子宫内膜异位症患者血清癌抗原125、罗马指数变化及其临床意义

Changes and clinical significance of serum CA125 and ROMA index in patients with endometriosis

目的探讨子宫内膜异位症(EMT)患者血清癌抗原125(CA125)、罗马(ROMA)指数变化及其临床意义。方法选取2019年1月至2022年3月安徽医科大学第四附属医院妇产科收治的68例EMT患者纳入EMT组,根据美国生物医学协会临床分期标准分为Ⅰ~Ⅱ期51例和Ⅲ~Ⅳ期17例,另选取55例同一医院同期健康体检女性纳入HC组。采集两组清晨空腹静脉血,采用酶联免疫吸附法检测血清CA125、人附睾蛋白4(HE4)水平,使用电化学发光免疫分析仪计算ROMA指数。比较EMT组和HC组及不同临床分期患者的血清CA125、HE4水平和ROMA指数;采用受试者工作特征(ROC)曲线检测血清CA125、HE4水平和ROMA指数诊断EMT及临床分期的效能;采用Spearman相关性分析EMT临床分期与血清CA125、HE4水平和ROMA指数的相关性。结果EMT组血清CA125、HE4水平和ROMA指数显著高于HC组(P<0.05);血清CA125、HE4水平和ROMA指数诊断EMT的曲线下面积(AUC)分别为0.752、0.833和0.870,联合检测诊断EMT的AUC为0.920(P<0.05);EMT组Ⅲ~Ⅳ期患者血清CA125、HE4水平和ROMA指数均显著高于Ⅰ~Ⅱ期(P<0.05);Spearman相关性分析显示,血清CA125、HE4水平和ROMA指数与EMT临床分期呈正相关(P<0.05);血清CA125、HE4水平和ROMA指数诊断Ⅲ~Ⅳ期EMT的AUC分别为0.805、0.852和0.860,联合检测诊断Ⅲ~Ⅳ期EMT的AUC为0.915(P<0.05)。结论EMT患者血清CA125水平和ROMA指数异常升高,血清CA125水平和ROMA指数联合检测可作为EMT诊断和临床分期的评估指标。

Objective To explore the changes and clinical significance of serum carbohydrate antigen 125(CA125)and Roma index in patients with endometriosis(EMT).Methods A total of 68 patients with EMT admitted to Gynaecology and Obstetrics Department of the Fourth Affiliated Hospital of Anhui Medical University between January 2019 and March 2022 were enrolled as EMT group.According to the clinical staging criteria of American Biomedical Association,there were 51 cases at stagesⅠ-Ⅱand 17 cases at stagesⅢ-Ⅳ.A total of 55 healthy women during the same period were enrolled as healthy control(HC)group.The fasting venous blood in the early morning was collected to detect levels of serum CA125 and human epididymal protein 4(HE4)by enzyme-linked immunosorbent assay.ROMA index was calculated by electrochemiluminescence immunoassay.Serum CA125,HE4 levels and ROMA index were compared between EMT group and HC group and among different clinical stages.The efficacy of serum CA125,HE4 levels and ROMA index in the diagnosis of EMT and clinical staging was determined by receiver operating characteristic(ROC)curve.Spearman correlation was used to analyze the correlation between clinical stage of EMT and serum CA125,HE4 levels and ROMA index.Results The serum CA125,HE4 levels and ROMA index in EMT group were significantly higher than those in HC group(P<0.05).The areas under the curve(AUC)values of serum CA125,HE4 and ROMA index in the diagnosis of EMT were 0.752,0.833 and 0.870,respectively.AUC of combined detection was 0.920(P<0.05).In EMT group,serum CA125,HE4 levels and ROMA index in patients at stageⅢ-Ⅳwere significantly higher than those at stagesⅠ-Ⅱ(P<0.05).Spearman correlation analysis showed that serum CA125,HE4 levels and ROMA index were positively correlated with clinical staging of EMT(P<0.05).AUC values of serum CA125,HE4 and ROMA index in the diagnosis of stageⅢ-ⅣEMT were 0.805,0.852 and 0.860,respectively.AUC of combined detection was 0.915(P<0.05).Conclusions The level of serum CA125 and ROMA index are abnormally increased in EMT patients.The combined detection of them can be applied in EMT diagnosis and clinical staging.