Braicu Elena Ioana, Van Gorp Toon, Nassir Mani, Richter Rolf, Chekerov Radoslav, Gasimli Khayal, Timmerman Dirk, Vergote Ignace, Sehouli Jalid
Department of Gynecology, Campus Virchow Clinic, Charité Medical University Berlin, Augustenburger Platz 1, Berlin 13353, Germany.
Department of Obstetrics and Gynecology, Maastricht University Medical Centre, PO Box 5800, Maastricht 6202 AZ, The Netherlands.
J Ovarian Res. 2014 May 7;7:49. doi: 10.1186/1757-2215-7-49. eCollection 2014.
Borderline tumors of the ovary (BOT) are a distinct entity of ovarian tumors, characterized by lack of stromal invasion. Recent studies postulated that the presence of invasive implants, incomplete staging, fertility sparing surgery and residual tumor after surgery are major prognostic factors for BOT. There are no biomarkers that can predict BOT or the presence of invasive implants.
The aim of our study was to assess the value of CA125 and HE4 alone, or within ROMA score for detecting BOT, and for predicting the presence of invasive implants.
Retrospective, monocentric study on 167 women diagnosed with BOT or benign ovarian masses. Serum HE4, CA125 levels and ROMA were assessed preoperatively. Due to low number of BOT with invasive implants, we performed an unmatched analysis (consecutive patients) and a matched analysis (according to age and histology) to compare BOT with invasive implants, BOT without invasive implants and benign disease.
There were no significant differences in the HE4 and CA125 expressions in the three groups of patients (p = 0.984 and p = 0.141, respectively). The ROC analysis showed that CA125 alone is superior to ROMA and HE4 in discriminating patients with BOT with invasive implants from patients with benign diseases and BOT without invasive implants. A newly established score, ROMABOT, did not perform better than ROMA. The analysis of the matched groups revealed similar results as the analysis of all samples.
Both HE4 and CA125 are not reliable biomarkers for the diagnosis of BOT or for predicting the presence of invasive implants.
卵巢交界性肿瘤（BOT）是卵巢肿瘤中的一种独特类型，其特征是缺乏间质浸润。最近的研究推测，侵袭性种植灶的存在、分期不完整、保留生育功能的手术以及术后残留肿瘤是BOT的主要预后因素。目前尚无能够预测BOT或侵袭性种植灶存在的生物标志物。
我们研究的目的是评估单独的CA125和HE4，或其在ROMA评分中对于检测BOT以及预测侵袭性种植灶存在的价值。
对167例诊断为BOT或良性卵巢肿块的女性进行回顾性单中心研究。术前评估血清HE4、CA125水平和ROMA。由于伴有侵袭性种植灶的BOT病例数较少，我们进行了非匹配分析（连续患者）和匹配分析（根据年龄和组织学），以比较伴有侵袭性种植灶的BOT、不伴有侵袭性种植灶的BOT和良性疾病。
三组患者的HE4和CA125表达无显著差异（分别为p = 0.984和p = 0.141）。ROC分析表明，单独的CA125在区分伴有侵袭性种植灶的BOT患者与良性疾病和不伴有侵袭性种植灶的BOT患者方面优于ROMA和HE4。新建立的ROMA BOT评分表现并不优于ROMA。匹配组分析结果与所有样本分析结果相似。
HE4和CA125都不是诊断BOT或预测侵袭性种植灶存在的可靠生物标志物。
