血清HE4,CA125联合ROMA指数在卵巢癌预测和诊断中的应用价值

目的 探讨血清肿瘤标志物人附睾分泌蛋白4（HE4）,CA125和ROMA指数在卵巢癌预测和诊断中的应用价值.方法 用化学发光法检测手术前卵巢癌患者96例和卵巢良性肿瘤患者60例及健康体检者75例的血清中HE4,CA125水平,并计算出卵巢癌风险预测模型（ROMA）值,联合绝经状态预测患卵巢癌的风险性.结果 卵巢癌组HE4,CA125和ROMA值三项指标的中位水平分别为222.2 pmol/L,153.9 U/ml和73.0％,与卵巢良性肿瘤组及正常对照组比较,差异均有统计学意义（P＜0.05）.将HE4和CA125的cut-off值定在140 pmol/L和35 U/ml,绝经前、后妇女ROMA指数cut-off值定为11.4％和29.9％,则HE4,CA125和ROMA指数预测和诊断卵巢癌的灵敏度分别为72.9％,89.6％和87.5％;特异度分别为98.3％,55.0％和90.0％;准确度分别为87.1％,81.9％和90.5％;联合检测HE4,CA125与ROMA指数预测和诊断卵巢癌的灵敏度、特异度分别为97.0％和92.8％.结论 联合检测血清HE4和CA125并计算出ROMA指数有助于预测腹盆腔肿块患者患卵巢癌的风险性,鉴别卵巢肿瘤的良恶性,提高卵巢癌的早期诊断率.

Value of Combined Assays of Human Epididymis Protein4,CA125 and ROMA Index in Patients with Ovarian Cancer

Objective To explore the value with the novel tumor maker human epididymis protein 4 （HE4） combined withCA125 and ROMA in epithelial ovarian cancer early diagnosis, treatment monitoring and prognosis evaluation. MethodsHE4 and CA125 was determined by electrochemical luminescence immunoassay （ECUA） in 96 ovarian cancer patients, 60benign ovarian disease patients, 75 health controls. ROMA were calculated for each patient by the separate logistic regressionalgorithm based on their menopausal status. Results Levels of HE4,CA125 and ROMA were significantly higher in ovariancancer patients than those in the benign ovarian disease patients and health controls （Median value was 222.2 pmol /L,153.9 U/ml and 73.0% ,P（0.05 ,respectively）. The cut-off value of HE4 ,CA125 were set at 140 pmol/L and 35 U/ml;thecut-off value of the premenopausal and Postmenopausal women group were established at 11.4% and 29.9% ,and the sensi-tivity of HE4 ,CA125 and ROMA index were 72.9% ,89.60/oo ,87.5% ,and specificity were 98. 3% ,55.0% ,90.0% and accu-racy was 87.1 % ,81.9 % and 90.5 % ,respectively. The sensitivity and specificity of HE4 combined with CA125 and ROMAto predict and diagnosis ovarian cancer were 97.0 % and 92.8 %,respectively. Conclusion HE4 determination is helpful fordisease diagnosis, therapy monitoring and prognosis evaluation in EOC patients. Determination of HE4 combined with CA125and ROMA could predict the risk and improve the early diagnosis,monitoring and prognosis of ovarian cancer.