血清人附睾蛋白和癌抗原125联合预测上皮性卵巢癌术后复发的价值分析

Value analysis of HE4 and CA125 combined to predict the recurrence of epithelial ovarian cancer

目的:分析上皮性卵巢癌患者减灭手术前后血清人附睾蛋白(HE4)和癌抗原125(CA125)水平及CA125/HE4比值变化,初步探索其对于预测疾病复发的价值。方法:按复发与否将50例行肿瘤细胞减灭术并接受术后规范性化疗的上皮性卵巢癌(EOC)患者分为复发组(n=22)和非复发组(n=28)。比较两组在术前、术后1、3、及6个月各时间点HE4、CA125水平、CA125/HE4比值变化及其与EOC复发的关系。结果:两组国际妇产科联盟(FIGO)分期比较,差异具有统计学意义(P<0.05)。两组HE4、CA125水平在术后各时间点均呈逐渐下降趋势(P<0.05)。术前,复发组HE4、CA125水平均高于非复发组(P<0.05)。术后3个月,复发组HE4水平低于非复发组(P<0.05),CA125/HE4比值高于非复发组,差异有统计学意义(P<0.05)。单因素Logistic回归分析显示,FIGO分期、术前高水平的HE4、CA125可能是EOC复发的危险因素(P<0.05)。受试者工作特征曲线(ROC)显示,术前HE4、CA125预测疾病复发的ROC曲线下面积(AUC)分别为0.964(95%CI:0.908~1.000)、0.849(95%CI:0.742~0.956),差异无统计学意义(P>0.05);术前HE4、CA125及二者联合预测复发的敏感度(86.4%vs.72.7%vs.90.9%),特异度(100%vs.85.7%vs.100%)。结论:血清HE4联合CA125对于检测EOC复发具有一定的价值,术前HE4、CA125较高的患者可能面临更高的卵巢癌复发风险。

Objective:To analyze the changes of serum HE4 and CA125 and the ratio of CA125/HE4 in patients with epithelial ovarian cancer(EOC)before and after subtractive surgery,and explore their value for predicting disease recurrence.Methods:A total of 50 patients with EOC who undergoing cytoreductive surgery and standard postoperative chemotherapy were selected,and they were divided into the recurrence group(n=22)and the non-relapse group(n=28)according to recurrence or not.The changes of serum HE4 and CA125 levels,and the ratio of CA125/HE4 and relationship between the recurrence of EOC were compared between the two groups before operation,1,3 and 6 m after operation.Results:Compared in International Federation of Obstetrics and Gynecology(FIGO)staging of the two groups,the difference was statistically significant(P<0.05).The levels of HE4 and CA125 in the recurrence group and the non-relapse group showed a gradual downward trend at the postoperative time point(P<0.05).Before surgery,levels of HE4 and CA125 in the recurrence group were higher than those in the non-relapse group(P<0.05).3 months after operation,the levels of HE4 in the recurrence group was lower than that in the non-relapse group(P<0.05),the ratio of CA125/HE4 in the recurrence group was higher than that in the non-relapse group,the difference were statistically significant(P<0.05).Univariate Logistic regression analysis showed that FIGO stage,preoperative serum HE4,CA125 may be the risk factor for recurrence of EOC(P<0.05).The ROC curve showed that the AUC s of preoperative HE4 and CA125 in predicting disease recurrence were 0.964(95%CI:0.908~1.000)and 0.849(95%CI:0.742~0.956),and there was no significant difference between them(P>0.05).The sensitivity of preoperative HE4,CA125,and their combination in predicting recurrence was(86.4%vs.72.7%vs.90.9%),and the specificity was(100%vs.85.7%vs.100%).Conclusion:Serum HE4 combined with CA125 has a positive effect on the detection of EOC recurrence.To a certain extent,patients with higher preoperative HE4 and CA125 may face a higher risk of ovarian cancer recurrence.