CA125及ROMA在阳春地区子宫内膜异位症患者风险评估中的应用研究

Study of the application of carbohydrate antigen 125 and ovarian cancer risk prediction model in the assessment of risk for endometrial endometriosis patients in Yangchun area

目的探讨CA125(CA125)及卵巢恶性肿瘤风险预测模型(ROMA)在阳春地区子宫内膜异位症患者风险评估中的应用价值。方法以阳春地区433例子宫内膜异位症患者为回顾性研究对象,以酶联免疫吸附法(ELISA)检测患者术前CA125水平和人附睾蛋白4(HE4)水平,并运用ROMA计算公式计算患者ROMA指数截断值,分析CA125水平及ROMA指数截断值与子宫内膜异位囊肿分期及术后妊娠率的相关性,并探讨CA125水平及ROMA指数截断值在子宫内膜异位症风险评估中的应用价值。结果子宫内膜异位囊肿Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期患者术后能妊娠者的血清CA125水平及ROMA指数截断值均低于不能妊娠者,比较差异有统计学意义(P<0.05);血清CA125水平及ROMA指数截断值与子宫内膜异位囊肿分期呈正相关(r值分别为0.986 2、0.988 3,P<0.05);血清CA125水平及ROMA指数截断值与子宫内膜异位患者术后妊娠率呈负相关(r值分别为0.597 5、0.952 8,P<0.05);ROMA指数在子宫内膜异位患者术后妊娠风险评估中的准确度、特异度、灵敏度、阴性预测值、阳性预测值及诊断符合率均高于血清CA125,比较差异有统计学意义(P<0.05)。结论 CA125及ROMA指数截断值均可用于子宫内膜异位症患者的病情风险评估和术后妊娠风险评估,但ROMA指数的评估价值优于CA125的评估价值。

Objective To investigate the application value of the carbohydrate antigen125(CA125)and ovarian cancer risk prediction model(ROMA)in risk assessment for endometrial endometriosis patient in Yangchun area.Methods A total of433cases of endometrial endometriosis patient in3hospitals were selected as the objects of the retrospective research.ELISA method was used to detect the CA125and human epididymis protein4(HE4)levels before operation.ROMA formula was used to calculate the ROMA index cutoff value,correlation between CA125level and ROMA index cutoff value and staging of endometriosis cysts and postoperative pregnancy rate was analyzed,and the CA125level and ROMA index cutoff value in endometriosis risk assessment were discussed.Results The endometrial cyst stageⅠ,Ⅱ,Ⅲ,the serum CA125level and the ROMA index truncation value of the pregnant women were lower than those of the non pregnant women,and there is a statistically significant difference in comparison(P<0.05);the serum CA125level and ROMA index cutoff value and staging of ovarian endometriosis cyst showed a positive correlation(r=0.9862,0.9883;P<0.05);the level of serum CA125and the truncated value of ROMA index were negatively correlated with the pregnancy rate of patients with endometriosis(r=0.5975,0.9528;P<0.05);the accuracy,specificity,sensitivity,positive and negative prediction value and diagnostic coincidence rate of ROMA index in patients with endometriosis after operation were higher than those of CA125(P<0.05).Conclusion CA125and ROMA index can be used for risk assessment of patients with endometriosis and assessment of postoperative pregnancy risk,but the evaluation value of ROMA index is better than that of CA125.