ROMA模型联合HE4与CA125检测在卵巢癌诊断中的作用  

The role of ROMA model combined with HE4 and CA125 in the diagnosis of ovarian cancer

作　　者：杨庆忠[1] 付宏伟[1] 李新善[2] 

机构地区：[1]江西省妇幼保健院核医学科,江西南昌330006 [2]江西省人民医院检验科,江西南昌330006

出　　处：《实验与检验医学》2017年第2期160-162,166,共4页Experimental and Laboratory Medicine

基　　金：江西省卫生厅科技计划项目(20133129)

摘　　要：目的探讨卵巢恶性肿瘤风险计算法(ROMA)联合血清人附睾蛋白4(HE4)与糖类抗原125(CAl25)检测在预测卵巢癌诊断中的价值。方法采用通过化学发光方法检测100例卵巢癌患者(卵巢癌组)、100例卵巢良性肿瘤患者(良性组)及100例女性健康对照者(健康对照组)的血清HE4与糖类抗原CAl25浓度,采用ROMA方法计算卵巢癌预测概率(PP),评价PP值的诊断效果。结果 (1)卵巢癌组血清HE4和CAl25水平分别为320.2±210.6pmo L/L和350.6±162.8k U/L,卵巢良性肿瘤组血清HE4和CAl25水平分别为52.8±12.6pmo L/L和32.6±10.5k U/L,健康对照组血清HE4和CAl25水平分别为36.4±12.8pmo L/L和21.4±8.2k U/L,卵巢癌组血清HE4和CAl25水平分别与卵巢良性肿瘤组和健康对照组比较,差异均有统计学意义(P<0.01)。(2)未绝经和绝经女性PP值的临界值分别为11.4%和29.9%,诊断未绝经患者的灵敏度和特异性分别为87.0%和83.8%,阳性预测值和阴性预测值分别为71.1%和93.4%;诊断绝经患者的灵敏度和特异度分别为88.4%和81.3%,阳性预测值和阴性预测值分别为91.0%和76.5%。结论 ROMA联合血清HE4与CAl25判定有助于提高患者卵巢癌诊断的准确度。Objective To investigate the diagnostic value of combination detection of human epididymis protein 4（HE4）,carbohydrate antigen 125（CAl25） and the Risk of Ovarian Malignancy Algorithm（ROMA） in diagnosis of ovarian carcinoma. Methods Chemiluminescence immunoassay was used to detect the serum concentration of HE4 and CAl25 by in patients of ovarian carcinoma group（n=l00）,benign ovarian neoplasm group（n=100） and female healthy control group（n=100）. The ROMA based on the serum concentration of CAl25,HE4 and a woman＇s menopausal status was used to calculate the predicted probability（PP） and estimate diagnostic results of the PP. Results ⑴The median levels and standard deviation of HE4 and CAl25 were significantly higher in ovarian carcinoma group（320.2±210.6pmo L/L and 350.6±162.8k U/L,respectively） than those of the benign ovarian neoplasm group（52.8±12.6pmo L/L and 32.6±10.5k U/L,respectively） and female healthy control group（36.4±12.8pmo L/L and 21.4±8.2k U/L,respectively）（P0.01）. ⑵The ROMA cut-off point classifying patients into high and low risk groups was established as 11.4% in premenopausal and 29.9% in postmenopausal women. The diagnosis sensitivity,specificity,positive predictive value and negative predictive value in premenopausal patients were respectively 87.0%,83.8%,71.1% and 93.4%;and those of the postmenopausal group were 88.4%,81.3%,91.0%and 76.5%. Conclusions Determination of ROMA combined with HE4 and CAl25 in patients with ovarian cancer is helpful to improve the accuracy of diagnosis of ovarian cancer.

关 键 词：卵巢恶性肿瘤风险计算法 人附睾蛋白4 糖类抗原125 卵巢癌 

分 类 号：R711.75[医药卫生—妇产科学] R446.62[医药卫生—临床医学]