人组织型激肽释放酶6在卵巢上皮性肿瘤中的表达及其与临床病理特征和预后的关系

Objective To approach the relationship between the expression of hK6 in ovarian neoplasm and clinicopathological variables and prognosis in ovarian cancer patients for finding a new tumor marker of the ovarian cancer. Methods The expression of hK6 was detected by immunohistochemistry in 19 cases of benign, 11 cases of borderline and 45 cases of malignant ovarian neoplasms and statistically analyzed whether its expression correlate with clinicopathological variables and prognosis in patients with ovarian cancer. Results The expression of hK6 in ovarian cancer tissues (60.0%) was significantly higher than that in the benign (15.8%) and borderline (27.3%) ovarian neoplasm tissues (P < 0.01). The expression of hK6 in higher-grade ovarian cancer tissues (68.4%) was higher than that in low-grade ones (14.3%, P<0.05). The expression of hK6 in late-stage (stage Ⅲ ,76.7%) was significantly higher than that in early-stage (stage Ⅰ or Ⅱ ,26.7%, P < 0.01). The expression of hK6 was significantly higher in patients with lymph node metastasis (77.8%) than that in patients without (33.3% ,P<0.01). The expression of hK6 in the cancer tissues in the patients died, or with reeeurence or metastasis within 3 years after surgery was higher (75.0%) than that in the patients with stable disease (42.9%, P < 0. 05). Conclusion The expression of hK6 in ovarian cancer was higher than that in benign and borderline ovarian neoplasms. The expression of hK6 is higher in the ovarian cancer of late stage, higher-grade, with lymph node metastasis and is associated with a poorer prognosis, hK6 may become a new markers in prediction of prognosis of the patients with ovarian tumors.     

人组织型激肽释放酶6在卵巢上皮性肿瘤中的表达及其与临床病理特征和预后的关系

Objective To approach the relationship between the expression of hK6 in ovarian neoplasm and clinicopathological variables and prognosis in ovarian cancer patients for finding a new tumor marker of the ovarian cancer. Methods The expression of hK6 was detected by immunohistochemistry in 19 cases of benign, 11 cases of borderline and 45 cases of malignant ovarian neoplasms and statistically analyzed whether its expression correlate with clinicopathological variables and prognosis in patients with ovarian cancer. Results The expression of hK6 in ovarian cancer tissues (60.0%) was significantly higher than that in the benign (15.8%) and borderline (27.3%) ovarian neoplasm tissues (P < 0.01). The expression of hK6 in higher-grade ovarian cancer tissues (68.4%) was higher than that in low-grade ones (14.3%, P<0.05). The expression of hK6 in late-stage (stage Ⅲ ,76.7%) was significantly higher than that in early-stage (stage Ⅰ or Ⅱ ,26.7%, P < 0.01). The expression of hK6 was significantly higher in patients with lymph node metastasis (77.8%) than that in patients without (33.3% ,P<0.01). The expression of hK6 in the cancer tissues in the patients died, or with reeeurence or metastasis within 3 years after surgery was higher (75.0%) than that in the patients with stable disease (42.9%, P < 0. 05). Conclusion The expression of hK6 in ovarian cancer was higher than that in benign and borderline ovarian neoplasms. The expression of hK6 is higher in the ovarian cancer of late stage, higher-grade, with lymph node metastasis and is associated with a poorer prognosis, hK6 may become a new markers in prediction of prognosis of the patients with ovarian tumors.     

