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Received:April 19, 2022 Published Online:November 20, 2022
Received:April 19, 2022 Published Online:November 20, 2022
中文摘要: 目的 探讨血清人附睾蛋白4（HE4）在结直肠癌中的诊断价值。方法前瞻性选取中山大学附属第七医院2020年7月至2021年11月期间收治的104例结直肠癌患者为病例组，93例结直肠良性病变患者为良性病变组，纳入同期接受体检的106例健康个体为对照组，检测血清糖类抗原72-4（CA72-4）、糖类抗原19-9（CA19-9）、癌胚抗原（CEA）、HE4水平，以手术病理活检结果为金标准，采用受试者工作特征曲线（ROC）分析上述血清标志物对结直肠癌的诊断价值。结果 病例组CA72-4、CA19-9、CEA以及HE4水平显著高于对照组和良性病变组（P＜0.05）；多因素logistic回归分析显示高水平CA19-9（OR=1.030，95%CI：1.003～1.058）、CA72-4（OR=1.022，95%CI：1.019～1.138）、CEA（OR=1.181，95%CI：1.012～1.379）、HE4（OR=1.072，95%CI：1.052～1.093）是结直肠癌的独立危险因素（P＜0.05）；HE4诊断结直肠癌的曲线下面积（AUC）为0.944，高于CA72-4、CA19-9、CEA，差异有统计学意义（P＜0.05）。结论 血清HE4用于结直肠癌的诊断具有较高的价值。
Abstract:Objective To explore the value of serum human epididymal protein 4（HE4） level in diagnosis of colorectal cancer(CRC). Methods Prospectively, 104 patients with CRC from July 2020 to November 2021 in the Seventh Affiliated Hospital of Sun Yat-sen University were selected as case group, 93 patients with benign colorectal lesions were selected as benign lesion group, and 106 healthy individuals were included as control group. Serum carbohydrate antigen 72-4(CA72-4), carbohydrate antigen 19-9(CA19-9), carcinoembryonic antigen(CEA), and HE4 were detected. The diagnostic value of the above serum markers for CRC was analyzed by ROC curve with the results of surgical pathological biopsy as the gold standard. Results The levels of CA72-4, CA19-9, CEA and HE4 in the case group were significantly higher than those in control group and the benign lesion group(P＜0.05). Multivariate logistic regression analysis showed that high levels of CA19-9（OR=1.030, 95%CI：1.003-1.058）, CA72-4（OR=1.022, 95%CI：1.019-1.138）, CEA（OR=1.181, 95%CI：1.012-1.379）, and HE4（OR=1.072, 95%CI：1.052-1.093） were independent risk factors for colorectal cancer(P＜0.05). The area under the curve(AUC) of HE4 in the diagnosis of colorectal cancer was 0.944, which was higher than CA72-4, CA19-9, CEA, and the difference was statistically significant(P＜0.05).Conclusions Serum HE4 has high value in diagnosis of CRC.
keywords: Colorectal cancer Carbohydrate antigen 72-4 Carbohydrate antigen 19-9 Carcinoembryonic antigen Human epididymis protein 4 Diagnostic efficiency
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