血清CA125、HE4联合ROMA指数对卵巢癌诊断的研究分析  

Diagnosis of combination of serum CA125,HE4 and ROMA in the patients with ovarian cancer

作　　者：杨士军[1] 陆卫平[2] 郑云会[1] 张金华[1] 刘满庆[1] 夏永祥[3] 

机构地区：[1]南京医科大学附属淮安第一医院核医学科,江苏淮安223300 [2]南京医科大学附属淮安第一医院内分泌科,江苏淮安223300 [3]南京医科大学附属南京医院检验科,南京210006

出　　处：《检验医学与临床》2016年第14期1931-1933,共3页Laboratory Medicine and Clinic

摘　　要：目的为探讨血清糖类抗原125(CA125)、人附睾蛋白4(HE4)及其加权指标ROMA指数对卵巢癌诊断的价值。方法应用电化学发光法(ECLIA)对70例病理确诊的卵巢良性疾病及137例卵巢癌患者治疗前的血清CA125及HE4进行检测,计算ROMA指数并进行统计分析。结果137例卵巢癌患者CA125、HE4及ROMA分别为270.1 U/mL、287.1pmol/L及71.5%,与良性卵巢疾病(25.4U/mL、69.3pmol/L、17.1%)及对照组(14.5U/mL、61.1pmol/L、11.8%)比较,差异有统计学意义(P<0.05);良性卵巢疾病组的HE4浓度与对照组比较差异无统计学意义(P>0.05);CA125、HE4、ROMA值的敏感度、特异度、阳性预测值、阴性预测值及符合率分别为:CA125(77.4%、74.3%、85.5%、62.6%、76.3%),HE4(79.6%、77.1%、87.2%、65.8%、78.7%),ROMA(89.8%、88.6%、93.9%、81.6%、89.4%);ROC分析,三项指标的曲线下面积(AUC)分别为:AUC(CA125)=0.854,AUC(HE4)=0.936,AUC(ROMA)=0.954(P<0.05),曲线下面积ROMA>HE4>CA125,HE4曲线下面积绝经前后相差较小。结论 HE4在诊断卵巢癌时可排除良性疾病的干扰,性能优于CA125,联合检测CA125、HE4以及ROMA指数,可提高卵巢癌的检出率。Objective To analyze the diagnostic value of serum carbohydrate antigen 125 （CA125） ,human epididymis protein 4 （HE4） and ROMA in patients with ovarian cancer .Methods By Electrochemical luminescence （ECLIA） ,serum HE4 and CA125 of 70 cases diagnosed as ovarian benign disease and 137 cases diagnosed as ovarian cancer were detected before treatment .ROMA were calculated and all the data were analyzed statistically .Results The level of CA125 ,HE4 and ROMA of patients with ovarian cancer were 270 .1 U/mL ,287 .1 pmol/L and 71 .5% respectively ,which of patients with benign ovarian diseases were 25 .4 U/mL , 69 .3 pmol/L ,17 .1% and the level of three indicators in the control group were 14 .5 U/mL ,61 .1 pmol/L and 11 .8% .The differ‐ence of HE4 between the group of benign ovarian diseases and the control group had no statistical significance （P〉0 .05） .The sen‐sitivity ,specificity ,positive predictive value ,negative predictive value and coincidence of CA 125 were 77 .4% ,74 .3% ,85 .5% , 62 .6% and 76 .3% respectively ,which of HE4 were 79 .6% ,77 .1% ,87 .2% ,65 .8% and 78 .7% respectively and of ROMA were 89 .8% ,88 .6% ,93 .9% ,81 .6% ,and 89 .4% respectively .The area under the curve （AUC） of CA125 ,HE4 and ROMA were 0 .854 ,0 .936 and 0 .954 respectively .AUC of ROMA was higher than HE4 ,and that of HE4 was also higher than CA125 .The difference of AUC of HE4 before and after menopause was little .Conclusion HE4 could eliminate the interference of ovarian be‐nign disease in the diagnosis of ovarian cancer and specificity of HE4 is higher than CA125 .Combined detection of CA125 ,HE4 and ROM A can improve the positive rate of ovarian cancer .

关 键 词：肿瘤标志物 卵巢癌 人附睾蛋白4 ROM A ROC 

分 类 号：R737.31[医药卫生—肿瘤]