人组织型激肽释放酶6在卵巢上皮性肿瘤中的表达及其与临床病理特征和预后的关系

Objective To approach the relationship between the expression of hK6 in ovarian neoplasm and clinicopathological variables and prognosis in ovarian cancer patients for finding a new tumor marker of the ovarian cancer. Methods The expression of hK6 was detected by immunohistochemistry in 19 cases of benign, 11 cases of borderline and 45 cases of malignant ovarian neoplasms and statistically analyzed whether its expression correlate with clinicopathological variables and prognosis in patients with ovarian cancer. Results The expression of hK6 in ovarian cancer tissues (60.0%) was significantly higher than that in the benign (15.8%) and borderline (27.3%) ovarian neoplasm tissues (P < 0.01). The expression of hK6 in higher-grade ovarian cancer tissues (68.4%) was higher than that in low-grade ones (14.3%, P<0.05). The expression of hK6 in late-stage (stage Ⅲ ,76.7%) was significantly higher than that in early-stage (stage Ⅰ or Ⅱ ,26.7%, P < 0.01). The expression of hK6 was significantly higher in patients with lymph node metastasis (77.8%) than that in patients without (33.3% ,P<0.01). The expression of hK6 in the cancer tissues in the patients died, or with reeeurence or metastasis within 3 years after surgery was higher (75.0%) than that in the patients with stable disease (42.9%, P < 0. 05). Conclusion The expression of hK6 in ovarian cancer was higher than that in benign and borderline ovarian neoplasms. The expression of hK6 is higher in the ovarian cancer of late stage, higher-grade, with lymph node metastasis and is associated with a poorer prognosis, hK6 may become a new markers in prediction of prognosis of the patients with ovarian tumors.     

人组织型激肽释放酶6在卵巢上皮性肿瘤中的表达及其与临床病理特征和预后的关系

Objective To approach the relationship between the expression of hK6 in ovarian neoplasm and clinicopathological variables and prognosis in ovarian cancer patients for finding a new tumor marker of the ovarian cancer. Methods The expression of hK6 was detected by immunohistochemistry in 19 cases of benign, 11 cases of borderline and 45 cases of malignant ovarian neoplasms and statistically analyzed whether its expression correlate with clinicopathological variables and prognosis in patients with ovarian cancer. Results The expression of hK6 in ovarian cancer tissues (60.0%) was significantly higher than that in the benign (15.8%) and borderline (27.3%) ovarian neoplasm tissues (P < 0.01). The expression of hK6 in higher-grade ovarian cancer tissues (68.4%) was higher than that in low-grade ones (14.3%, P<0.05). The expression of hK6 in late-stage (stage Ⅲ ,76.7%) was significantly higher than that in early-stage (stage Ⅰ or Ⅱ ,26.7%, P < 0.01). The expression of hK6 was significantly higher in patients with lymph node metastasis (77.8%) than that in patients without (33.3% ,P<0.01). The expression of hK6 in the cancer tissues in the patients died, or with reeeurence or metastasis within 3 years after surgery was higher (75.0%) than that in the patients with stable disease (42.9%, P < 0. 05). Conclusion The expression of hK6 in ovarian cancer was higher than that in benign and borderline ovarian neoplasms. The expression of hK6 is higher in the ovarian cancer of late stage, higher-grade, with lymph node metastasis and is associated with a poorer prognosis, hK6 may become a new markers in prediction of prognosis of the patients with ovarian tumors.     

人组织型激肽释放酶6在卵巢上皮性肿瘤中的表达及其与临床病理特征和预后的关系

Objective To approach the relationship between the expression of hK6 in ovarian neoplasm and clinicopathological variables and prognosis in ovarian cancer patients for finding a new tumor marker of the ovarian cancer. Methods The expression of hK6 was detected by immunohistochemistry in 19 cases of benign, 11 cases of borderline and 45 cases of malignant ovarian neoplasms and statistically analyzed whether its expression correlate with clinicopathological variables and prognosis in patients with ovarian cancer. Results The expression of hK6 in ovarian cancer tissues (60.0%) was significantly higher than that in the benign (15.8%) and borderline (27.3%) ovarian neoplasm tissues (P < 0.01). The expression of hK6 in higher-grade ovarian cancer tissues (68.4%) was higher than that in low-grade ones (14.3%, P<0.05). The expression of hK6 in late-stage (stage Ⅲ ,76.7%) was significantly higher than that in early-stage (stage Ⅰ or Ⅱ ,26.7%, P < 0.01). The expression of hK6 was significantly higher in patients with lymph node metastasis (77.8%) than that in patients without (33.3% ,P<0.01). The expression of hK6 in the cancer tissues in the patients died, or with reeeurence or metastasis within 3 years after surgery was higher (75.0%) than that in the patients with stable disease (42.9%, P < 0. 05). Conclusion The expression of hK6 in ovarian cancer was higher than that in benign and borderline ovarian neoplasms. The expression of hK6 is higher in the ovarian cancer of late stage, higher-grade, with lymph node metastasis and is associated with a poorer prognosis, hK6 may become a new markers in prediction of prognosis of the patients with ovarian tumors.     

