Detection And Clinical Significance Of Serum CA125,HE4 And Roma In Endometrial Carcinoma

Objective:To investigate the diagnostic value of carbohydrate antigen 125(CA125),human epididymis protein(HE4),and risk of ovarian malignancy algorithm(ROMA)in endometrial carcinoma.To analyze the relationship of serum CA125,HE4 and ROMA with the clinicalopathological parameters of endometrial carcinoma,and to guide the preoperative evaluation of endometrial carcinoma.Methods:142 cases of endometrial carcinoma confirmed by pathology test were include as the experimental group whereas 100 cases of endometrial polyps were randomly selected as the control group.They were both from selected from the admissions,to the First Affiliated Hospital of Dalian Medical University from January 2016 to November2018.There was no significant difference between the experimental group and the control group.The levels of serum CA125 and HE4 in the experimental group and the control group were detected by chemiluminescence immunoassay.The ROMA was calculated by combining the menopausal status with CA125 and HE4.The diagnostic value of serum CA125,HE4 and ROMA in endometrial carcinoma was analyzed.The relationship between serum CA125,HE4 and ROMA and clinicalopathological parameters of endometrial carcinoma was also analyzed.The statistical analysis software(SPSS version 22.0)was used for data analysis and the statistical significance was assumed when P<0.05.Results:1.The levels of serum CA125,HE4 and ROMA in the experimental group weresignificantly higher than those in the control group(P<0.05).The area under the curve of the ROMA,serum CA125 and HE4 was 0.804,0.725 and 0.750.The cut-off value of serum CA125 and HE4 was 13.33 U/ml and 75.35 pmol/L,respectively.The cut-off value of pre-menopausal ROMA(LMZS-Q)and post-menopausal ROMA(LMZS-H)was 10.65% and 16.62%,respectively.CA125≥13.33U/ml,HE4≥75.35pmol/L,LMZS-Q≥10.65%,LMZS-H≥16.62% were considered positive.While the sensitivity of CA125,HE4 and ROMA for diagnosis of endometrial carcinoma was 71.12%,49.30% and 66.20%,respectively,the specificity was 65.00%,93.00% and 88.00%,respectively.Their diagnostic coincidence rates were 68.60%,67.36%,and 75.21%,respectively.The diagnostic value of the ROMA is higher than the single detection of serum CA125 and HE4.2.The level of serum CA125 was correlated with the depth of myometrial invasion and FIGO stage(P<0.05).The level of serum HE4 was associated with depth of myometrial invasion and cervical mesenchyme infiltration(P<0.05).ROMA was associated with the depth of myometrial invasion,cervical mesenchyme infiltration and FIGO stage(P<0.05),but there was no significant correlation with pathological grade,lymph node metastasis and pathological type(P>0.05).Also,ROMA is better than serum CA125 and HE4 in predicting myometrial invasion.We found that the cut-off value of the ROMA for deep myometrial invasion was 21.75%,the area under the curve was 0.724,the sensitivity was 80.00%,and the specificity was 63.20%.In terms of cervical mesenchyme infiltration,ROMA had an area under the curve,a sensitivity and sensitivity of 0.719,81.81%,34.35%,respectively,compared with their respective counterparts for HE4 of 0.760,81.81% and 53.44%.The ROMA was not as good as HE4 in evaluating cervical mesenchyme infiltration.3.Compared with MRI,there was no significant difference between ROMA and MRI in predicting pathological stage,depth of myometrial invasion,cervical mesenchyme infiltration and lymph node metastasis of endometrial carcinoma(P<0.05).Conclusions:1.The diagnostic value of ovarian malignancy algorithm(ROMA)in endometrialcarcinoma is superior to that of serum HE4 and CA125.2.ROMA is related to myometrial invasion,cervical mesenchyme infiltration,and FIGO staging,and ROMA is superior to serum HE4 and CA125 in predicting myometrial invasion.In terms of cervical mesenchyme infiltration,HE4 has an advantage over the ROMA.3.There was no significant difference between ROMA and MRI in predicting pathological stage,depth of myometrial invasion,cervical mesenchyme infiltration and lymph node metastasis of endometrial carcinoma,the preoperative evaluation ability of the ROMA is not lower than MRI.