血清HE4与CA125联合检测在盆腔包块患者恶性卵巢癌风险评估中的应用价值

Significance of combined detection of HE4 and CA125 in risk assessment of patients with pelvic mass with malignant ovarian cancer

目的本研究应用血清人附睾蛋白4(HE4)与糖类蛋白125(CA125)联合检测并结合卵巢癌恶性风险模型(ROMA法则)对拟行手术的盆腔包块患者进行卵巢癌恶性风险评估,并探讨其应用价值。方法收集盆腔包块拟行手术患者196例血清(包括术前、术后),按术后病理诊断结果分为卵巢癌组和卵巢良性疾病组,并收集120例女性健康对照组血清,采用全自动化学发光微粒子免疫分析方法测定HE4和CA125水平并计算ROMA风险值。结果卵巢癌组血清HE4、CA125水平[分别为(227.46±375.68)pmol/L和(477.22±929.90)U/mL]与卵巢良性疾病组[(37.37±9.23)pmol/L和(51.04±61.06)U/mL]和健康对照组[分别为(35.75±9.71)pmol/L和(11.61±5.77)U/mL]比较,均呈显著升高(P<0.05);将75%的卵巢良性疾病分类为低风险所对应的ROMA值确定为判断标准,其中未绝经患者ROMA≥5.6%归为患上皮性卵巢癌的高风险性。而绝经患者RO-MA≥17.5%归为患上皮性卵巢癌的高风险性。按上述标准风险评估特异度75%,总的灵敏度为58.5%,阳性预测值为67.9%,阴性预测值为66.1%。结论联合检测盆腔包块患者血清HE4和CA125浓度并采用ROMA法则在评估患者恶性卵巢癌风险中具有一定的应用价值,为临床上卵巢癌的早发现、早诊治以及提高卵巢癌患者的预后水平提供了新的思路。

Objective To investigate the value of combined detection of serum HE4and CA125and the ROMA method used to assess the risk of malignant ovarian cancer in patients with pelvic mass.Methods The serum of 196patients with pelvic mass were collected（before and after operation）.According to the result of pathology diagosis after operation,all patients were divided into ovarian cancer group（94patients）,benign ovarian disease group（102patients）and 120healthy controls.Serum HE4and CA125 were assayed by automatic chemical microparticle Immunoassay.The value of ROMA was calculated.Results Serum HE4and CA125level of ovarian cancer patients[（227.46±375.68pmol/L）and（477.22±929.90）U/mL]were significantly higher than the healthy controls[（35.75±9.71）pmol/L and（11.61±5.77）U/mL]and ovarian benign disease group[（37.37±9.23）pmol/L and（51.04±61.06）U/mL]（P0.05）.ROMA value is determined as 75%of benign ovarian disease classified as low-risk,if ROMA value≥5.6%there was high risk of epithelial ovarian cancer for pre-menopausal patients and≥17.5%for post-menopausal patients respectively.The specificity,sensitivity,positive predictive value and negative predictive value of risk assessment were 75 %,58.5%,67.9%and 66.1%respectively,according to the above criteria.Conclusion Combined detection of serum HE4and CA125and the use of ROMA rule is suitable to assess the risk of malignant ovarian cancer in patients with pelvic mass and provides a new way for early detection and diagnosis of ovarian cancer and to improve the prognosis of ovarian cancer patients.