% CI: 1.052, 1.156) ], CA199 [O^R = 1.270 (95% CI: 1.141, 1.413) ], HE4 [O^R = 1.157 (95% CI: 1.081, 1.239) ], NLR [O^R = 1.352 (95% CI: 1.174, 1.558) ] and Fib [O^R = 1.908 (95% CI: 1.371, 2.656) ] were all risk factors for the development of EMs (P 0.05). The ROC curve analysis indicated that the area under the curve (AUC) of the combined detection of CA125, CA199, and HE4 for diagnosing EMs was 0.893, with a sensitivity of 89.3% (95% CI: 0.825, 0.942) and a specificity of 88.0% (95% CI: 0.796, 0.939). The levels of HE4, CA125 and CA199 were higher in the poor-prognosis group than in the favorable-prognosis group (P 0.05).Conclusion CA125, CA199 and HE4 are associated with the clinical stage of patients with EMs. The combined detection of these three markers demonstrates higher diagnostic performance for Ems, and they are related to the poor prognosis in patients with EMs.