人组织型激肽释放酶6在卵巢上皮性肿瘤中的表达及其与临床病理特征和预后的关系

Objective To approach the relationship between the expression of hK6 in ovarian neoplasm and clinicopathological variables and prognosis in ovarian cancer patients for finding a new tumor marker of the ovarian cancer. Methods The expression of hK6 was detected by immunohistochemistry in 19 cases of benign, 11 cases of borderline and 45 cases of malignant ovarian neoplasms and statistically analyzed whether its expression correlate with clinicopathological variables and prognosis in patients with ovarian cancer. Results The expression of hK6 in ovarian cancer tissues (60.0%) was significantly higher than that in the benign (15.8%) and borderline (27.3%) ovarian neoplasm tissues (P < 0.01). The expression of hK6 in higher-grade ovarian cancer tissues (68.4%) was higher than that in low-grade ones (14.3%, P<0.05). The expression of hK6 in late-stage (stage Ⅲ ,76.7%) was significantly higher than that in early-stage (stage Ⅰ or Ⅱ ,26.7%, P < 0.01). The expression of hK6 was significantly higher in patients with lymph node metastasis (77.8%) than that in patients without (33.3% ,P<0.01). The expression of hK6 in the cancer tissues in the patients died, or with reeeurence or metastasis within 3 years after surgery was higher (75.0%) than that in the patients with stable disease (42.9%, P < 0. 05). Conclusion The expression of hK6 in ovarian cancer was higher than that in benign and borderline ovarian neoplasms. The expression of hK6 is higher in the ovarian cancer of late stage, higher-grade, with lymph node metastasis and is associated with a poorer prognosis, hK6 may become a new markers in prediction of prognosis of the patients with ovarian tumors.     

人组织型激肽释放酶6在卵巢上皮性肿瘤中的表达及其与临床病理特征和预后的关系

Objective To approach the relationship between the expression of hK6 in ovarian neoplasm and clinicopathological variables and prognosis in ovarian cancer patients for finding a new tumor marker of the ovarian cancer. Methods The expression of hK6 was detected by immunohistochemistry in 19 cases of benign, 11 cases of borderline and 45 cases of malignant ovarian neoplasms and statistically analyzed whether its expression correlate with clinicopathological variables and prognosis in patients with ovarian cancer. Results The expression of hK6 in ovarian cancer tissues (60.0%) was significantly higher than that in the benign (15.8%) and borderline (27.3%) ovarian neoplasm tissues (P < 0.01). The expression of hK6 in higher-grade ovarian cancer tissues (68.4%) was higher than that in low-grade ones (14.3%, P<0.05). The expression of hK6 in late-stage (stage Ⅲ ,76.7%) was significantly higher than that in early-stage (stage Ⅰ or Ⅱ ,26.7%, P < 0.01). The expression of hK6 was significantly higher in patients with lymph node metastasis (77.8%) than that in patients without (33.3% ,P<0.01). The expression of hK6 in the cancer tissues in the patients died, or with reeeurence or metastasis within 3 years after surgery was higher (75.0%) than that in the patients with stable disease (42.9%, P < 0. 05). Conclusion The expression of hK6 in ovarian cancer was higher than that in benign and borderline ovarian neoplasms. The expression of hK6 is higher in the ovarian cancer of late stage, higher-grade, with lymph node metastasis and is associated with a poorer prognosis, hK6 may become a new markers in prediction of prognosis of the patients with ovarian tumors.     

人组织型激肽释放酶6在卵巢上皮性肿瘤中的表达及其与临床病理特征和预后的关系

Objective To approach the relationship between the expression of hK6 in ovarian neoplasm and clinicopathological variables and prognosis in ovarian cancer patients for finding a new tumor marker of the ovarian cancer. Methods The expression of hK6 was detected by immunohistochemistry in 19 cases of benign, 11 cases of borderline and 45 cases of malignant ovarian neoplasms and statistically analyzed whether its expression correlate with clinicopathological variables and prognosis in patients with ovarian cancer. Results The expression of hK6 in ovarian cancer tissues (60.0%) was significantly higher than that in the benign (15.8%) and borderline (27.3%) ovarian neoplasm tissues (P < 0.01). The expression of hK6 in higher-grade ovarian cancer tissues (68.4%) was higher than that in low-grade ones (14.3%, P<0.05). The expression of hK6 in late-stage (stage Ⅲ ,76.7%) was significantly higher than that in early-stage (stage Ⅰ or Ⅱ ,26.7%, P < 0.01). The expression of hK6 was significantly higher in patients with lymph node metastasis (77.8%) than that in patients without (33.3% ,P<0.01). The expression of hK6 in the cancer tissues in the patients died, or with reeeurence or metastasis within 3 years after surgery was higher (75.0%) than that in the patients with stable disease (42.9%, P < 0. 05). Conclusion The expression of hK6 in ovarian cancer was higher than that in benign and borderline ovarian neoplasms. The expression of hK6 is higher in the ovarian cancer of late stage, higher-grade, with lymph node metastasis and is associated with a poorer prognosis, hK6 may become a new markers in prediction of prognosis of the patients with ovarian tumors.     

