术前HE4、CA125及ROMA在附件区良恶性肿块鉴别诊断中的应用
Preoperative HE4, CA125 and ROMA in the differential diagnosis of benign and malignant adnexal masses.
作者信息
Terlikowska Katarzyna M, Dobrzycka Bozena, Witkowska Anna M, Mackowiak-Matejczyk Beata, Sledziewski Tomasz Kamil, Kinalski Maciej, Terlikowski Slawomir J
机构信息
Department of Food Science and Technology, Medical University of Bialystok, 37 Szpitalna Street, 15-295, Bialystok, Poland.
Department of Obstetrics, Gynaecology and Maternity Care, Medical University of Bialystok, 15 Warszawska Street, 15-062, Bialystok, Poland.
出版信息
J Ovarian Res. 2016 Jul 19;9(1):43. doi: 10.1186/s13048-016-0254-7.
BACKGROUND
The aim of this study was to evaluate HE4, CA125 and ROMA in the preoperative differentiation benign ovarian diseases from epithelial ovarian cancer depending on the menopausal status.
METHODS
In order to estimate markers' concentrations in the serum of women with benign ovarian disease (n = 128) and with epithelial ovarian carcinoma (n = 96) the electrochemiluminescence (ECLIA) technique has been applied.
RESULTS
Using the ROC analysis, although no statistical differences were found among their AUCs, the ROMA algorithm seems to be effective in gathering the diverse performance of HE4 and CA125. The AUC for HE4, CA125 and ROMA for all patients were: 0.895; 0.879 and 0.918, respectively. At established new optimal cutoff values for HE4, CA125 and ROMA we found higher specificity in postmenopausal compared to premenopausal women (96.9 vs 89.8 % and 97.7 vs 84.1 % and 95.9 vs 89.1 %, respectively). The sensitivity of HE4 in pre- and postmenopausal women was similar (83.5 vs 83.8 %), while for CA125 was the highest in premenopausal women (87.0 vs 84.1 %). For HE4, CA125 and ROMA the negative predictive value was high (97.6, 93.9 and 94.4 %, respectively).
CONCLUSIONS
The ROMA algorithm shows the best diagnostic performance to distinguish epithelial ovarian cancer from benign ovarian disease. We found the high specificity of HE4 and CA125 while differentiating ovarian benign diseases from epithelial ovarian cancer in postmenopausal women and the high sensitivity of CA125 in detecting epithelial ovarian cancer in premenopausal patients.
背景
本研究旨在根据绝经状态评估人附睾蛋白4（HE4）、癌抗原125（CA125）和风险卵巢恶性肿瘤算法（ROMA）在术前鉴别良性卵巢疾病与上皮性卵巢癌中的作用。
方法
为了评估良性卵巢疾病患者（n = 128）和上皮性卵巢癌患者（n = 96）血清中标志物的浓度，采用了电化学发光免疫分析（ECLIA）技术。
结果
通过ROC分析，尽管HE4、CA125和ROMA的曲线下面积（AUC）之间无统计学差异，但ROMA算法似乎能有效地综合HE4和CA125的不同表现。所有患者中HE4、CA125和ROMA的AUC分别为：0.895、0.879和0.918。在确定HE4、CA125和ROMA的新最佳临界值时，我们发现绝经后女性与绝经前女性相比具有更高的特异性（分别为96.9%对89.8%、97.7%对84.1%、95.9%对89.1%）。HE4在绝经前和绝经后女性中的敏感性相似（83.5%对83.8%），而CA125在绝经前女性中最高（87.0%对84.1%）。HE4、CA125和ROMA的阴性预测值较高（分别为97.6%、93.9%和94.4%）。
结论
ROMA算法在鉴别上皮性卵巢癌与良性卵巢疾病方面显示出最佳的诊断性能。我们发现HE4和CA125在绝经后女性中将卵巢良性疾病与上皮性卵巢癌区分开来时具有高特异性，而CA125在检测绝经前患者的上皮性卵巢癌时具有高敏感性。
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