Clinical Significance Of Combined Serum Human Epididymis Secretory Protein4and CA125Assay In Ovarian Cancer

Objective：To explore clinical significance of combined or separate Serum HumanEpididymis Secretory Protein4and CA125assay in detecting ovarian cancer.Methods：1. HE4and CA125levels were decteted in serum samples of50cases withovarian malignant tumors(in ovarian malignant tumors group),40cases with benignovarian diseases(in ovarian benignd iseases group) and20healthy women(in controlgroup) by CobasR6000full-automation electrochemiluminescence immunoassay(ECLIA).2. To compare the sensitivity and specificity of combined or separate serumHE4、CA125for diagnosing ovarian cancer. To explore whether it is beneficial forthe detection ovarian cancer by combining serum HE4and CA1253.23patients were included in this study according to the inclusion criteria(finished a satisfied cytoreductive surgery and completed6-8cycles of standardizedchemotherapy). Preoperative and post-chemotherapy serum HE4and CA125leverswere detected to analyze whether it can provide some clue for the therapeuticevaluation, surveillance and prognosis of ovarian cancer by serum HE4or combinedto CA125.4. These23selected patients were followed-up in outpatient department toobserve whether the cancer relapsed (relapse were confirmed by pathology or met therecurrence criteria of ovarian cancer) and their serum HE4and CA125levels weredetected every three months. To explore the clinical significance of HE4or combinedto CA125in the surveillance of ovarian cancer.5.The data were analyzed by SPSS13.0software.Results：1. Serum HE4and CA125levels in ovarian malignant group were significantlyhigher than that in the benign group and normal control group, the difference was statistically significant(P<0.05), while there was no statistical significance betweenthe benign group and normal control group. The Serum HE4and CA125levels werealso correlated with the patients’ age, staging, lymph node metastasis status andtumor size.2. The sensitivity、 negative predictive values and youden index of combineddetection of serum HE4and CA125for diagnosing ovarian cancer is96.0％、94.9％and0.912, which are higher than that of using either of them（P＜0.05）.3.The HE4and CA125levels of the23selected patients decreased to normalafter operation and chemotherapy. The pre-operative median value of HE4was354.16pmol/L, which decreased to73.26pmol/L after the second cycle chemotherapy.While the pre-operative median value of CA125was103.70U/L, and declined to15.2U/L after the fifth chemotherapy. The pre-operative median value of HE4andCA125were higher than that of post-operative and post-chemotherapy, and thedifference was statistically significant (P<0.05). The correlation coefficient betweenHE4and CA125was0.832, which indicates a strong correlation.4. There are2patients are recurrence. in23patients of Ovary Malignant Tumor, theirserum HE4、CA125are rising, but CA125is detectioned later a month than HE4.SerumHE4、CA125of3case Ovary Malignant Tumor in no recurrence patients are rising,2patientsthat their serum CA125are rising are pelvic cavity or inflammatory mass, and imagingdiagnosis confirms no recurrence, and their HE4、CA125are reduced to normal after betreated by anti-inflammation..Conclusions：1. Combining detection of Serum HE4、 CA125can significantly improve thesensitivity and youden index of detecting ovarian cancer; It may be usefull to thediagnosis of early-stage ovrian cancer by comprehensively analyzing the expressionsboth HE4、CA125level.2. Serum HE4or combined to CA125can be useful serum markers fortherapeutic evaluation and prognostic assessment of ovarian cancer. It is also can beused as a follow-up index and may provide some evidence for predicting recurrencerisk for ovarian cancer.