血清人附睾蛋白4、糖类抗原125和卵巢恶性肿瘤风险模型对卵巢癌鉴别诊断的比较  

Comparison of the clinical significance of serum HE4,CA125 and ROMA in the differential diagnosis of ovarian tumor

作　　者：曹生亚[1] 李佳[2] 杨洪鹏[1] 顾锋[1] 赵峰[2] 张旭光[3] Cao Shengya;Li Jia;Yang Hongpeng;Gu Feng;Zhao Feng;Zhang Xuguang(Department of Clinical Laboratory,Xuzhou Cancer Hospital,Xuzhou,Jiangsu 221005,China;Department of Medical Oncology,Xuzhou Cancer Hospital,Xuzhou,Jiangsu 221005,China;Department of Radiotherapy,Xuzhou Cancer Hospital,Xuzhou,Jiangsu 221005,China)

机构地区：[1]徐州市肿瘤医院检验科,江苏省221005 [2]徐州市肿瘤医院肿瘤内科,江苏省221005 [3]徐州市肿瘤医院放疗科,江苏省221005

出　　处：《中国基层医药》2020年第1期11-14,共4页Chinese Journal of Primary Medicine and Pharmacy

基　　金：江苏省徐州市科技局社会发展项目(KC16SH101)。

摘　　要：目的评价人附睾蛋白4(HE4)、糖类抗原125(CA125)和卵巢恶性肿瘤风险模型(ROMA)在卵巢癌鉴别诊断中的应用价值。方法选取徐州市肿瘤医院2016年5月至2017年10月收治的卵巢肿瘤患者240例,根据术后病理结果将卵巢肿瘤患者分为两组,其中卵巢癌组120例,卵巢良性肿瘤组120例(良性组);选取同期该院体检中心体检的健康女性100名作为对照组。电化学发光法检测三组受试者血清HE4和CA125浓度,并计算ROMA,统计分析CA125、HE4、ROMA对卵巢癌的诊断性能。结果卵巢癌组CA125、HE4、ROMA依次为(370.9±213.2)U/mL、(364.4±227.0)pmpl/L、(80.2±26.1)%,与良性组及对照组相比,卵巢癌组均高于良性组和对照组(均P<0.01),良性组与对照组相比三项指标均差异无统计学意义(P=0.356,P=0.321,P=0.292);ROMA的灵敏度、特异度、阳性预测值、阴性预测值、准确度均高于HE4和CA125,HE4的特异度、阳性预测值、阴性预测值、准确度均高于CA125,CA125灵敏度高于HE4;应用受试者工作特征曲线分析三项指标对卵巢癌的诊断价值,CA125、HE4、ROMA的曲线下面积分别为0.832、0.888、0.960。结论CA125、HE4在卵巢癌鉴别诊断中具有重要价值,而ROMA诊断性能优于HE4、CA125,在卵巢癌诊断中具有更高的应用价值。Objective To compare the clinical significance of human epididymis protein 4(HE4),CA125,ROMA in the differential diagnosis of ovarian cancer.Methods From May 2016 to October 2017,240 patients with ovarian tumor in Xuzhou Cancer Hospital were selected.According to the result of postoperative pathology,the patients were divided into benign ovarian disease group(n=120)and ovarian cancer group(n=120).And 100 healthy women from medical examination center were selected as control group.The electrochemiluminescence(ECLIA)technique was used to assess the serum levels of CA125,HE4,and ROMA was calculated.The clinical significance of HE4,CA125,ROMA in the differential diagnosis of ovarian cancer was analyzed by statistic methods.Results The CA125,HE4 concentrations and ROMA in the ovarian cancer group[(370.9±213.2)U/mL,(364.4±227.0)pmpl/L,(80.2±26.1)%]were higher than those in the benign ovarian disease group and the health control group(all P<0.01),there were no statistically significant differences between the benign ovarian disease group and the healthy control group(P=0.356,P=0.321,P=0.292).The sensitivity,specificity,positive and negative predictive values,accuracy of ROMA were higher than those of HE4 and CA125.By using the ROC analysis,the AUC for CA125,HE4,ROMA were 0.832,0.888,0.960,respectively,AUC(CA125)<AUC(HE4)<AUC(ROMA).Conclusion CA125 and HE4 have important value in the diagnosis of ovarian cancer,but the ROMA shows the best diagnostic performance and actual value.

关 键 词：卵巢肿瘤 CA-125抗原 人附睾蛋白4 ROC曲线 诊断 鉴别 卵巢恶性肿瘤风险模型 

分 类 号：R737[医药卫生—肿瘤]