人组织型激肽释放酶6在卵巢上皮性肿瘤中的表达及其与临床病理特征和预后的关系

Objective To approach the relationship between the expression of hK6 in ovarian neoplasm and clinicopathological variables and prognosis in ovarian cancer patients for finding a new tumor marker of the ovarian cancer. Methods The expression of hK6 was detected by immunohistochemistry in 19 cases of benign, 11 cases of borderline and 45 cases of malignant ovarian neoplasms and statistically analyzed whether its expression correlate with clinicopathological variables and prognosis in patients with ovarian cancer. Results The expression of hK6 in ovarian cancer tissues (60.0%) was significantly higher than that in the benign (15.8%) and borderline (27.3%) ovarian neoplasm tissues (P < 0.01). The expression of hK6 in higher-grade ovarian cancer tissues (68.4%) was higher than that in low-grade ones (14.3%, P<0.05). The expression of hK6 in late-stage (stage Ⅲ ,76.7%) was significantly higher than that in early-stage (stage Ⅰ or Ⅱ ,26.7%, P < 0.01). The expression of hK6 was significantly higher in patients with lymph node metastasis (77.8%) than that in patients without (33.3% ,P<0.01). The expression of hK6 in the cancer tissues in the patients died, or with reeeurence or metastasis within 3 years after surgery was higher (75.0%) than that in the patients with stable disease (42.9%, P < 0. 05). Conclusion The expression of hK6 in ovarian cancer was higher than that in benign and borderline ovarian neoplasms. The expression of hK6 is higher in the ovarian cancer of late stage, higher-grade, with lymph node metastasis and is associated with a poorer prognosis, hK6 may become a new markers in prediction of prognosis of the patients with ovarian tumors.     

人组织型激肽释放酶6在卵巢上皮性肿瘤中的表达及其与临床病理特征和预后的关系

Objective To approach the relationship between the expression of hK6 in ovarian neoplasm and clinicopathological variables and prognosis in ovarian cancer patients for finding a new tumor marker of the ovarian cancer. Methods The expression of hK6 was detected by immunohistochemistry in 19 cases of benign, 11 cases of borderline and 45 cases of malignant ovarian neoplasms and statistically analyzed whether its expression correlate with clinicopathological variables and prognosis in patients with ovarian cancer. Results The expression of hK6 in ovarian cancer tissues (60.0%) was significantly higher than that in the benign (15.8%) and borderline (27.3%) ovarian neoplasm tissues (P < 0.01). The expression of hK6 in higher-grade ovarian cancer tissues (68.4%) was higher than that in low-grade ones (14.3%, P<0.05). The expression of hK6 in late-stage (stage Ⅲ ,76.7%) was significantly higher than that in early-stage (stage Ⅰ or Ⅱ ,26.7%, P < 0.01). The expression of hK6 was significantly higher in patients with lymph node metastasis (77.8%) than that in patients without (33.3% ,P<0.01). The expression of hK6 in the cancer tissues in the patients died, or with reeeurence or metastasis within 3 years after surgery was higher (75.0%) than that in the patients with stable disease (42.9%, P < 0. 05). Conclusion The expression of hK6 in ovarian cancer was higher than that in benign and borderline ovarian neoplasms. The expression of hK6 is higher in the ovarian cancer of late stage, higher-grade, with lymph node metastasis and is associated with a poorer prognosis, hK6 may become a new markers in prediction of prognosis of the patients with ovarian tumors.     

