血清人附睾分泌蛋白4和卵巢恶性肿瘤风险值在上皮性卵巢癌的诊断和风险评估中的应用价值  

The serum levels of human epididymis protein 4(HE4) and the risk values of ovarian malignancy algorithm(ROMA) in patients with ovarian cancer

作　　者：董作亮[1] 杜雪[2] 李江[1] 

机构地区：[1]天津医科大学总医院医学检验科,天津300052 [2]天津医科大学总医院妇产科

出　　处：《中国慢性病预防与控制》2013年第4期440-442,共3页Chinese Journal of Prevention and Control of Chronic Diseases

摘　　要：目的探讨人附睾分泌蛋白4(HE4)及卵巢恶性肿瘤风险(ROMA)值在中国人群上皮性卵巢癌的诊断和卵巢癌风险评估中的应用价值。方法应用酶联免疫吸附试验(ELISA)法检测206例上皮性卵巢癌、子宫良性疾病,子宫内膜癌,卵巢良性疾病患者血清中HE4水平,选64例卵巢癌患者为恶性肿瘤组,57例良性卵巢肿瘤患者及60例健康者为对照组。经测定血清糖类抗原125(CA125)水平后,带入公式计算其ROMA值,结合绝经状态评价诊断和患卵巢癌的风险性。结果上皮性卵巢癌组患者HE4水平明显高于对照组、子宫良性疾病组、子宫内膜癌组及卵巢良性疾病组的患者,差异均有统计学意义(P<0.05)。经受试者工作特性曲线(ROC)分析,HE4的ROC曲线下面积为0.827,以150pmol/L为界值时,检测卵巢癌的灵敏度和特异度达73.4%和89.5%。由ROMA值结合绝经状态在121例患者中诊断出卵巢癌的敏感度和特异度分别为87.5%和77.2%,未绝经患者高危组罹患卵巢癌的风险是低危组的9.6倍;绝经患者高危组罹患卵巢癌的风险是低危组的3.8倍,绝经前后高风险间差异有统计学意义(P<0.01)。阳性预测值和阴性预测值分别为81.2%和88.0%。结论 HE4可作为临床诊断上皮性卵巢癌新的肿瘤标志物,ROMA值的计算有望成为评估患者上皮性卵巢癌风险的一种新的辅助手段。Objective To evaluate the application of serum human epididymis protein 4（HE4） and the risk values of ovarian malignancy algorithm（ROMA） levels in the diagnosis and risk assessment of epithelioid ovarian cancer in Chinese population.Methods The serum HE4 levels in 206 patients with different tumors（epithelioid ovarian cancer,uterine benign disease patients,endometrial cancer and ovary benign disease） were determined by Elisa.The values of ROMA in the ovarian cancer group（64 cases）,ovary benign tumor group（57 cases） and control group（60 healthy subjects） calculated by HE4 and CA125 levels combined with menopause state were used to assess the risk of epithelioid ovarian cancer.Results The serum levels of HE4 in patients with epithelioid ovarian carcinoma were significantly higher than those in controls and patients with uterine benign disease,endometrial cancer,ovary benign disease（P 0.05）.The receiver operating characteristic（ROC） analysis showed that the AUC of ROC curve was 0.827,when the cut-off was 150 pmol/L,the sensitivity and specificity were 73.4%and 89.5%,respectively.When ROMA with menopause state was used to diagnose the ovarian cancer in 121 patients,the sensitivity and specificity were 87.5% and 77.2%,respectively.The risk in the premenopausal patients with high risk was 9.6 times as compared with patients with low risk,the risk in the postmenopausal patients with high risk was 3.8 times as compared with patients with low risk（P 0.01）.The positive predictive value and negative predictive value were 81.2% and 88.0%,respectively.Conclusion HE4 is a helpful biomarker for ovarian carcinoma diagnosis,ROMA determination may be a new method to assess the risk of epithelioid ovarian cancer.

关 键 词：人附睾上皮分泌蛋白4 糖类抗原125 诊断试验 评价 卵巢恶性肿瘤风险值 

分 类 号：R181.3[医药卫生—流行病学]