血清人附睾蛋白4、糖链抗原125及卵巢恶性肿瘤风险算法在上皮性卵巢癌二元论分型中的应用价值

The application value of serum HE4,CA125 and ovarian malignant tumor risk algorithms in the dualistic classification of epithelial ovarian cancer

目的探讨血清HE4和CA125及ROMA在上皮性卵巢癌二元论分型中的价值。方法选择2016年1月-2018年6月温州医科大学第二附属医院因盆腔肿块收治而拟行手术的患者,其中上皮性卵巢癌(Epithelial ovarian cancer,EOC)患者112例(Ⅰ型63例,Ⅱ型49例),卵巢良性疾病(Benign ovarian disease,BOD)患者169例,另包括同期体检后各项指标正常对照(Normal control,NC)100例;采用电化学发光法检测血清HE4、CA125水平,并计算ROMA指数值,分析3个指标在上皮性卵巢癌中的应用价值。结果EOC组HE4、CA125及ROMA指数水平显著高于NC组和BOD组(P<0.01),而NC组和BOD组3个指标水平无差异(P>0.05);EOC患者随着FIGO病理分期增加,HE4、CA125水平和ROMA指数逐渐升高,并且EOC-II患者HE4、CA125水平和ROMA指数显著高于EOC-Ⅰ患者;ROMA指数诊断卵巢癌效率优于HE4和CA125,并且ROMA指数区分EOC-Ⅰ和EOC-Ⅱ特异性优于HE4和CA125,而HE4和CA125敏感性更高。结论HE4和CA125在诊断EOC中的敏感性优于ROMA指数,但是ROMA指数在诊断EOC和EOC分型中更有效,特异度更高。

Objective To investigate the values of serum HE4,CA125,and ROMA in the dualistic classification of epithelial ovarian cancer.Methods The patients who planned to undergo surgery for pelvic masses were selected from the Second Affiliated Hospital of Wenzhou Medical University from January 2016 to June 2018.Among them,112 patients were with epithelial ovarian cancer(EOC)(63 cases of type I,49 cases of type II),169 patients were the benign ovarian disease(BOD),and100 people for medical examination were included at the same time as the normal control(NC).HE4 and CA125 levels were detected by electrochemiluminescence.And then the ROMA index value were calculated and the application value of three indicators in epithelial ovarian cancer were analyzed.Results The levels of HE4,CA125,and ROMA in the EOC group were significantly higher than those in the NC and BOD groups,but there was no difference in the levels of the three indexes in the NC and BOD groups(P<0.01).With the increase of FIGO pathological stages in EOC patients,the levels of HE4,CA125 and ROMA index gradually increased,and the levels of HE4,CA125 and ROMA index in EOC-Ⅰpatients were significantly higher than those in EOC-Ⅰpatients;the specificity of CA125 and ROMA index is better than that of HE4 and CA125,and the sensitivity of HE4 and CA125 is higher.Conclusion The sensitivity of HE4 and CA125 in the diagnosis of EOC is better than that of ROMA index,but ROMA index is more effective and specific in the diagnosis of EOC and EOC classification.