CA125、HE4、ROMA对卵巢肿瘤诊断及良恶性鉴别的临床价值

Clinical value of CA125,HE4 and ROMA in the diagnosis of benign and malignant ovarian tumors

目的研究癌抗原125(CA125)、人附睾分泌蛋白4(HE4)、卵巢癌风险预测模型(ROMA)对卵巢肿瘤诊断及良恶性鉴别的临床价值。方法回归性分析2015年6月到2016年8月间收治的卵巢肿瘤患者113例,其中卵巢癌54例,卵巢良性肿瘤59例,分别作为卵巢癌组和卵巢良性肿瘤组,同期选择46例健康体检者作为对照组。分别检测各组血清CA125、HE4水平,计算ROMA,同时计算出CA125、HE4和ROMA值的敏感度和特异度。结果卵巢癌组患者的血清CA125、HE4水平及ROMA值均明显高于对照组和卵巢良性肿瘤组(P<0.01);卵巢癌组与卵巢良性肿瘤患者的血清CA125水平、ROMA值均明显高于对照组(P<0.01);卵巢良性肿瘤组HE4水平与对照组比较差异无统计学意义(P>0.05)。HE4的敏感度、特异度、诊断符合率均明显高于CA125(P<0.01);ROMA的敏感度明显高于CA125、HE4(P<0.01);CA125、HE4和ROMA联合诊断的敏感度、特异度、诊断符合率均明显高于CA125、HE4、ROMA单项诊断(P<0.01)。结论 CA125、HE4、ROMA对于诊断卵巢肿瘤均有一定诊断价值,同时联合各指标检测可明显提高诊断准确率,对早期诊断及治疗有着指导作用,值得在临床推广。

Objective To study the clinical value of cancer antigen 125 （CA125）, human epididymal secretory protein 4 （HE4） and ovarian cancer risk prediction model （ROMA） in the diagnosis and benign and malignant identification of ovarian tumors. Methods From June 2015 to August 2016, 113 patients with ovarian neoplasms in our hospital were retrospectively analyzed. Fifty-five patients with ovarian cancer and 59 benign ovarian tumors were selected as ovarian cancer and ovarian benign tumor groups. 46 healthy subjects were taken as control group. Serum CA125 and HE4 levels were measured, and the sensitivity and specificity of CA125, HE4 and ROMA were calculated. Results The levels of serum CA125, HE4 and ROMA in ovarian cancer group were significantly higher than those in control group and benign ovarian tumor group （ P 〈0.01）. The level of CA125 and ROMA in ovarian benign tumor group were significantly higher than those in control group （ P 〈0.01）. HE4 level and the control group was no significant difference （ P 〉0.05）. The sensitivity, specificity and predictive value of HE4 were significantly higher than those of CA125 （ P 〈0.01）. The sensitivity of ROMA was significantly higher than that of CA125 and HE4 （ P 〈0.01）. The sensitivity, specificity and specificity of CA125, HE4 and ROMA （ P 〈0.01）, and the predicted values were significantly higher than those of CA125, HE4 and ROMA （ P 〈0.01）. Conclusion CA125, HE4 and ROMA have certain diagnostic value for the diagnosis of ovarian tumors. Combined with the detection of each index can significantly improve the diagnostic accuracy, and have a guiding effect on early diagnosis and treatment. It is worthy of clinical promotion.