HE4、CA125、SMRP检测联合ROMA在卵巢癌诊断中的应用

The Application of HE4,CA125,SMRP Detection Combined with ROMA in the Diagnosis of Ovarian Cancer

目的探讨HE4,CA125,SMRP检测联合ROMA对卵巢癌的诊断价值。方法以153例卵巢肿瘤患者为研究对象,其中恶性病变患者68例(恶性组),良性病变患者85例(良性组)。同期选取100例健康女性作为健康对照(健康组)。比较3组的血清糖类抗原125 (CA125)、人附睾蛋白4 (HE4)和可溶性间皮素相关蛋白(SMRP)水平,分析卵巢恶性肿瘤风险预测模型(ROMA)对绝经患者和未绝经患者的卵巢癌风险评估结果,并评价、比较各单项指标以及各指标联合对卵巢癌的诊断效能。结果恶性组的血清HE4、CA125和SMRP水平高于健康组和对照组(P <0. 05)。ROMA对绝经患者卵巢癌的阳性预测值高于未绝经患者(P <0. 05),ROMA对绝经患者卵巢癌的阴性预测值低于未绝经患者(P <0. 05)。ROMA的灵敏度高于其它各项指标(P <0. 05),ROMA的特异度和准确度均高于SMRP(P <0. 05);ROMA联合HE4和CA125检测以及ROMA联合HE4、CA125和SMRP检测的灵敏度高于ROMA联合HE4检测以及ROMA联合CA125检测(P <0. 05)。结论 HE4,CA125,SMRP检测联合ROMA或HE4,CA125检测联合ROMA均能有效提高单项指标对卵巢癌的诊断效能,有利于卵巢癌的筛查和早期诊断。

Objective To discuss the diagnostic value of HE4,CA125,SMRP detection combined with ROMA for ovarian cancer. Methods A total of 153 ovarian cancer patients,68 patients( malignant group) and 85 benign lesions( benign group) were the subjects. Over the same period,100 healthy women were selected as healthy controls( health group). The serum saccharide antigen 125( CA125),human epididymis 4( HE4) and soluble mesoprotein( SMRP) levels were compared among 3 groups. Ovarian cancer risk prediction model( ROMA) risk assessment for postmenopausal and non-menopausal patients were analyzed. The diagnostic efficacy of each index and the combination of them was evaluated. Results Serum HE4,CA125 and SMRP levels of malignant group were higher than those healthy group and control group( P < 0. 05). The positive predictive value of ROMA for ovarian cancer in postmenopausal patients was higher than that of non-menopausal patients( P < 0. 05),and the negative predictive value of ROMA for ovarian cancer was lower than that of non-menopausal patients( P < 0. 05). The sensitivity of ROMA was higher than that of other indicators( P < 0. 05),and the specificity and accuracy of ROMA are higher than that of SMRP( P < 0. 05). The sensitivity of ROMA combined with HE4 and CA125 and ROMA combined with HE4,CA125 and SMRP were higher than that of ROMA combined with HE4 or ROMA combined with CA125( P < 0. 05). Conclusion ROMA combined with HE4,CA125 and SMRP or ROMA combined with HE4 and CA125 and ROMA can effectively improve the diagnostic efficacy of single index for ovarian cancer,which is beneficial to the screening and early diagnosis of ovarian cancer.