血清HE4和CA125水平联合ROMA预测和诊断卵巢癌的临床价值

Clinic Value of HE4,CA125 Combined with Risk of Ovarian Malignancy Algorithm(ROMA) in the Diagnosis for Ovarian Cancer

[目的]探讨血清肿瘤标志物人附睾分泌蛋白4(HE4)、CA125和卵巢癌风险预测模型(RO-MA)在卵巢癌预测和诊断中的应用价值。[方法]回顾性分析因卵巢肿瘤住院接受手术的患者70例,用ELISA法检测70例卵巢癌和卵巢良性肿瘤患者血清中HE4与CA125水平,计算出ROMA值,联合绝经状态评估患卵巢癌的风险性。[结果]卵巢癌组HE4和CA125血清水平分别为(223.50±87.48)pmol/L、(111.00±24.11)U/ml,卵巢良性肿瘤组分别为(41.00±3.73)pmol/L、(32.00±3.86)U/ml,两组比较有统计学差异(P=0.000)。若将CA125及HE4的切割值定在37U/ml、71.5pmol/L,则CA125、HE4预测和诊断卵巢癌的灵敏度、特异性分别为97.5%、80.0%,80.0%、100.0%;两者联合(ROMA计算)其预测和诊断卵巢癌的灵敏度、特异性分别为97.5%、80.0%;CA125ROC曲线下面积为0.868,HE4ROC曲线下面积为0.939,ROMAROC曲线下面积为0.972,与CA125、HE4比较有显著性差异(P=0.000)。据绝经前后状态不同得出绝经前、后ROC曲线下面积分别为0.862(CA125)、0.968(HE4)、0.938(ROMA);0.854(CA125)、0.920(HE4)、0.938(ROMA),ROMA与CA125及HE4比较有显著性差异(P=0.000)。在理想的切割值下,绝经前后均显示ROMA预测诊断卵巢癌具有高灵敏度(93.3%、92.0%)和特异性(65.0%、80.0%)。[结论]ROMA指数相对于单独血清CA125、HE4具有更好的预测和诊断卵巢恶性肿瘤的临床价值。

[Purpose] To evaluate clinic value of HE4,CA125 combined with ROMA in the diagnosis for ovarian cancer.[Methods] Serum HE4 and CA125 levels were detected by ELISA in 40 ovarian cancer patients and 30 ovarian benign cyst patients.ROMA was evaluated by HE4 and CA125 levels combined with menopause status.[Results] The serum CA125,HE4 levels were（223.50±87.48）pmol/L and（111.00± 24.11）U/ml in ovarian cancer group,respectively,（41.00±3.73）pmol/L and（32.00±3.86）U/ml in ovarian benign cyst group,with significant difference（P=0.000）.If the cut-off values of CA125,HE4 were 37U/ml and 71.5pmol/L,the sensitivity and specificity of CA125 for ovarian cancer diagnosis were 97.5% and 80.0%;those of HE4,80.0% and 100.0%;and those of ROMA,97.5% and 80.0%,respectively.The area of ROC was 0.868（CA125）,0.939（HE4）,and 0.972（ROMA）.The area of ROC of ROMA was higher than the others（P=0.001,P=0.000）.[Conclusion] ROMA is helpful with great value in the clinic predication and diagnosis for ovarian cancer.