Macuks Ronalds, Baidekalna Ieva, Donina Simona
Department of Gynecology and Obstetrics of Riga Stradins University, Riga, Latvia.
Asian Pac J Cancer Prev. 2012;13(9):4695-8. doi: 10.7314/apjcp.2012.13.9.4695.
To analyze differential diagnostic accuracy of urinary human epidydimis secretory protein 4 (HE4) in patients with ovarian tumors.
In the case-control study 23 patients with ovarian cancer, 37 patients with benign ovarian tumors and 18 women in the control group were included. Serum CA125 values and urinary concentrations of HE4were assessed quantitatively. Urinary creatinine concentrations and glomerular filtration rate were also determined and used to calculate ratios to HE4.
Higher urinary HE4 concentrations were observed in patients with late stage ovarian cancer (p=0.001) and also in patients with early stage ovarian cancer when compared to patients with benign ovarian tumors (p=0.044). On analysis where all ovarian cancer patients were included, higher diagnostic accuracy was observed with calculated ratio of HE4 to glomerular filtration rate (GFR) to unchanged urinary HE4 concentrations -AUC 0.861 vs. 0.858. When discriminatory accuracy was calculated for urinary HE4/GFR ratio and unchanged urinary HE4 concentrations, the last demonstrated a higher area under the curve - 0.701 vs. 0.602. The urinary HE4/creatinine ratio had lower discriminatory characteristics than unchanged concentrations of urinary HE4. However, HE4 serum concentration was more accurate for discrimination of patients with benign and malignant ovarian tumors when compared to urinary HE4 and CA125 in sera (AUCs were 0.868 for serum HE4 and 0.856 and 0.653 for urinary HE4 and CA125, respectively).
Ovarian cancer patients have higher urinary concentrations of human epidydimis secretory protein 4 than patients with benign ovarian tumors. Urinary HE4 has comparable discriminatory accuracy with serum HE4 for benign and malignant ovarian tumors and can be recommended as a non-invasive ovarian cancer risk assessment method.
分析尿中人附睾分泌蛋白4（HE4）在卵巢肿瘤患者中的鉴别诊断准确性。
在病例对照研究中，纳入了23例卵巢癌患者、37例卵巢良性肿瘤患者和18名对照组女性。对血清CA125值和尿中HE4浓度进行定量评估。还测定了尿肌酐浓度和肾小球滤过率，并用于计算与HE4的比值。
与卵巢良性肿瘤患者相比，晚期卵巢癌患者尿HE4浓度更高（p = 0.001），早期卵巢癌患者尿HE4浓度也更高（p = 0.044）。在纳入所有卵巢癌患者的分析中，计算的HE4与肾小球滤过率（GFR）的比值在尿HE4浓度不变时具有更高的诊断准确性——曲线下面积（AUC）为0.861，而尿HE4浓度不变时为0.858。当计算尿HE4/GFR比值和尿HE4浓度不变时的鉴别准确性时，后者显示出更高的曲线下面积——0.701对0.602。尿HE4/肌酐比值的鉴别特征低于尿HE4浓度不变时的情况。然而，与血清中的尿HE4和CA125相比，HE4血清浓度在鉴别卵巢良性和恶性肿瘤患者时更准确（血清HE4的AUC为0.868，尿HE4和CA125的AUC分别为0.856和0.653）。
卵巢癌患者尿中人附睾分泌蛋白4的浓度高于卵巢良性肿瘤患者。尿HE4在鉴别卵巢良性和恶性肿瘤方面与血清HE4具有相当的准确性，可作为一种非侵入性的卵巢癌风险评估方法推荐。
