Serum HE4and CA125and YKL40Clinical Value Of Combined Detection In Epithelial Ovarian Cancer Diagnosis

Objective:By using enzyme-linked immunoassay (ELISA) to detect serum HE4and CA125and YKL40in the normal control group, patients with benignovarian epithelial tumors, ovarian epithelial carcinoma patients expression level,discusses the three markers detection alone and in combination in ovarianepithelial carcinoma clinical value in diagnosis and prognosis.Methods:1.Collected in Shanxi Province tumor hospital confirmed bypathological diagnosis of40cases of epithelial ovarian cancer patients and40cases of ovarian benign tumor patients with preoperative serum and in the sameperiod in Shanxi Province tumor hospital physical examination center of40cases of healthy women serum.Using enzyme-linked immunoassay (ELISA) todetect serum HE4and CA125and YKL40level, the level of analysis andcomparison between groups of three indicators and epithelial ovarian cancer inthe group stage Ⅰ/Ⅱ and Ⅲ/Ⅳ between the level of each index, and toobserve the epithelial ovarian cancer patients in group three indicators of levelchanges before and after operation.2.In healthy group and epithelial ovarian benign tumor generally used as areference, analysis of HE4and CA125and YKL40the ability of diagnosis ofovarian cancer, to determine the serum HE4and CA125and YKL40best boundvalues.3.To compare serum HE4and CA125and YKL40-the sensitivity of the singleor combined detection of epithelial ovarian cancer.4. All statistical analyses were performed with SPSS13.0statistical softwarepackage.Results:1.Serum YKL40-in the normal control group, patients with benignovarian epithelial tumors, ovarian epithelial carcinoma in patients with mean concentrations were35.53ng/ml,43.85ng/ml,106.14ng/ml, the mean differencesbetween groups of HE4concentration were44.16pmol/, pmol/81.81L and81.81L pmol/L, the mean differences between groups of CA125concentrationwere24.21U/ml,62.75U/ml,242.03U/ml. Healthy controls, the epitheliumbenign ovarian tumor and epithelial ovarian cancer groups in the serum HE4and CA125and YKL40expression level comparison: three groups of serumHE4and CA125and YKL40difference had statistical significance (p <0.001),epithelial ovarian cancer group, the expression level of the three markers inserum were significantly higher than the healthy group and benign group,further LSD multiple comparisons-t, HE4and CA125and YKL40in theexpression level of ovarian epithelial carcinoma group were higher than othertwo groups (p <0.05), HE4and CA125in epithelial sex expression level inbenign ovarian tumor groups were higher than healthy controls (p <0.05), YKL40in epithelium benign ovarian tumor group and healthy controls theexpression level of no statistical significance (p>0.05) difference. And epithelialovarian cancer group were Ⅰ/Ⅱ with Ⅲ/Ⅳ midterm serum HE4and CA125and YKL40-the expression level of comparison: the level of serum HE4Ⅰ/Ⅱcompared with Ⅲ/Ⅳ difference was statistically significant (t﹦7.833, P <0.001), serum CA125level in Ⅰ/Ⅱ compared with Ⅲ/Ⅳ difference wasstatistically significant (t﹦12.98, P <0.001), the level of serum YKL40-Ⅰ/Ⅱcompared with Ⅲ/Ⅳ difference was statistically significant (t﹦6.786, P <6.786).2.Epithelial ovarian cancer group before and after the surgery, the expression ofserum HE4and CA125and YKL40horizontal comparison: serum HE4andCA125before and after operation and YKL40expression level difference hadstatistical significance (p <0.05), after the operation, the expression of serumHE4and CA125and YKL40levels are lower than before the operation.3.To the normal control group and benign ovarian tumor groups for reference,draw respectively HE4and CA125and YKL40ROC curve, in (sensitivity andspecificity)-1maximize value for the best value. Ovarian cancer patients serum HE4and CA125and YKL40best point, according to the ROC curve Youdenindex, can be HE4and CA125and YKL40-the best point of103.5,95.6,59.975,respectively. The diagnostic value of at this point they are the largest.4.HE4and CA125in serum and YKL40points on their best bound value as apositive reference value range, namely HE4concentration is greater than103.5pmol/L diagnosed as positive, CA125concentrations greater than95.6U/mLdiagnosed as positive, YKL40concentration is greater than59.975ng/mL whendiagnosed with positive, alone or combined detection of serum HE4and CA125and YKL40level to evaluate the effect of diagnosis of epithelial ovarian cancer.5.Epithelial ovarian cancer patients serum HE4and CA125sensitivity, specificand YKL40degrees of comparison: the three indicators combined detectionsensitivity is higher than the single index, specific degrees lower than that ofsingle index, the sensitivity of HE4and speciality degree were better.Conclusions:1.Epithelial ovarian cancer patients serum HE4and CA125andYKL40epithelial benign tumor group were significantly higher than the leveland the level of healthy controls, however, HE4and CA125in epithelial sexualexpression level in benign ovarian tumor group were higher than that of healthycontrols, and YKL40-in epithelium benign ovarian tumor group and healthycontrol group there was no statistically significant difference expression level,prompt YKL40-may become a marker of ovarian cancer screening.2.Epithelial ovarian cancer patients before and after treatment serum HE4andCA125and YKL40comparison: the level of serum HE4postoperatively inpatients with ovarian cancer, the levels of CA125and YKL40significantly belowthe level of preoperative, difference is statistically significant. Hint of epithelialovarian cancer patients with preoperative serum HE4and CA125and YKL40levels are expected to be ovarian cancer screening markers, play an importantrole in ovarian cancer screening, so can help the diagnosis of ovarian cancer;Epithelial ovarian cancer patients with postoperative serum HE4and CA125and YKL40levels may be ovarian cancer diagnosis, and clinical curative effect of surgery postoperative condition monitoring of promising indicators.3.Ovarian cancer patients serum HE4and CA125and YKL40detectionsensitivity were92.5%,90%and82.5%, specificity of93.8%,95%and95%,respectively, three indicators of joint detection sensitivity and specificity of97.5%and85%, three indicators of joint detection sensitivity is higher thansingle detection, specific degrees lower than that of single index, and thesensitivity of HE4and speciality degree were better. Prompt combined detectionof HE4and CA125and YKL40can improve the diagnosis of ovarian cancer,and serum HE4has important significance in the diagnosis of ovarian cancer.