血清HE4、CA125、ROMA联合检测在上皮性卵巢癌诊断中的应用

目的:观察HE4、CA125、ROMA值及联合检测对早期卵巢癌风险的预测价值。方法:收集确诊为卵巢肿物女性患者术前的血清样本,分析血清HE4、CA125的表达水平和ROMA值,并与术后病理结果对比,使用受试者工作曲线（ROC-curve）做数据跟踪分析。结果:血清HE4、CA125表达水平和ROMA值在恶性组中高于其他组（P<0.001）。ROMA值良性组与健康组比较差异无显著性（P>0.05）。在早期卵巢癌血清肿瘤标志物对比中,HE4+CA125+ROMA的联合检测与其它血清标志物的差异有显著性（P<0.01）,敏感度98.7%;特异度74.6%;准确度71.5%。结论:在早期卵巢癌检测中HE4单独检测有最高的灵敏度,但HE4+CA125+ROMA联合检测可以在早期更加准确的预测早期卵巢恶性肿瘤的风险。     

三维超声联合ROMA指数在卵巢良恶性肿瘤鉴别中的应用价值

目的:探讨三维超声联合卵巢恶性肿瘤风险预测模型（ROMA）指数在卵巢良恶性肿瘤鉴别中的应用价值。方法:选取2017年10月至2018年10月在本院接受外科手术治疗的152例卵巢肿瘤患者作为受试对象,术后按照病理学检查结果分为卵巢良性肿瘤组84例、卵巢恶性肿瘤组68例。术前采用Voluson E8超声诊断仪进行三维超声检查;应用酶联免疫吸附试验（ELISA）检测血清人附睾蛋白4（HE4）、糖类抗原125（CA125）水平,由两者水平计算ROMA指数,并采用ROC曲线分析三者对卵巢良恶性肿瘤的诊断价值。结果:卵巢恶性肿瘤组患者三维超声诊断符合率明显低于卵巢良性肿瘤组（P＜0.05）。卵巢恶性肿瘤组患者血清HE4、CA125水平及ROMA指数均显著高于卵巢良性肿瘤组（P＜0.05）。血清HE4、CA125水平及ROMA指数诊断卵巢良恶性肿瘤的ROC曲线下面积分别为0.849、0.871、0.933,最佳截断值分别为132.46 pmol/L、150.27 U/mL、40.21%,且三维超声联合ROMA指数诊断灵敏度、特异度、准确度均高于单项指标检测。结论:应用三维超声联合ROMA指数能明显提高鉴别诊断卵巢良恶性肿瘤的灵敏度、特异度及准确度。     

HE4 a novel tumour marker for ovarian cancer: comparison with CA 125 and ROMA algorithm in patients with gynaecological diseases

The aim of this study is to evaluate a new tumour marker, HE4, in comparison with CA 125 and the Risk of Ovarian Malignancy Algorithm (ROMA) in healthy women and in patients with benign and malignant gynaecological diseases. CA 125 and HE4 serum levels were determined in 66 healthy women, 285 patients with benign gynaecological diseases (68 endometriosis, 56 myomas, 137 ovarian cysts and 24 with other diseases), 33 patients with non-active gynaecological cancer and 143 with active gynaecological cancer (111 ovarian cancers). CA 125 and HE4 cut-offs were 35 U/mL and 150 pmol/L, respectively. ROMA algorithm cut-off was 13.1 and 27.7 for premenopausal or postmenopausal women, respectively. HE4, CA 125 and ROMA results were abnormal in 1.5%, 13.6% and 25.8% of healthy women and in 1.1%, 30.2% and 12.3% of patients with benign diseases, respectively. Among patients with cancer, HE4 (in contrast to CA 125) had significantly higher concentrations in ovarian cancer than in other malignancies (p < 0.001). Tumour marker sensitivity in ovarian cancer was 79.3% for HE4, 82.9% for CA 125 and 90.1% for ROMA. Both tumour markers, HE4 and CA 125 were related to tumour stage and histological type, with the lowest concentrations in mucinous tumours. A significantly higher area under the ROC curve was obtained with ROMA and HE4 than with CA 125 in the differential diagnosis of benign gynaecological diseases versus malignant ovarian cancer (0.952, 0.936 and 0.853, respectively). Data from our population indicate that ROMA algorithm might be further improved if it is used only in patients with normal HE4 and abnormal CA 125 serum levels (cancer risk for this profile is 44.4%). ROMA algorithm in HE4 positive had a similar sensitivity and only increases the specificity by 3.2% compared to HE4 alone.     

