Diagnostic Value Of The Combination Detection Of Human Epididymal Protein And Carbohydrate Antigen 125 On The Ovarian Epithelial Malignant Tumor

Objective:Through the detection of epithelial ovarian malignant tumor group,non-epithelial ovarian malignant tumors,ovarian benign tumor and healthy crowd control serum human epididymis protein 4(human epididymis protein 4),CA125(carbohydrate antigen 125)levels,and on the basis of the values of serum human epididymis protein 4(HE4)and carbohydrate antigen 125(CA125),the ovarian malignant tumor risk prediction probability(PP)has been calculated by the model prediction(ROMA).The diagnosis significance of ovarian epithelial malignant tumor has been discussed by the study of the relationship of serum human epididymis protein 4(HE4),carbohydrate antigen 125(CA125)and ovarian malignant tumor risk prediction model(ROMA).Methods:In this study,286 hospital patients have been selected as the research objects.These patients are hospitalized in LiaoNing province tumor hospital in September2016 to August 2017.Among them,139 patients are diagnosed with ovarian malignant epithelial tumors,their age range are 23 to 76,mean age is 57.2±0.3 years old.18 patients are diagnosed with ovarian borderline epithelial neoplasms,Their age range are 22 to 76,mean age is 44.2±0.7 years old.;90 patients are diagnosed with benign ovarian tumors,Their age range are 20 to 90,mean age is 50.0±0.8 years old.All patients are treated for the first time.No chemotherapy or special treatment has been performed before operation.Routine examination has been performed in the hospital,and the postoperative pathological diagnosis was the final gold standard.There are 39 uterine fibroids patients in the control group,their age range are 28 to 69,mean age is 47.3±0.5 years old.The clinical has the perfect auxiliary examination including imaging markers and serological detection.The clinical has ruled out ovarian lesions.These people are hospitalized just because of uterine leiomyomaBy the method of enzyme-linked immunosorbent(ELISA)and micro particle chemiluminescence method,the levels of erum human epididymis protein 4(HE4),carbohydrate antigen 125(CA125)have been detected through the analysis of ovarian malignant epithelial neoplasm group,border oarian epithelial tumors,ovarian benign tumor group and uterine fibroids in the control group.The normal range of HE4 protein is 0-70pmol/L and 0-140pmol/L respectively before and after menopause,and the normal range of CA125 protein is 0-35u/ml.The test results were in the median form and higher than the reference value.SPSS is used for data analysis to compare the differences between HE4 and CA125 protein expression in each group.In addition,according to the patient's menstrual,ROMA index has been calculated.The significance of diagnosis of ovarian malignant epithelial tumors has been discussed by the study of the relationship of serum human epididymis protein 4(HE4),carbohydrate antigen 125(CA125)and ovarian malignant tumor risk prediction modelResults:1.The level of HE4(human epididymal protein 4)in each group:the median of the ovarian malignant epithelial tumor group was 326.95pmol/L and 473.20pmol/L respectively,before and after menopause.In the ovarian borderline epithelial tumor group,the median premenopausal and postmenopausal median was 75.5 pmol/L and 49.90pmol/L respectively.In the benign tumor group of the ovary,the median premenopausal and postmenopausal median was 44.00pmol/L and 3 5.20pmol/L respectively.In the control group of uterine leiomyoma,the median premenopausal and postmenopausal median was 39.30pmol/L and 35.95 pmol/L respectively.Statistical analysis results showed that HE4(human epididymis protein 4)expression level is higher in ovarian malignant epithelial neoplasm group than in the border oarian epithelial tumors group,ovarian benign tumor group and uterine fibroids in the control group,the difference has statistical significance(P<0.05);There was no statistical difference in the control group of ovarian borderline epithelial tumor group,benign ovarian tumor group and uterine leiomyoma(P>0.05).2.CA125 level:In the ovarian malignant epithelial tumor group,the median pre-menopausal and postmenopausal,the medians were 760.25 U/ml,1000.00 U/ml respectively.The postmenopausal median of the ovarian borderline epithelial tumor group were 26.25U/ml and 121.85 U/ml respectively.In the benign ovarian cancer group,the premenopausal and postmenopausal median were 11.50 U/ml and 37.4U/ml respectively.In the control group of uterine leiomyoma,the premenopausal and postmenopausal median were 9.50U/ml and 15.95 U/ml respectively.Statistical analysis results show that:CA125(carbohydrate antigen 125)expression level was higher in ovarian malignant epithelial tumor group than in the border oarian epithelial tumors,ovarian benign tumor group and uterine fibroids controls,the difference has statistical significance(P<0.05).CA125(carbohydrate antigen 125)expression level was higher in borderline ovarian tumors group and the ovary benign tumor group than in the uterine leiomyoma control group,the difference has statistical significance(P<0.05)?3.The antigen positive rate of HE4(human epididymis protein 4)and CA125(carbohydrate antigen 125)in the uterine leiomyoma control group was higher in premenopausal group than the group after menopause.The levels of HE4(human epididymis protein 4),CA125(carbohydrate antigen 125)of the ovarian malignant epithelial neoplasm group were higher in premenopausal than in postmenopausal,the difference has statistical significance(P>0.05);ROMA positive detection rate was smaller in premenopausal than in postmenopausal,the difference has statistical significance(P>0.05).4.The sensitivities to diagnose ovarian malignant epithelial tumors of HE4 in postmenopausal group(human epididymis protein 4),CA125(carbohydrate antigen 125),ROMA are 71.15%,93.26%and 71.15%respectively,the sensitivity of specific degree are 96.77%,75.81%and 77.42%respectively.PPV are 97.37%,86.61%and 87.27%respectively.NPV are 66.67%,87.04%and 85.71%respectively.Youden index are 0.68,0.69 and 0.70.The sensitivities to diagnose ovarian malignant epithelial tumors of HE4(human epididymis protein 4)in the premenopausal group,CA125(carbohydrate antigen 125),ROMA are 85.71%,100%and 91.43%respectively;the sensitivity of specific degree are 100%,67.16%and 95.52%respectively;PPV are 100%,61.40%and 91.43%respectively.NPV are 93.06%,100%and 95.52%;Youden index are 0.86,0.67 and 0.87 respectively.5.The area under the ROC curve(AUC)of ROMA,HE4 and carbohydrate antigen 125(CA125)were 0.947,0.937,0.913 in postmenopausal group respectively and 0.937,0.935,0.926 in premenopausal group.Compared HE4 with carbohydrate antigen 125(CA125)in premenopausal group and postmenopausal group,P>0.05,the difference has not statistical significance.Compared ROMA with serum human epididymal protein 4(HE4),P=0.29(P>0.05),the difference has not statistical significance.Compared HE4 with carbohydrate antigen 125(CA125),P<0.05,the difference has statistical significance.Compared ROMA with carbohydrate antigen 125(CA125),P<0.05,the difference has statistical significance.Conclusion:1.The combined detection of serum human epididymis 4(HE4)and carbohydrate antigen 125(CA125)can be used as the basis for differential diagnosis of ovanan malignant epithelial neoplasm.2.HE4 has the value of diagnosing ovarian malignant epithelial neoplasm,and its specificity is superior to that of carbohydrate antigen 125(CA125).However,the value of its single item detection in benign and malignant differential diagnosis of ovarian tumor is not superior to that of carbohydrate antigen 125(CA125).3.The ROMA model of serum human epididymal protein 4(HE4)combined with carbohydrate antigen 125(CA125)is superior to the diagnosis of ovarian malignant epithelial tumors than HE4 and carbohydrate antigen 125(CA125)single test.