The Study Of CA125、HE4and ROMA Algorithm In The Diagnosis Of Ovarian Tumor

Objective: Because ovarian cancer is often discovered late, the prognosis is poor, so farnot an accurate method for early screening, and proper surgical staging of ovarian cancerpatients is essential. So to have an effective prediction of benign and malignant ovariantumors is very important. Currently in clinical practice, the determination of ovarian tumormarkers is important for clinicians to assess ovarian cancer risk, the present study was toinvestigate the serum tumor marker CA125, HE4, ROMA value for the differential diagnosisof ovarian tumors.Methods:1. Included in the object:94cases of primary ovarian cancer from January2011toNovember2014during our hospital,97cases of patients with ovarian tumor,103cases ofpatients with borderline ovarian tumors and44cases of healthy subjects to the hospitalexamination. Each object included fasting serum collection, HE4and CA125levelDepartment of Obstetrics and Gynecology hospital by enzyme-linked immunosorbent assay(ELISA) method measured. Compare CA125, HE4, ROMA value for differential diagnosis ofbenign and malignant ovarian tumors of whether the differences. According to the pathologyreport after paraffin group patients were divided into benign ovarian tumors、 normal controlgroup、the border ovarian tumors and ovarian cancer patients. The International Federation ofGynecology and Ostetrics (FIGO) criteria for cancer group were used to classify the patients.Higher serum HE4150pmol/L, CA125higher than35U/ml as positive. The CA125, HE4value into ovarian cancer risk assessment software was ROMA index. Application SPSS17.0statistical software for statistical analysis.Results:(1)The median levels of serum HE4， CA125and ROMA index in the group ofbenignovarian tumors and normal control group were in the normal range. Pairwise comparisons,ovarian cancer group median level of HE4, CA125median level, ROMA index weresignificantly higher than the median benign ovarian tumor group, borderline tumors andnormal control group, the difference was statistically significance (P=0.000), median levels of HE4borderline tumors of the group, CA125median level, the median water ROMA indexwere significantly higher than benign group, the differences were statistically significant (P<0.05). Benign group median levels of HE4, CA125median level, the difference in medianlevels of the healthy control group was not statistically significant ROMA Index ((P>0.05)).(2) As a reference to the benign group,the sensitivity and negative predictive value ofROMA index were highest（88.29%and93.64%)，The difference was statistically significant(P<0.001)，the specificity and positive predictive value and accuracy of HE4were highest(95.97%、88.29%)(P<0.001)，The difference was statistically significant(P<0.001)．(3) In the32patients in stage Ⅰ, ROMA positive rate of71.9%, significantly higherthan the HE4and CA125(positive rates were12.5%and53.1%), the difference wasstatistically significant (P <0.001). Borderline ovarian tumor group, the positive rate ofROMA was48.5%, and significantly higher than the HE4and CA125(positive rate of5.8%and36.9%), the differences were statistically significant (P <0.001).(4) The positive rate of ROMA index and age were significantly associated (P valueswere <0.05), but the positive rate of ROMA index and menopausal tatus、pathologicalcharacteristics of patients (preoperative lymph node, ascites transfer status) was nosignificant correlation (P values were>005);. HE4the positive rate of patients withmenopausal status, and lymph node metastasis was significantly associated (P values were<0.05), but not with ascites whether the transfer was no significant correlation (P valueswere>0.05); the positive rate of CA125with age and the presence of ascites carcinoma wassignificantly associated (P values were <0.05), but not with menopausal status, lymph nodemetastasis was no significant correlation (P values were>0.05). The positive rate of CA125、HE4and ROMA index in epithelial ovarian cancer patients were statis-tically higher thannon-epithelial ovarian cancer patients．(5)As the control of benign ovarian tumor and normal control group, the area under thereceiver operating characteristic curve(ROC) of HE4, CA125and the ROMA index were0.872(95%CI为0.824~0.919, P=0.000),0.854(95%CI为0.802~0.907, P=0.000).0.886(95%CI为0.840~0.931, P=0.000).Conclusion: Compared with CA125and HE4, ROMA in the evaluation of patientssuffering from ovarian cancer risk, has better clinical value. The positive rate of CA125、HE4and ROMA index in epithelial ovarian cancer patients were statis-tically higher thannon-epithelial ovarian cancer patients. HE4is better than CA125in the evaluation of patientssuffering from ovarian cancer risk, while borderline tumors prediction, ROMA reflects betterpredictive value. Serum combination of HE4, CA125testing and the ROMA indexcalculation helps assess the risk of ovarian cancer，early diagno-sis and improve the five yearsurvivals of ovarian cancer.