Song Liyun, Wu Qi, Bai Suning, Zhao Jing, Qi Jie, Zhang Junmei
Department of Gynecology, Hebei General Hospital, Shijiazhuang, China.
Front Oncol. 2024 Jul 2;14:1381268. doi: 10.3389/fonc.2024.1381268. eCollection 2024.
This study aimed to determine the diagnostic accuracy of CA125, HE4, systemic immune-inflammation index (SII), prognostic nutritional index (PNI), fibrinogen-to-albumin ratio (FAR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and the combination of the six inflammatory-nutritional markers for ovarian cancer (OC) to identify the best diagnostic indicator for OC early diagnosis. An extensive study was performed to establish the connection between these indicators and the pathological aspects of OC.
A total of 170 individuals were included in this study, with 87 diagnosed with OC and 83 with benign ovarian tumors (BOTs). The diagnostic abilities of the variables were evaluated by calculating sensitivity, specificity, and area under the ROC curves. Through the use of DCA, we evaluated the variables' clinical value in the discrimination of ovarian masses.
All markers showed significant diagnostic power for OC. CA125, HE4, SII, FAR, and MLR levels significantly increased from the BOTs group to the early-stage OC group. The advanced-stage OC group had significantly lower PNI values compared to the early-stage OC group but significantly higher levels of CA125, HE4, SII, NLR, and FAR. Moreover, the OC group with lymph node metastasis exhibited significantly higher levels of CA125, HE4, SII, NLR, PLR, and FAR, in contrast to the non-metastatic group, while PNI levels were significantly lower. Categorical factors, such as histological grade and pathological classification, showed noticeable discrepancies in CA125 and HE4 levels. NLR was significantly different among the pathological type groups. Among the six inflammatory-nutritional markers, the FAR displayed the greatest diagnostic value. In the analysis of logistic regression, it was observed that a combination marker containing all six inflammatory-nutritional markers exhibited a notably higher AUC value (0.881; 95% CI, 0.823 - 0.926) than any of the individual marker.
PNI, NLR, PLR, MLR, SII, and FAR showed excellent diagnostic performance for OC. The combination of these markers demonstrated a superior diagnostic capability compared to each individual one. The systemic inflammatory indicators may be helpful to diagnose OC.
本研究旨在确定CA125、HE4、全身免疫炎症指数（SII）、预后营养指数（PNI）、纤维蛋白原与白蛋白比值（FAR）、中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）以及单核细胞与淋巴细胞比值（MLR）这六种炎症营养标志物联合检测对卵巢癌（OC）的诊断准确性，以找出用于OC早期诊断的最佳诊断指标。开展了一项广泛研究以建立这些指标与OC病理特征之间的联系。
本研究共纳入170例个体，其中87例诊断为OC，83例患有良性卵巢肿瘤（BOTs）。通过计算敏感性、特异性和ROC曲线下面积来评估各变量的诊断能力。通过使用决策曲线分析（DCA），我们评估了各变量在鉴别卵巢肿块中的临床价值。
所有标志物对OC均显示出显著的诊断效能。从BOTs组到早期OC组，CA125、HE4、SII、FAR和MLR水平显著升高。晚期OC组的PNI值显著低于早期OC组，但CA125、HE4、SII、NLR和FAR水平显著更高。此外，与无转移组相比，有淋巴结转移的OC组的CA125、HE4、SII、NLR、PLR和FAR水平显著更高，而PNI水平显著更低。组织学分级和病理分类等分类因素在CA125和HE4水平上存在明显差异。病理类型组之间NLR存在显著差异。在这六种炎症营养标志物中，FAR显示出最大的诊断价值。在逻辑回归分析中，观察到包含所有六种炎症营养标志物的联合标志物的AUC值（0.881；95%CI，0.823 - 0.926）显著高于任何单个标志物。
PNI、NLR、PLR、MLR、SII和FAR对OC显示出优异的诊断性能。这些标志物的联合检测显示出比单个标志物更优越的诊断能力。全身炎症指标可能有助于诊断OC。