MMP3 in Comparison to CA 125, HE4 and the ROMA Algorithm in Differentiation of Ovarian Tumors

Ovarian cancer is a highly malignant neoplasm with high mortality rates. Research to identify markers facilitating early detection has been pursued for many years. Currently, diagnosis is based on the CA 125 and HE4 markers, as well as the ROMA algorithm. The search continues for new proteins that meet the criteria of good markers A total of 90 patients were included in the present study, allocated into: group 1, ovarian cancer, with 29 patients; group 2, endometrial cysts, with 30s; and group 3, simple ovarian cysts, with 31. Following histopathological verification, the CA 125, HE4, and metalloproteinase 3 (MMP3) levels were determined and the ROMA algorithm was calculated for all patients. The mean concentrations of all determined proteins, CA 125, HE4, and MMP3, as well as the ROMA values, were significantly higher in group 1 (ovarian cancer) compared to group 3 (simple ovarian cysts). The highest significant differences for the CA 125 levels (<0.000001) and ROMA (<0.000001) values were observed in postmenopausal women. For HE4, statistical significance was at the level of p=0.00001 compared to p=0.002 for MMP3. For the differentiation between ovarian cancer and endometrial cysts, the respective AUC ratios were obtained for CA 125, HE4, and MMP3 levels, as well as the ROMA values ( 0,93 / 0,96 / 0,75 / 0,98). After removing the post-menopausal patients, the MMP3 AUC value for ovarian cancer vs. benign ovarian cysts increased to 0.814. For post-menopausal women, the MMP3 AUC value for ovarian cancer vs. endometrial cysts was 0.843. As suggested by the results above, both the CA 125 and HE4 markers, as well as the ROMA algorithm, meet the criteria of a good diagnostic test for ovarian cancer. MMP3 seems to meet the criteria of a good diagnostic test, particularly in postmenopausal women; however, it is not superior to the tests used to date.     

人附睾分泌蛋白4与糖类抗原125对卵巢肿瘤的诊断价值

目的：探讨人附睾分泌蛋白4（HE4）和糖类抗原125（CA125）的检测对卵巢肿瘤患者的诊断价值。方法采用酶联免疫法检测1109例卵巢肿瘤患者的HE4和CA125的值,评估单一和联合检测的敏感性和特异性。结果①绝经后卵巢肿瘤患者HE4、CA125水平均高于未绝经卵巢肿瘤患者（t＝8．40,P＜0．05;t＝7．02,P＜0．05）;卵巢肿瘤患者生育胎数越多,HE4及CA125水平越高,差异有统计学意义（F＝15．36,P＜0．05;F＝13．00,P＜0．05）。②卵巢癌患者HE4水平高于交界性及卵巢良性疾病患者,差异有统计学意义（t＝13．68,P＜0．05;t＝14．94,P＜0．05）;卵巢癌患者的CA125水平高于交界性及卵巢良性疾病患者（t＝14．16,P＜0．05;t＝17．27,P＜0．05）;有腹腔积液和脉栓者HE4水平明显高于无腹腔积液和脉栓者（t＝7．08,P＜0．05;t＝4．41,P＜0．05）;有腹腔积液和脉栓者CA125水平明显高于无腹腔积液和脉栓者（t＝9．67,P＜0．05;t＝4．75,P＜0．05）。③术后3个月随访230例患者,其HE4、CA125水平明显低于术前,差异有统计学意义（t＝9．86,P＜0．05;t＝5．12,P＜0．05）。④HE4、CA125、卵巢恶性肿瘤风险计算法（ROMA ）值的接受者操作特性曲线（ROC ）下面积无明显差异。⑤CA125的敏感性高于 HE4,但其特异性低于 HE4,HE4＋CA125联合检测敏感性高于单一检测及ROMA值,特异性低于单一检测及 ROMA 值。按绝经状态分组后的 ROMA 值具有更高的敏感性（73．84％,84．19％）和较低的特异性（66．06％,66．67％）。结论对于卵巢肿瘤患者,CA125的敏感性高,HE4的特异性高,联合检测可进一步提高诊断的敏感性及准确性。     

Diagnostic Performance of F-18 FDG PET/CT Compared with CA125, HE4, and ROMA for Epithelial Ovarian Cancer

