Research on the diagnosis significance of human epididymis protein 4 for chronic kidney disease

doi:10.3969/j.issn.1673-8640.2015.05.013

Abstract

Abstract: Objective To determine the level of human epididymis protein 4(HE4), and to evaluate its diagnosis significance for chronic kidney disease(CKD). Methods A total of 81 CKD patients and 73 healthy controls were enrolled. The determinations of serum HE4, carbohydrate antigen(CA)125, alpha fetoprotein(AFP), carcinoembryonic antigen(CEA), CA199, CA15-3 and so on were performed by electrochemiluminescence. The results were analyzed by receiver operating characteristic(ROC) curve for the diagnosis of CKD with different stages. Results The levels of serum HE4, CA125, CEA, CA15-3, urea, creatinine and uric acid were significantly higher in CKD patients than those in healthy controls(P<0.05), while there was no statistical significance for AFP and CA199 between the 2 groups (P>0.05). ROC curve analysis indicated that compared with other parameters, HE4 had a better diagnosis significance for CKD. The area under the curve of HE4 was larger than those of urea, creatinine and uric acid. Additionally, there were statistical significances for serum levels of HE4, CEA, urea, creatinine and uric acid among various stages of CKD(P<0.005). Moreover, the serum levels of these parameters increased with severity of CKD. ROC curve analysis showed that serum HE4, urea, creatinine and uric acid had significant diagnosis significance for staging CKD(CKD4-5), with the area under the curve>0.9. Conclusions Serum HE4 shows an excellent diagnosis significance for CKD. Furthermore, it is closely associated with the severity of CKD. It is significant for judging the stages of CKD.

Key words: Human epididymis protein 4, Carbohydrate antigen 125, Glomerular filtration rate, Creatinine, Urea, Tumor marker, Chronic kidney disease

CLC Number:

R446.62

WU Ping, YE Weimin, LI Chen, XIA Xiaohong, ZHANG Zhencheng, ZHAO Wenjing, CUI Yanfang, ZHANG Caiying, ZHONG Renqian, YANG Zaixing. Research on the diagnosis significance of human epididymis protein 4 for chronic kidney disease[J]. Laboratory Medicine, 2015, 30(5): 461-464.

Figures/Tables 6

References 11

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组别	例数	HE4(pmol/L)	CA125(U/mL)	CEA(μg/L)		CA15-3(U/mL)
CKD组	81	287.2(46.5~1 231.0)	14.68(4.13~549.00)	2.19(0.20~20.10)		9.80(3.92~56.16)
正常对照组	73	43.5(18.2~88.7)	11.90(1.92~80.13)	1.10(0.20~7.13)		8.90(4.20~34.59)
P值		<0.001	0.002	<0.001		0.029
组别	例数	尿素(mmol/L)	肌酐(μmol/L)	尿酸(μmol/L)	AFP(μg/L)	CA199(U/mL)
CKD组	81	12.9(3.0~52.0)	271(45~1 892)	451(137~932)	1.90(0.51~42.37)	8.46(0.50~80.20)
正常对照组	73	5.0(2.8~9.2)	56(39~90)	254(111~576)	1.87(0.51~6.32)	9.12(0.60~34.78)
P值		<0.001	<0.001	<0.001	0.354	0.537

组别	例数	HE4(pmol/L)	CA125(U/mL)	CEA(μg/L)		CA15-3(U/mL)
CKD组	81	287.2(46.5~1 231.0)	14.68(4.13~549.00)	2.19(0.20~20.10)		9.80(3.92~56.16)
正常对照组	73	43.5(18.2~88.7)	11.90(1.92~80.13)	1.10(0.20~7.13)		8.90(4.20~34.59)
P值		<0.001	0.002	<0.001		0.029
组别	例数	尿素(mmol/L)	肌酐(μmol/L)	尿酸(μmol/L)	AFP(μg/L)	CA199(U/mL)
CKD组	81	12.9(3.0~52.0)	271(45~1 892)	451(137~932)	1.90(0.51~42.37)	8.46(0.50~80.20)
正常对照组	73	5.0(2.8~9.2)	56(39~90)	254(111~576)	1.87(0.51~6.32)	9.12(0.60~34.78)
P值		<0.001	<0.001	<0.001	0.354	0.537

指标	曲线下面积	95%可信区间	P值
HE4	0.978	0.960~0.996	<0.001
尿素	0.875	0.819~0.930	<0.001
肌酐	0.956	0.922~0.990	<0.001
尿酸	0.832	0.762~0.901	<0.001

指标	曲线下面积	95%可信区间	P值
HE4	0.978	0.960~0.996	<0.001
尿素	0.875	0.819~0.930	<0.001
肌酐	0.956	0.922~0.990	<0.001
尿酸	0.832	0.762~0.901	<0.001

分期	例数	HE4(pmol/L)	CA125(U/mL)	CEA(μg/L)	CA15-3(U/mL)	尿素(mmol/L)	肌酐(μmol/L)	尿酸(μmol/L)
CKD1	28	87.6 (52.1~252.0)	19.00 (9.00~549.00)	1.98 (0.20~5.91)	13.09 (6.93~23.88)	3.9 (3.0~6.4)	76 (46~153)	361 (141~413)
CKD2	22	94.9 (46.5~633.0)	16.78 (6.62~398.20)	1.87 (0.67~5.17)	9.64 (3.92~56.16)	6.4 (3.9~30.6)	92 (45~124)	431 (167~587)
CKD3	5	252.3 (119.0~417.2)	15.24 (4.13~220.70)	2.72 (0.69~4.17)	11.08 (5.96~33.51)	9.1 (2.9~16.1)	135 (119~401)	413 (137~671)
CKD4	8	781.3 (199.6~976.0)	21.35 (8.15~93.28)	3.41 (0.49~7.58)	8.49 (6.01~36.16)	17.2 (12.5~44.2)	439 (153~1 892)	545 (321~671)
CKD5	18	899.2 (553.8~1 231.0)	12.60 (4.98~98.24)	5.29 (1.13~20.10)	12.96 (11.92~35.71)	28.9 (6.2~52.0)	701 (330~1 315)	631 (237~932)
P值		<0.001	0.336	0.001	0.871	<0.001	<0.001	0.001