| BackgroundThe incidence of ovarian cancer is the third in the gynecologic tumor after cervical cancer and uterine cancer, but it’s fatality rate is at the first.One of the most common ovarian cancer is epithelial cancer (epithelial ovarian cancer, EOC),85%-90% of ovarian cancer is EOC. More than 70% of the patients is too late to see a doctor because the ovaries is located in depth of pelvic, it’s early symptoms is hidden and the early diagnosis is difficult. Most of the early detection of ovarian cancer after surgery and chemotherapy can be cured or completely remitted and the 5-year survival rate can reach 90%.But the five years of survival rate is only 20% in patients with advanced ovarian cancer.According to World Health Organization(WHO) data, the prevention of ovarian cancer disease is feasible with screeningand diagnostic approaches. Regards to National Institutes of Health (NIH), screening test is just recommended for women at high risk to disease because family history have important role in severity of disease. It’s a great challenge to select a reliable and possible screening test for ovarian cancer. So early it is important to find a efficient screening test for ovarian cancer for patients with ovarian cancer, so they can be diagnosed and treated in the early stage. ObjectivesTo explore human epididymis protein 4 (HE4), lysophosphatide acid (LPA) and carbohydrate antigen 125 (CA125) detection alone and combined detection in the diagnosis of ovarian epithelial carcinoma.Methodsl.A total of 85 cases which consist of 35 cases (epithelial ovarian cancer group),30 cases(ovarian benign tumor group), and 20 cases (medical healthy women group) as normal control subjects at the same period, were enrolled in this prospective study.And all cases are in accordance with the criteria from January 2013 to February 2014 in the first affiliated hospital of Xinxiang Medical College. The level of HE4 was measured by enzyme-linked immunosorbent assay,the serum level of CA125 was measured by chemiluminescence analysis system, while plasma LPA was measured by biochemical method. to analysis the expression level in epithelial ovarian cancer group、ovarian benign tumor group and medical healthy women group,in Ⅰ～Ⅱ、Ⅲ～IVof EOC and between the different pathological types of EOC.2. Take the benign tumor group and healthy group as control group, make the receiver operator characteristic, and calculate the area under the curve.And to determine the diagnostic value point of the ovarian epithelial carcinoma of the serum HE4,plasma LPA and serum CA125.3. Take the pathological diagnosis as golden standard, to draw four tables.At last, compare sensitivity、specificity、odd product of three indicators alone detection and combined detection of three indicators in epithelial ovarian cancer.4. All statistical daters were analyzed by Spssl9.0 statistical software package.Results1.Compared with benign tumor group and the healthy group, the levels of HE4 CA125 and LPA were significantly high in ovarian cancer group(P<0.05),and there was no statistically differences between the benign tumor group and healthy group (P> 0.05);2.The levels of HE4、CA125 and LPA in Ⅰ～Ⅱ pathological grade of ovarian cancer was significantly high compared with Ⅲ～Ⅳpathological grade,the difference was statistic-ally significant (P< 0.05);3. Compared with mucous ovarian cancer group, the level of serum HE4 was significantly high in cystadenocarcinoma group and endometrial carcinoma group (P< 0.05), whie there was no statistically significant difference between cystadenocarcinoma group and endometrial carcinoma group;The levels of serumCA125 in cystadenocarcinoma was significantly higher than the other two types of ovarian cancer, the difference was statistically significant (P< 0.05);The levels of plasma LPA in the three types of ovarian cancer were no statistically significant difference (P> 0.05).4. The area under the ROC curve (AUC) of HE4、CA125、LPA and combined to diagnose epithelial ovarian carcinoma were:0.886,0.907,0.832,0.907; Yueden index were 74.9%、56.0%、69.4%、77.1%.The best value point of HE4、CA125、LPA and combined detection of epithelial ovarian carcinoma were 153.3pmol·L-1、2.748μmol·L-1、33.48×103 U·L-1, which were the biggest value point of diagnostic value.5. The sensitivity of HE4、CA125、LPA alone and combined to diagnose epithelial ovarian carcinoma were:82.9% (29/35),80.0% (28/35),91.4% (32/35),97.1% (34/35), the specific were:92.0% (45/50),76.0% (38/50),78.0% (39/50),80% (40/50), the most odd product were 35.45,12.67,21.27,96.77.6. The sensitivity of HE4、CA125、LPA alone and combined to diagnose early epithelial ovarian carcinoma were 72.2% (13/18)、66.7%(12/18)、77.8%(14/18)、 94.4%(17/35) and the specificity were 88.0%(44/50)、76.0%(38/50)、78.0%(39/50)、 74%(37/50), the most odd product were 19.1、6.3、12.4、43.4. Conclusions 1.The combination of the HE4、CA125 and LPA is an effective method to detect EOC,and it can improve the diagnosis efficiency for ovarian carcinoma. |
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