血清人附睾蛋白 4 和癌抗原 125 在鉴别Ⅰ型和Ⅱ型上皮性卵巢癌中的意义。
Significance of Serum Human Epididymis Protein 4 and Cancer Antigen 125 in Distinguishing Type I and Type II Epithelial Ovarian Cancers.
机构信息
Departments of Obstetrics and Gynecology, and.
出版信息
Int J Gynecol Cancer. 2018 Jul;28(6):1058-1065. doi: 10.1097/IGC.0000000000001277.
OBJECTIVE
The objective of this study was to assess the effectiveness of human epididymis protein 4 (HE4) and cancer antigen 125 (CA125), and risk of ovarian malignancy algorithm (ROMA) in identifying type I and type II epithelial ovarian cancers (EOCs).
METHODS
A cross-sectional diagnostic study was conducted of 499 Thai women older than 18 years who had clinically diagnosed pelvic masses and underwent elective surgery at our hospital between July 2012 and July 2014. Preoperative serum HE4 and CA125 levels were measured, and postoperative pathologic slides were reviewed.
RESULTS
Of 499 Thai women enrolled in this study, 357 were noncancerous (NC), 79 had type I EOCs (EOCs-I) and 63 had type II (EOCs-II). Risk of ovarian malignancy algorithm revealed significantly better performance than HE4 and CA125 in discriminating between NC and EOCs-I (receiver operating characteristic curve and area under the curve [ROC-AUC]: ROMA, 0.86; HE4, 0.80; and CA125, 0.77), and NC and EOCs-II (ROC-AUC: ROMA, 0.97; HE4, 0.95; and CA125, 0.93). In differentiation between EOCs-I and EOCs-II (setting EOC-II as reference), ROMA yielded a better performance than HE4 and CA125 (ROC-AUC: ROMA, 0.83; HE4, 0.82; and CA125, 0.77); however, CA125 and HE4 showed higher sensitivity (CA125, 77.8%; HE4, 76.2%), whereas ROMA had the highest specificity (79.8%).
CONCLUSIONS
In women who present with pelvic masses, ROMA performed very well in distinguishing between noncancer lesions and EOCs but the combined HE4 and CA125 test was more effective in predicting EOC types.
目的
本研究旨在评估人附睾蛋白 4（HE4）和癌抗原 125（CA125）以及卵巢恶性肿瘤风险算法（ROMA）在识别 1 型和 2 型上皮性卵巢癌（EOC）中的有效性。
方法
这是一项横断面诊断研究，纳入了 2012 年 7 月至 2014 年 7 月在我院接受择期手术的 499 名年龄大于 18 岁的泰国女性，这些女性均经临床诊断为盆腔肿块。术前检测血清 HE4 和 CA125 水平，并对术后病理切片进行复查。
结果
在这项研究中，共有 499 名泰国女性入组，其中 357 名是非癌性（NC），79 名患有 1 型上皮性卵巢癌（EOCs-I），63 名患有 2 型上皮性卵巢癌（EOCs-II）。与 HE4 和 CA125 相比，卵巢恶性肿瘤风险算法在鉴别 NC 和 EOCs-I（受试者工作特征曲线和曲线下面积[ROC-AUC]：ROMA，0.86；HE4，0.80；CA125，0.77），以及 NC 和 EOCs-II（ROC-AUC：ROMA，0.97；HE4，0.95；CA125，0.93）方面具有更好的表现。在鉴别 EOCs-I 和 EOCs-II（以 EOC-II 为参照）方面，ROMA 的表现优于 HE4 和 CA125（ROC-AUC：ROMA，0.83；HE4，0.82；CA125，0.77）；然而，CA125 和 HE4 的敏感性更高（CA125，77.8%；HE4，76.2%），而 ROMA 的特异性最高（79.8%）。
结论
在患有盆腔肿块的女性中，ROMA 可很好地区分非癌性病变和 EOC，但联合检测 HE4 和 CA125 可更有效地预测 EOC 类型。
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