| 血清CA125、HE4、VEGF及ROMA指数对卵巢癌诊断及预测术后复发的价值 |
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| 引用本文： | 朱莉,秦丽,王瑞雅,任志帅,马沈倩,郭玉琪△. 血清CA125、HE4、VEGF及ROMA指数对卵巢癌诊断及预测术后复发的价值[J]. 广东医学, 2021, 42(7): 796-801. DOI: 10.13820/j.cnki.gdyx.20204081 |
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| 作者姓名： | 朱莉 秦丽 王瑞雅 任志帅 马沈倩 郭玉琪△ |
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| 作者单位： | 郑州大学人民医院妇产科 河南郑州450003;河南省人民医院妇产科 河南郑州450003 |
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| 基金项目： | 河南省高等学校重点科研项目;河南省医学科技攻关计划 |
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| 摘 要： | 目的 评价血清糖链抗原125（CA125）、人附睾蛋白4（HE4）、血管内皮生长因子（VEGF）及ROMA指数对卵巢癌的诊断价值和对卵巢癌复发的预测。方法回顾性分析308例卵巢肿瘤患者血清中CA125、HE4、VEGF水平及ROMA指数。计算血清CA125、HE4、VEGF及ROMA指数的敏感度、特异度并绘制受试者工作特征（ROC）曲线。通过ROC曲线分析评价以上肿瘤标志物单独及联合检测对卵巢癌的诊断效果，并对卵巢癌患者手术后上述生物标志物的动态变化进行分析。结果共纳入308例患者，其中卵巢恶性肿瘤125例，交界性肿瘤15例，卵巢良性肿瘤168例。恶性肿瘤组血清中CA125、HE4、VEGF水平及ROMA指数高于良性肿瘤组（P<0.05）；血清肿瘤标志物的水平与临床分期有关（Ⅲ~Ⅳ期vs Ⅰ~Ⅱ期，P<0.05）。血清肿瘤标志物的水平与病理类型有关（EOC vs非EOC，P<0.05），联合诊断的AUC、敏感度显著高于单项检测（P<0.05），联合检测的特异度低于单项检测。卵巢癌患者CA125、HE4、VEGF及ROMA指数的动态变化与病情的缓解和复发一致。结论血清CA125、HE4、VEGF及ROMA指数可作为卵巢癌术前诊断的指标，联合检测进一步提高了诊断价值，术后定期检测血清CA125、HE4、VEGF及ROMA指数对预测卵巢癌术后复发或转移有临床意义。
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| 关 键 词： | 卵巢癌 CA125 HE4 VEGF ROMA指数 |
Clinical value of serum CA125, HE4, VEGF and ROMA index in diagnosis of ovarian cancer and prediction of postoperative recurrence |
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| ZHU Li☆,QIN Li,WANG Rui-ya,REN Zhi-shuai,MA Shen-qian,GUO Yu-qi. Clinical value of serum CA125, HE4, VEGF and ROMA index in diagnosis of ovarian cancer and prediction of postoperative recurrence[J]. Guangdong Medical Journal, 2021, 42(7): 796-801. DOI: 10.13820/j.cnki.gdyx.20204081 |
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| Authors: | ZHU Li☆ QIN Li WANG Rui-ya REN Zhi-shuai MA Shen-qian GUO Yu-qi |
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| Affiliation: | Department of Obsterics and Gynecology, People′s Hospital of Zhengzhou University, Zhengzhou 450003, Henan, China |
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| Abstract: | Objective To evaluate the diagnostic value of serum CA125, HE4, VEGF and ROMA index in ovarian cancer and the prediction of recurrence of ovarian cancer. Methods Retrospective analysis of 308 cases of ovarian tumor were conducted. Serum CA125, HE4 and VEGF levels and ROMA index were assessed in all participants. The ROCs of serum CA125, HE4 and VEGF for diagnosis of ovarian carcinoma were drew and for assessment of the sensitivities and specificities. Meanwhile, the combination detection of these markers for diagnosis of ovarian carcinoma were also evaluated. Results A total of 308 patients were included, including 125 cases of ovarian malignant tumors, 15 cases of borderline tumors and 168 cases of benign ovarian tumors. The serum levels of CA125, HE4, VEGF and ROMA index in ovarian malignant tumor group were significantly higher than those in ovarian benign tumor group (P<0.05). The serum levels of tumor markers were significantly correlated to clinical stages (stage Ⅲ-Ⅳ vs. stage Ⅰ-Ⅱ, P<0.05). The levels of serum tumor markers were significantly correlated with pathological types (EOC vs. non EOC, P<0.05). The AUC and sensitivity of combined diagnosis were significantly higher than those of single detections (P<0.05), and the specificity of combined detection was significantly lower than those of single detections. The dynamic changes of CA125, HE4, VEGF and ROMA index were consistent with remission and recurrence of ovarian cancer. Conclusion Serum CA125, HE4, VEGF and ROMA index can be used as indicators for preoperative diagnosis of ovarian cancer; and combined detection can further improve the diagnostic value. Regular detection of serum CA125, HE4, VEGF and ROMA index after surgery has clinical significance in predicting postoperative recurrence or metastasis of ovarian cancer. |
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| Keywords: | ovarian cancer CA125 HE4 VEGF ROMA index |
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