临床特征和血清 CA19-9 联合 HE4 对诊断子宫内膜异位症相关卵巢癌具有重要价值。

Clinical characteristics and serum CA19-9 combined with HE4 are valuable in diagnosing endometriosis-associated ovarian cancer.

机构信息

Department of Gynecology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.

出版信息

Int J Gynaecol Obstet. 2023 Aug;162(2):472-478. doi: 10.1002/ijgo.14695. Epub 2023 Feb 13.

DOI:10.1002/ijgo.14695

PMID:36708088

Abstract

OBJECTIVE

Endometriosis-associated ovarian cancer (EAOC) is difficult to diagnose because of its low incidence, uncertain risk factors, and the absence of effective markers. This study aimed to investigate the clinical characteristics of EAOC and identify useful serological markers.

METHODS

We retrospectively studied the clinical characteristics of patients with EAOC and ovarian endometriosis, obtained between January 1, 2011 and October 31, 2021. Univariate and multivariate logistic regression analyses were used to explore the relationship between clinical characteristics and EAOC. Receiver operating characteristic curves were applied to access the diagnostic value of serological markers in EAOC.

RESULTS

In total, the clinical characteristics of 220 patients were obtained; 44 with EAOC and 176 with ovarian endometriosis. EAOC patients were older (46.20 vs. 36.26 years, P < 0.001) and had larger tumors (9.10 vs. 6.73 cm, P = 0.003) together with higher CA19-9 (21.44 vs. 4.72 U/mL, P < 0.001) and HE4 levels (62.35 vs. 44.19 pmol/L, P < 0.001) when compared with ovarian endometriosis patients. Multivariate analysis showed that HE4 greater than 59.7 pmol/L, CA19-9 greater than 8.5 U/mL, age 42 years or older, and tumor length 9.2 cm or longer were independent risk factors for EAOC. Significantly, CA19-9 combined with HE4 had high sensitivity (72.73%) and specificity (78.41%) in diagnosing EAOC.

CONCLUSION

Age over 42 years, large ovarian tumor, serum CA19-9 and HE4 are valuable in the diagnosis of EAOC.

摘要

目的

子宫内膜异位症相关卵巢癌（EAOC）发病率低、发病因素不确定、缺乏有效的标志物，因此诊断较为困难。本研究旨在探讨 EAOC 的临床特征并寻找有用的血清标志物。

方法

回顾性分析 2011 年 1 月 1 日至 2021 年 10 月 31 日期间就诊的 EAOC 和卵巢子宫内膜异位症患者的临床资料。采用单因素和多因素逻辑回归分析探讨临床特征与 EAOC 的关系。应用受试者工作特征曲线评估血清标志物对 EAOC 的诊断价值。

结果

共获得 220 例患者的临床资料，其中 EAOC 患者 44 例，卵巢子宫内膜异位症患者 176 例。EAOC 患者年龄较大（46.20 岁比 36.26 岁，P<0.001），肿瘤较大（9.10 cm 比 6.73 cm，P=0.003），CA19-9 水平较高[21.44（4.72~~502.52）U/ml 比 4.72（0.93~~30.10）U/ml，P<0.001]和 HE4 水平较高[62.35（17.17~~1928.30）pmol/L 比 44.19（16.64~~400.10）pmol/L，P<0.001]。多因素分析显示，HE4 大于 59.7 pmol/L、CA19-9 大于 8.5 U/ml、年龄 42 岁及以上、肿瘤长度 9.2 cm 及以上是 EAOC 的独立危险因素。CA19-9 联合 HE4 诊断 EAOC 的敏感性为 72.73%，特异性为 78.41%。