血清HE4和CA125检测及ROMA模型在恶性卵巢癌诊断中的应用

Application of Detecting Serum HE4 and CA125 and ROMA Model in Malignant Ovarian Cancer Diagnosis

目的结合卵巢癌风险预测模型（ROMA模型）探讨肿瘤标志物人附睾蛋白4（HE4）和糖类抗原-125（CA125）各自及联合检测在卵巢良、恶性肿瘤临床诊断中的应用价值。方法2012年12月～2013年7月在内蒙古医科大学附属医院收集住院的68例妇科恶性肿瘤患者、38例妇科良性病变患者以及60例体检健康女性的清晨空腹静脉血，分离血清，利用美国雅培公司i2000全自动微粒子化学发光免疫分析仪检测血清中HE4的表达及cA125的水平，并据此计算每例患者的ROMA指数。结果健康对照组、卵巢良性肿瘤和卵巢癌（Ⅰ，Ⅱ期和Ⅲ，Ⅳ期）受检者血清中的检测指标分别是CA125：17．2±9．24，52．4±20．69，77．8±32．58和148±87．54U／ml；HE4：36．7±8．45，79．3±19．4，120．2±21．325和252．3±45．87pmol／L；ROMA：3．1％±2．12％，7．8％±3．56％，21．8％±11．5％和37．3％±18．9％。健康对照组与卵巢良性肿瘤组，卵巢癌（Ⅰ，Ⅱ期）组和卵巢癌（Ⅲ，Ⅳ期）组的cA125，HE4含量和ROMA经q，χ^2检验处理，差异均有统计学意义（P〈0．01，CA125间F值分别为5．25，14．87和65．07；HE4间F值分别为6．45，15．65和66．98；ROMA间χ^2值分别为5．98，15．89和45．85）。CA125＋HE4联合检测灵敏度高达89．3％，但特异度较低；ROMA灵敏度、特异度都较高。结论卵巢肿瘤术前的血清学分析中，单指标分析首选HE4，ROMA在临床上拥有良好的应用价值。

Objective Combined to ovarian cancer risk prediction model（ROMA model） to investigate tumor marker human epididymis protein 4 （HE4） and carbohydrate antigen-125 （CA125） and their combined detection of benign and malignant ovarian clinical diagnosis significance and value. Methods The samples were venous blood collected on empty stomach at early morning among the patients in Affiliated Hospital of Inner Mongolia Medical University from December 2012 to July 2013,including 68 cases of patients with gynecologic malignant tumors, 38 cases of patients with gynecological benign lesion and 60 normal controls. After blood serum separation,the U. S. Abbott i2000 automated chemiluminescent immunoassay was used toanalyzed expression of serum HE4 and CA125 levels,and accordingly calculated for each patient＇s ROMA index. Re- suits The serum testing indexes of normal controls,patients with benign ovarian tumors and ovarian cancer （Stage I , Ⅱ ） and （Stage Ⅲ ,Ⅳ） were as followed respectively,CA125 ： 17.2±9.24,52.4±20.69,77.8±32.58 and 148±87.54 U/ml; HE4：36.7±8.45,79.3±19.4,120.2±21.325 and 252.3±45.87 pmol/L±ROMA：3.1%±2.12%,7.80/00 ±3.56%/00, 21.8 %±11.5 % and 37.3 % ± 18.9 %. The CA125, HE4 content and ROMA index of the three groups were all treated by q test and ）f2-test,and the results were significantly different in statistics （P〈0.01 ,F value of CA125 were 5.25,14.87 and 65.07,F value of HE4 were 6.45,15.65,66.98 and the X2 value of ROMA were 5.98,15.89,45.85）. The sensitivity of CA125＋HE4 combined detection was up to 89.3%0 ,but lower specificity;ROMA had both high sensitivity and specificity. Conclusion In preoperative ovarian tumors serological analysis, HE4 performed better as a single index,ROMA performed good in clinical application with good applied value and significance.