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人附睾蛋白4与CA125联合检测在卵巢恶性肿瘤患者中的诊断价值

[Diagnostic value of combining detection of human epididymis protein 4 and CA125 in patients with malignant ovarian carcinoma].

作者信息

Wang Min-jie, Qi Jun, Wang Hai, Li Xue-xiang, Wei Bao-jun, Fu Chao, Gao Jia, Han Bin-Bin

机构信息

Clinical Laboratory, Chinese Academy of Medical Sciences, Beijing, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2011 Jul;33(7):540-3.

Abstract

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.

摘要

目的

探讨人附睾蛋白4(HE4)、CA125及卵巢恶性肿瘤风险算法(ROMA)联合检测在卵巢癌诊断中的临床价值。

方法

采用酶联免疫吸附测定法(ELISA)检测卵巢癌组(n = 119)、卵巢交界性肿瘤组(n = 36)、卵巢良性肿瘤组(n = 96)及女性健康对照组(n = 53)患者血清HE4浓度,采用电化学发光法(ECL)检测CA125浓度。基于CA125、HE4血清水平及女性绝经状态的ROMA用于计算卵巢癌的预测概率(PP)和诊断结果。

结果

受试者工作特征(ROC)分析显示,截断值为67.3 pmol/L(曲线下面积[AUC]为0.906,灵敏度为80.7%,特异度为94.6%)。卵巢癌组血清HE4和CA125水平显著高于卵巢交界性肿瘤组、卵巢良性肿瘤组及女性健康对照组(P < 0.01)。卵巢交界性肿瘤组与卵巢良性肿瘤组血清CA125和HE4水平差异无统计学意义(P > 0.05)。手术治疗后卵巢癌患者HE4和CA125水平显著降低(P < 0.01)。HE4 + CA125联合检测的灵敏度和特异度分别为92.7%和72.5%。将绝经前女性ROMA分类为高风险和低风险组的界值设定为9.3%,绝经后女性为27.3%。

结论

HE4是卵巢癌诊断的有用生物标志物。HE4与CA125联合作为生物标志物,并应用ROMA有助于提高卵巢癌诊断的准确性。

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