Objective: This study aimed to examine the diagnostic performance of F-18 fluorodeoxyglucose positron emission tomography with computed tomography (F-18 FDG PET/CT) compared with cancer antigen 125 (CA125), human epididymis protein 4 (HE4), and risk of ovarian malignancy algorithm (ROMA) score to distinguish epithelial ovarian cancer from benign tumors. Methods: A total of 46 patients with pelvic masses, who underwent F-18 FDG PET/CT, CA125, and HE4 before surgery between January 2015 and December 2018, were included in this retrospective study. The diagnostic performance of CA125, HE4, ROMA score, and maximum standardized uptake value (SUVmax) to differentiate epithelial ovarian cancer from benign pelvic tumors was examined by receiver operating characteristic curve analysis. Results: Among the 46 patients, 28 were cases of ovarian cancers and 18 were of benign. The mean values of CA125, HE4, ROMA score, and SUVmax were significantly higher in the ovarian cancer group than the benign group. In early cancer stages (stages I and II), Area under the curve for SUVmax was significantly higher than CA125 and ROMA score (0.778 for CA125, 0.753 for HE4, 0.682 for ROMA score, and 0.922 for SUVmax). Conclusion: SUVmax using F-18 FDG PET/CT showed a high diagnostic accuracy for differentiating epithelial ovarian cancer from benign pelvic tumors, including early stage ovarian cancer. F-18 FDG PET/CT can be a useful modality for the assessment of pelvic mass.     

联合检测HE4与OPN及CA125对卵巢癌诊断价值的探讨

目的:探讨血清人附睾分泌蛋白4(HE4)、骨桥蛋白(OPN)和CA125水平联合检测对卵巢恶性肿瘤的诊断价值.方法:在30例卵巢癌患者(卵巢癌组)、30例卵巢良性肿瘤患者(卵巢良性肿瘤组)和30例患子宫肌瘤等妇科疾病但卵巢正常者(对照组)中,采用酶联免疫吸附试验(ELISA)法检测HE4、OPN,全自动化学发光分析系统检测血清CA125.HE4参考范围0～80ρmol/L;OPN计算临界值为30 ng/mL,≥30 ng/mL为阳性;CA125≥35 U/mL为阳性.通过制作受试者工作特征(ROC)曲线,以曲线下面积(AUC)反映诊断的准确性.结果:1)各组血清肿瘤标志检测结果显示,卵巢癌患者HE4,CA125、OPN水平明显高于对照组以及卵巢良性肿瘤组,差异有统计学意义,F值分别为39.23、84.03和104.09,P＜0.01;而卵巢良性肿瘤患者与对照组之间差异均无统计学意义,P＞0.05.2)HE4在不同组织类型卵巢癌中的表达不同,卵巢浆液性癌(95.23％)和内膜样癌(100.00％)中高表达,透明细胞癌(0)和黏液性癌(0)不表达.3)OPN在卵巢癌Ⅲ～Ⅳ期患者中的含量明显高于Ⅰ～Ⅱ期患者,且与肿瘤转移有关,有淋巴结转移患者明显高于无转移者.4)以卵巢良性肿瘤组及卵巢正常组为对照,CA125+ HE4+OPN、CA125+HE4、CA125+OPN、HE4和CA125为盆腔恶性肿瘤诊断指标,ROC曲线下面积依次为0.91.0.90、0.85、0.85和0.80.在特异性为98.3％时,各肿瘤标志诊断盆腔恶性肿瘤的敏感度依次是73.3％、70.0％、66.6％、63.3％和20.0％.特异度为95.0％时,敏感度80.0％、76.6％、70.0％、70.0％和40.0％.特异度是90.0％时,敏感度83.3％、80.0％、76.6％、73.3％和56.6％.结论:CA125+ HE4+OPN3种肿瘤标志联合检测对提高卵巢恶性肿瘤的诊断价值有一定的意义.     

