血清HE4、CA125检测及ROMA模型在卵巢癌诊断中的应用价值

目的 探讨人附睾分泌蛋白4(HE4)、糖类抗原125(CA125)及卵巢恶性肿瘤风险预测模型(ROMA)在卵巢癌诊断中的应用价值.方法 采用酶联免疫吸附试验及化学发光方法检测56例卵巢癌患者、73例卵巢良性肿瘤患者及50例健康对照者血清HE4及CA125水平,根据患者的绝经状况通过公式计算ROMA指数,绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC).结果 HE4、CA125水平及ROMA指数在卵巢癌组分别为(345.33士605.03)pmol/L、(701.46±1 500.30)U/mL、(58.72±31.00)％,卵巢良性肿瘤组分别为(53.84±14.68)pmol/L、(44.25±45.81)U/mL、(10.80±6.75)％,健康对照组分别为(46.03±10.26) pmol/L、(17.39±10.64) U/mL、(6.92±3.85)％,卵巢癌组血清HE4、CA125水平及ROMA指数高于卵巢良性肿瘤组,差异有统计学意义(P＜0.05).健康对照组和卵巢良性肿瘤组比较,HE4水平和ROMA指数差异无统计学意义(P＞0.05).而CA125水平差异有统计学意义(P＜0.05).血清HE4、CA125水平和ROMA指数对卵巢癌诊断的灵敏度分别为71.43％、76.79％、89.28％,特异度分别为93.15％、53.42％、94.52％,ROC-AUC分别为0.930、0.809、0.937,当对卵巢癌诊断的特异度为95.00％时,HE4、CA125和ROMA指数对卵巢癌诊断的灵敏度分别为80.40％、53.60％和83.90％.结论 联合检测HE4和CA125计算ROMA指数对卵巢癌诊断灵敏度和特异度较高.

The value of HE4, CA125, and ROMA model in diagnosis of the ovarian carcinoma

Objective To explore the value of human epididymis protein 4(HE4),cancer antigen 125(CA125) and the risk of ovarian malignancy algorithm(ROMA) in the diagnosis of ovarian cancer.Methods Electrochemical luminescence and Enzymelinked immunosorbent assay (ELISA) were used to determine the levels of serum HE4,CA125 in 56 patients with ovarian carcinoma,73 cases of ovarian benign tumor and 50 health women,and the ROMA was calculated by HE4 and CA125 levels depending on the menopause state,drawing the receiver operating characteristics(ROC) curve and calculating the area under the curve(AUC).Results The average levels of the HE4,CA125 and the value of the ROMA were (345.33±605.03)pmol/L,(701.46±1 500.30) U/mL,(58.72±31.00) ％ in the ovarian carcinoma group,(53.84± 14.68)pmol/L,(44.25±45.81)U/mL,(10.80± 6.75) ％ in the ovarian benign tumor group,and (46.03±10.26)pmol/L,(17.39±10.64)U/mL,(6.92±3.85)％ in the health control group respectively,compared with the benign tumor group and the health control group,the ovarian carcinoma group were higher in HE4,CA125 and the ROMA value,and the difference were significantly (P＜0.05),whereas compared in the ovarian benign group and the health group,except the CA125 was higher in the benign group and the difference had statistical significance(P＜0.05),the HE4 level and the value of the ROMA had no statistical significance(P＞0.05).The sensitivities of the HE4,CA125 and ROMA were 71.43％,76.79 ％,89.28％,the specificities were 93.15 ％,53.42％,94.52 ％ and the ROC-AUCs were 0.930,0.809,0.937 respectively.When the specificity for the diagnosis of the ovarian carcinoma was 95.00％,the sensitivities of the HE4,CA125 and ROMA were 80.40％,53.60％,83.90％ respectively.Conclusion HE4 and CA125 combined detection to calculate the ROMA can elevate the sensitivity and specificity for the ovarian carcinoma diagnosis.