CAJ | 학술논문

目的探讨患者血清人附睾蛋白4(HE4)与糖类抗原125(CA125)联合检测及卵巢恶性风险计算法(ROMA)在卵巢癌诊断中的价值.方法采用酶联免疫吸附试验(ELISA)检测119例卵巢癌患者(卵巢癌组)、36例交界性卵巢肿瘤(交界性组)、96例卵巢良性肿瘤患者(良性组)及53例女性健康对照者(健康对照组)的血清HE4浓度,同时用电化学发光法检测患者的血清CA125浓度,综合评价HE4与CA125组合的检测效能.结合女性的月经状态,采用ROMA方法计算卵巢癌预测概率(PP),评价PP值的诊断效果.结果根据受试者工作特性曲线(ROC)分析,HE4的临界值为67.3 pmol/L,灵敏度和特异度分别为80.7%和94.6%.治疗前卵巢癌组患者血清HE4和CA125的中位浓度分别为227.3 pmol/L和444.0 U/ml,与交界性组、良性组和健康对照组差异均有统计学意义(均P＜0.01).手术治疗后,卵巢癌患者的血清HE4和CA125水平明显降低(均P＜0.01).HE4与CA125联合检测时,灵敏度和特异度分别为92.7%和72.5%.未绝经和绝经女性PP值的临界值分别为9.3%和27.3%,诊断未绝经患者的灵敏度和特异度分别为84.6%和77.0%,阳性预测值和阴性预测值分别为70.2%和88.7%;诊断绝经患者的灵敏度和特异度分别为86.3%和77.1%,阳性预测值和阴性预测值分别为94.5%和71.1%.结论血清HE4是一种良好的血清肿瘤标记物.HE4与CA125联合检测并借助ROMA判定卵巢癌的患病风险有助于提高卵巢癌诊断的准确度.
목적 탐토환자혈청인부고단백4(HE4)여당류항원125(CA125)연합검측급란소악성풍험계산법(ROMA)재란소암진단중적개치.방법 채용매련면역흡부시험(ELISA)검측119례란소암환자(란소암조)、36례교계성란소종류(교계성조)、96례란소량성종류환자(량성조)급53례녀성건강대조자(건강대조조)적혈청HE4농도,동시용전화학발광법검측환자적혈청CA125농도,종합평개HE4여CA125조합적검측효능.결합녀성적월경상태,채용ROMA방법계산란소암예측개솔(PP),평개PP치적진단효과.결과 근거수시자공작특성곡선(ROC)분석,HE4적림계치위67.3 pmol/L,령민도화특이도분별위80.7%화94.6%.치료전란소암조환자혈청HE4화CA125적중위농도분별위227.3 pmol/L화444.0 U/ml,여교계성조、량성조화건강대조조차이균유통계학의의(균P＜0.01).수술치료후,란소암환자적혈청HE4화CA125수평명현강저(균P＜0.01).HE4여CA125연합검측시,령민도화특이도분별위92.7%화72.5%.미절경화절경녀성PP치적림계치분별위9.3%화27.3%,진단미절경환자적령민도화특이도분별위84.6%화77.0%,양성예측치화음성예측치분별위70.2%화88.7%;진단절경환자적령민도화특이도분별위86.3%화77.1%,양성예측치화음성예측치분별위94.5%화71.1%.결론 혈청HE4시일충량호적혈청종류표기물.HE4여CA125연합검측병차조ROMA판정란소암적환병풍험유조우제고란소암진단적준학도.
Objective To investigate the clinical value of combination of human epididymis protein 4 (HE4), CA125 and the Risk of Ovarian Malignancy Algorithm (ROMA) in diagnosis of ovarian carcinoma. Methods To detect the serum concentration of HE4 using ELISA and CA125 using ECL in patients of ovarian carcinoma group (n=119), borderline ovarian tumor group (n=36), benign ovarian neoplasm group (n=96) and female healthy control group (n=53). The ROMA based on the serum level of CA125, HE4 and a woman′s menopausal status was used to calculate the predicted probability (PP) and diagnostic results of ovarian cancers. Results The receiver operating characteristic (ROC) analysis showed the cut-off value was 67.3 pmol/L (the AUC was 0.906, the sensitivity was 80.7% and specificity was 94.6%). The serum levels of HE4 and CA125 in the ovarian carcinoma group were significantly higher than that in the borderline ovarian tumor group, benign ovarian neoplasm group and female healthy control group (P<0.01). The serum levels of CA125 and HE4 showed statistically no significant difference between the borderline ovarian tumor group and benign ovarian neoplasm group (P>0.05). The levels of HE4 and CA125 were reduced significantly in ovarian patients after surgery therapy (P＜0.01). The sensitivity and specificity of HE4 + CA125 combination was 92.7% and 72.5%. The ROMA that can classify patients into high and low risk groups was established as 9.3% in premenopausal and 27.3% in postmenopausal women. Conclusions HE4 is a helpful biomarker for ovarian carcinoma diagnosis. Biomarker combination of HE4 and CA125, and applying of the ROMA are helpful to improve the accuracy in diagnosis of ovarian cancers.