卵巢恶性风险计算法预测盆腔包块患者卵巢癌风险

  目的   探讨血清人附睾蛋白4（Human epididymis protein 4 HE4）和癌抗原125（CA125）联合检测（卵巢恶性风险计算法ROMA）预测盆腔包块患者上皮性卵巢癌（EOC）风险。   方法   采用电化学发光法检测因盆腔包块或卵巢囊肿住院拟行手术的患者血清HE4和CA125水平,根据是否绝经,采用ROMA方法计算卵巢癌预测概率（PP）,绘制受试者工作曲线（ROC）,分别确定绝经前后临界值,并将患者划分至高危组和低危组,评估预测模型的应用价值。   结果   评估了1 683例患者,其中1 448例盆腔良性疾病,235例盆腔恶性肿瘤,包括106例EOC。在经病理确诊为良性盆腔包块患者中有1 356例被划分至低危组,特异性93.6%;盆腔恶性肿瘤中121例划分至高危组,敏感度80.7%;卵巢交界性上皮瘤20例划分至高危组,敏感度28.2%;EOC中93例划分至高危组,敏感度87.7%,未划分至高危组包括黏液性腺癌2例,透明细胞癌11例。卵巢非上皮性恶性肿瘤患者中5例划分至高危组,敏感度38.5%;非卵巢恶性肿瘤患者中35例划分至高危组,敏感度85.3%;转移性卵巢癌患者中1例划分至高危组,敏感度25.0%。   结论   ROMA较成功地将盆腔恶性肿瘤患者划分至高危组,其中EOC患者大部分被正确地划分至高危组,ROMA在诊断恶性肿瘤尤其是EOC方面具有较高的应用价值。      

卵巢癌肿瘤标志的优化筛选与临界值确定

目的：筛选卵巢癌实验诊断比较适合的肿瘤标志,进一步探究其临界值。方法将研究对象分为卵巢癌组、卵巢良性肿瘤组和健康体检组,采用电化学发光法检测CA153、CA724、CA125、人附睾蛋白4（human epididymis protein 4,HE4）等项目的浓度,并以文献报道的方法计算卵巢恶性肿瘤风险模型（risk of ovarian malignancy algorithm,ROMA）;以SPSS软件分析研究对象肿瘤标志的表达差异,并分析它们的诊断指数（灵敏度＋特异性）;根据受试者工作特征曲线（receiver operating characteristics, ROC）,试确定各肿瘤标志的最佳临界值。结果三组的肿瘤标志表达水平存在显著差异（P＜0．05）;ROMA的诊断能力最佳（诊断指数1．94,灵敏度0．94、特异性1．00）,其它依次是HE4（诊断指数1．86,灵敏度0．89、特异性0．97）、CA125（诊断指数1．75,灵敏度0．83、特异性0．91）;依据曲线下面积（area under the curve,AUC）,诊断卵巢癌能力大小的肿瘤标志（或项目）分别是：ROMA、HE4、CA125、CA153、CA724。结论诊断卵巢癌应优先考虑CA125、HE4和ROMA等项目,相应临界值可拟定为90．96 U/ml、81．38 pmol/l和37．22％。     

血清中人附睾蛋白4、抑制素A及癌胚抗原125联合检测在卵巢癌诊断中的意义

目的：探讨人附睾蛋白4（HE4）、抑制素A（inhibinA）及癌胚抗原125（CA125）在卵巢癌患者中的诊断价值。方法：应用ELISA法检测卵巢癌组、卵巢良性肿瘤组及正常对照组患者血清中HE4、InhibinA、CA125水平。结果：血清HE4水平：卵巢癌组（133.86±127.94）pmol/L、卵巢良性肿瘤组（42.67±22.77）pmol/L、正常对照组（33.40±19.50）pmol/L;血清InhibinA水平：卵巢癌组（177.22±114.35）ng/L、卵巢良性肿瘤组（76.60±14.10）ng/L、正常对照组（70.70±21.66）ng/L;血清CA125水平：卵巢癌组（750.52±1230.34）U/L、卵巢良性肿瘤组（67.25±106.16）U/L、正常对照组（17.69±6.13）U/L。统计学分析血清HE4、InhibinA数值显示：卵巢癌组与卵巢良性肿瘤组、正常对照组比较,P〈0.05,差异有统计学意义;而卵巢良性肿瘤组与正常对照组比较,P〉0.05,差异无统计学意义。血清CA125卵巢癌组与卵巢良性肿瘤组、正常对照组比较,P〈0.05,差异有统计学意义;良性肿瘤组与正常对照组比较,P〈0.05,差异有统计学意义。卵巢癌诊断中的阳性率分别是：HE4 71.8%、InhibinA 66.7%、CA125 61.5%,三者联合阳性率为92.3%。结论：HE4、InhibinA、CA125在卵巢癌诊断中有重要意义,三者联合检测能明显提高卵巢癌的诊断率。