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

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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 CA 125,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 HE 4 and CA125.By using the ROC analysis ,the AUC for CA125,HE4, ROMA were 0.832,0.888,0.960,respectively,AUC(CA125)
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