| Objective:Through the detection of serum CA125, HE4 levels,to explore the value of CA125 and HE4 alone and in combination detection in ovarian cancer and analysis whether there is a relationship between HE4 and pathological types and clinical stages of ovarian cancer; and further explore the value of ROMA in predicting the risk of ovarian cancer.Methods:Collection and statistics January 2014 October 2015 Jilin University First Hospital, admitted for surgical treatment of ovarian cancer patients(104 cases),ovarian benign disease patients(150cases),borderline ovarian tumor patients(19cases), to postoperative pathological diagnosis as "gold standard", the statistical Pro bed cases, were retrospectively analyzed. Electrochemiluminescence assay for the detection of serum CA125 concentration, enzyme linked immunoassay in the detection of HE4 levels, income data by SPSS 18.0 statistical analysis software to input, edit underwent statistical processing, each index were compared among the three groups have no difference.The results:1.The positive cases of CA125, HE4 and CA125+HE4 combined detection in ovarian cancer group were significantly higher than those in the benign lesion group and the borderline ovarian tumor group, the difference was statistically significant(P<0.05).The age of the three groups was compared, with statistical significance(P<0.05), in which the ovarian cancer group was older.2.The expression level of CA125 and HE4 in ovarian cancer group was significantly higher than that in benign ovarian disease group and borderline ovarian tumor group, and there was statistical significance(p<0.05).But there was no significant statistical significance(p>0.05) in the ovarian benign disease group and the borderline ovarian tumor group.3.The sensitivity of combined detection of serum CA125+HE4 combined detection was highest, and the specificity and accuracy of HE4 were highest;The consistency of Kappa and the Youden index of the serum HE4 alone test are better than that of the CA125+HE4 combined detection and CA125alone(HE4:Kappa=0.834, Youden index =0.819; CA125+HE4 combined detection: Kappa=0.665, Youden index =0.695; CA125:Kappa=0.631, Youden index =0.654).The best critical value of HE4 was 109.5PM, and the area under the ROC curve was the largest when the HE4 was set to this point, and the efficiency of the diagnosis of ovarian cancer was the highest.4.The expression of serum HE4 and was positively correlated with the expression of CA125 in ovarian cancer patients, rs=0.491, P<0.001.5.The expression level and positive rate of serum HE4 was correlated with the pathologic type of ovarian cancer.6.Serum CA125, HE4 expression level of III-IV period is higher than I-II in ovarian cancer patients, the difference was statistically significant(P<0.05).The positive rate of serum CA125+HE4 combined detection in patients with stage III-IV ovarian cancer was 100%, which was higher than that of CA125, HE4, and combined detection in any stage of ovarian cancer.7.In the epithelial ovarian cancer group and the benign ovarian disease group,the ROMA predictive index for the diagnosis of ovarian cancer was 95%,and the specificity was47.7% in non menopausal patients; The sensitivity and specificity of postmenopausal patients were 95.1% and 80%.Two groups of patients with the risk of the difference was statistically significant,X2=60.368,P=0.01.Conclusion:1.The value of serum HE4 in the diagnosis and differential diagnosis of ovarian cancer is high, and it can be used as a screening index for ovarian cancer.2.The level of serum HE4 was positively correlated with the level of CA125 expression, and the expression level of serum HE4 was related to the histological type and clinical stage of ovarian cancer.3.The combined detection of serum CA125+HE4 can improve the sensitivity of ovarian cancer and reduce the rate of missed diagnosis, but its diagnostic efficacy is limited.4.ROMA value can be used as a new assistant method to predict the risk of ovarian cancer. |
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