用于卵巢癌诊断的生物标志物和算法：CA125、HE4、RMI 和 ROMA，综述。
Biomarkers and algorithms for diagnosis of ovarian cancer: CA125, HE4, RMI and ROMA, a review.
机构信息
Service de Gynécologie-Obstétrique, CHU de Nantes, 44093, Nantes, France.
Service de Biochimie, CHU de Nantes, Nantes, France.
出版信息
J Ovarian Res. 2019 Mar 27;12(1):28. doi: 10.1186/s13048-019-0503-7.
Abstract
Ovarian cancer is the 5th leading cause of death for women with cancer worldwide. In more than 70% of cases, it is only diagnosed at an advanced stage. Our study aims to give an update on the biological markers for diagnosing ovarian cancer, specifically HE4, CA 125, RMI and ROMA algorithms.Serum CA125 assay has low sensitivity in the early stages and can be increased in certain conditions such as menstruation or endometriosis. The level of HE4 is overexpressed in ovarian tumors. Its specificity is 94% and its level is not affected by endometriosis cysts. The combined measures of CA125 and HE4 have proved to be highly efficient with an area under the curve (AUC) of up to 0.96. Furthermore, this combined measure of CA125 can correct the variations in HE4 which are due to smoking or contraception combining estrogen plus progestin. While the specificity of RMI sometimes reaches 92%, the rather low AUC of 0.86 does not make it the best diagnostic tool. The specificity of ROMA is lower than HE4 (84% compared to 94%).To date, the most efficient biological diagnostic tool to diagnose ovarian cancer is the combination of CA125 and HE4.
摘要
卵巢癌是全球女性癌症死亡的第 5 大原因。在超过 70%的病例中，它仅在晚期被诊断出来。我们的研究旨在提供有关卵巢癌诊断的生物标志物的最新信息，特别是 HE4、CA 125、RMI 和 ROMA 算法。血清 CA125 检测在早期阶段的灵敏度较低，并且在某些情况下（如月经或子宫内膜异位症）可能会增加。HE4 在卵巢肿瘤中过度表达。其特异性为 94%，其水平不受子宫内膜异位症囊肿的影响。CA125 和 HE4 的联合检测已被证明具有很高的效率，曲线下面积（AUC）高达 0.96。此外，这种 CA125 的联合检测可以纠正因吸烟或同时使用雌激素加孕激素的避孕药而导致的 HE4 变化。虽然 RMI 的特异性有时可达到 92%，但其 AUC 仅为 0.86，这使得它不是最佳的诊断工具。ROMA 的特异性低于 HE4（84%对 94%）。迄今为止，诊断卵巢癌最有效的生物诊断工具是 CA125 和 HE4 的联合检测。
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