血清人附睾蛋白4水平及ROMA指数对CA125升高卵巢良恶性肿瘤的鉴别诊断价值

Serum HE4 and ROMA index in differential diagnosis between malignant and benign ovarian tumors with elevated CA125

目的探讨血清人附睾蛋白4(HE4)水平及卵巢癌风险预测模型(ROMA)指数对CA125升高卵巢良、恶性肿瘤的鉴别诊断价值。方法选取2020年6月至2021年6月浙江省肿瘤医院妇瘤外科首诊手术治疗并经病理检查证实的卵巢恶性肿瘤97例(恶性组)和卵巢良性肿瘤61例(良性组),比较两组患者血清CA125、HE4水平以及ROMA指数的差异,采用ROC曲线分析血清HE4水平和ROMA指数诊断CA125阳性的卵巢恶性肿瘤的AUC。结果恶性组患者血清CA125、HE4水平以及ROMA指数均高于良性组,差异均有统计学意义(均P<0.01)。在CA125阳性卵巢疾病中,恶性组的血清HE4水平和ROMA指数和阳性率均高于良性组,差异均有统计学意义(均P<0.01)。CA125阳性的14例良性组患者血清HE4均阴性。ROC曲线分析显示,在CA125阳性的患者中,血清HE4诊断卵巢恶性肿瘤AUC为0.941(95%CI:0.895~0.988);ROMA指数诊断卵巢恶性肿瘤AUC分别为绝经前0.897(95%CI:0.793~1.000)、绝经后0.937(95%CI:0.872~1.000)。结论血清HE4水平和ROMA指数对CA125升高的卵巢良、恶性肿瘤具有良好的鉴别诊断价值,值得临床推广。

Objective To explore the application of serum HE4 levels and ROMA index in differential diagnosis between benign and malignant ovarian tumors with elevated CA125 level.Methods Ninety seven patients with malignant ovarian tumors and 61 patients with benign ovarian tumors admitted in Zhejiang Cancer Hospital from June 2020 to June 2021 were enrolled.The serum CA125 and HE4 expression levels and ROMA index were determined and compared between the two groups.ROC curve was used to analyze the area under curve(AUC),sensitivity and specificity of serum HE4 and ROMA index in differentiating ovarian lesions with elevated CA125.Results The serum CA125 and HE4 expression levels and ROMA index in patients with ovarian cancer were significantly higher than those in patients with benign ovarian tumor(all P<0.01).In patients with elevated CA125,serum HE4 and ROMA index values and positive rates were significantly higher in malignant patients than those in benign patients(all P<0.01).Serum HE4 was negative in 14 benign ovarian tumors with elevated CA125.In patients with elevated CA125,ROC curve showed that the AUC of serum HE4 for differentiating malignant from benign tumors was 0.941(95%CI:0.895-0.988).The AUC of ROMA index for differentiating malignant and benign diseases were 0.897(95%CI:0.793-1.000)for premenopause and 0.937(95%CI:0.872-1.000)for postmenopause,respectively.Conclusion Serum HE4 and ROMA index have good value in the differential diagnosis of ovarian benign and malignant diseases in patients with elevated CA125,which is worthy of clinical promotion.