[1]邢瑞青,吴永昌,陈慧昱,等.血清CA125,HE4及ROMA指数对卵巢癌诊断价值的临床研究[J].现代检验医学杂志,2016,31(06):37-40，43.[doi:10.3969/j.issn.1671-7414.2016.06.010]
　XING Rui-qing,WU Yong-chang,CHEN Hui-yu,et al.Diagnostic Value of Serum CA125,HE4 and ROMA Index in Patients with Ovarian Cancer[J].Journal of Modern Laboratory Medicine,2016,31(06):37-40，43.[doi:10.3969/j.issn.1671-7414.2016.06.010]
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血清CA125,HE4及ROMA指数对卵巢癌诊断价值的临床研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第31卷
期数:
2016年06期
页码:
37-40，43
栏目:
论著
出版日期:
2016-12-20

文章信息/Info

Title:
Diagnostic Value of Serum CA125,HE4 and ROMA Index in Patients with Ovarian Cancer
作者:
邢瑞青; 吴永昌; 陈慧昱; 张小宁; 房艳; 秦爽; 彭道荣
第四军医大学附属西京医院临床实验研究所,西安 710032
Author(s):
XING Rui-qing; WU Yong-chang; CHEN Hui-yu; ZHANG Xiao-ning; FANG Yan;  QIN Shuang; PENG Dao-rong
Research institute of Clinical Laboratory Medicine of PLA, Xijing Hospital,Fourth Military Medical University,Xi'an 710032,China
关键词:
卵巢癌;  糖原125;  人附睾蛋白4;  卵巢恶性肿痛风险算法
分类号:
R737.31; R730.43
DOI:
10.3969/j.issn.1671-7414.2016.06.010
文献标志码:
A
摘要:
目的 探讨血清CA125,HE4及ROMA指数对卵巢癌临床诊断价值,提高绝经前、后卵巢癌诊断的准确率。方法 采用化学发光法对307例卵巢癌患者,271例卵巢囊肿患者和289例健康对照者进行血清CA125和HE4水平的检测,计算ROMA指数,并进行统计学分析。结果 ①卵巢癌组血清CA125,HE4水平和ROMA指数均较健康对照组和卵巢囊肿组显著升高,差异具有统计学意义(P<0.05)。②绝经前ROMA指数(Pre-ROMA)对卵巢癌诊断效能敏感度最高(100%),与CA125,HE4相比,差异具有统计学意义(χ2=10.69,P<0.05)。HE4的特异度和阳性预测值均为100%,与CA125,Pre-ROMA相比,差异具有统计学意义(χ2=19.74,11.05,P<0.05)。Pre-ROMA指数的阴性预测值(100%)高于HE4,差异有统计学意义(χ2=12.50,P<0.05)。③在绝经后卵巢癌诊断效能的比较中,CA125的敏感度和阴性预测值(92.77%和93.62%)高于HE4,差异均具有统计学意义(χ2=7.48,6.28,P<0.05)。HE4的特异度和阳性预测值(92.78%和90.41%)高于Post-ROMA,差异均具有统计学意义(χ2=7.34,6.05,P<0.05)。④以卵巢囊肿和正常对照组为参照,HE4和Pre-ROMA诊断绝经前卵巢癌的AUC分别为0.574和0.573,差异具有统计学意义(P<0.05),而CA125差异无统计学意义(P>0.05)。⑤以卵巢囊肿和正常对照组为参照,HE4,Post-ROMA和CA125诊断绝经后卵巢癌的AUC由大到小分别为0.677,0.665及0.641,差异均具有统计学意义(P<0.05)。结论 ①血清CA125对绝经后卵巢癌患者诊断具有更高的敏感度; ②血清HE4对绝经前和绝经后卵巢癌患者均具有很好的临床诊断效能; HE4对卵巢癌的诊断特异度较CA125更高; ③HE4和CA125联合检测,并计算ROMA指数对绝经前和绝经后卵巢癌患者均具有很好的临床诊断效能,可显著提高单项检测对绝经前卵巢癌的诊断敏感度和阴性预测价值。
Abstract:
Objective To investigate the diagnostic valueof serum CA125,HE4 and ROMA indexin patients with ovarian cancer in order to improve the accuracy of diagnosis of ovarian cancer.Methods HE4 and CA125 was detected by electrochemical luminescence immunoassay(ECUA)in307 ovarian cancer patients,271 ovarian cysts patients and 289 health controls.ROMA index were calculated for each selected women by the separated logistic regression algorithm based on the menopausal status.All data were analyzed statistically.Results ①Levels of CA125,HE4 and ROMA index were significently higher in ovarian cancer patients than those in ovarian cystspatients and health controls(P<0.05).②When these indexes were used to diagnize pre-ovarian cancer,the sensitivity(100%)and negative predicitive value(100%)of Pre-ROMA index was higher than CA125,HE4(χ2=10.69,12.50,P<0.05)while the spectivity(100%)and post predicitive value(100%)of HE4was higher than CA125,Pre-ROMA index(χ2=19.74,11.05,P<0.05).③When these indexes were used to diagnize post-ovarian cancer,the sensitivity(92.77%)and negative predicitive value(93.62%)of CA125 was higher than HE4(χ2=7.48,6.28,P<0.05)while the spectivity(92.78%)and post predicitive value(90.41%)of HE4 was higher than Post-ROMA index(χ2=7.34,6.05,P<0.05).④As the control of ovarian cysts patients and normal control group,the area under the receiver operating characteristic curve(ROC)ofHE4 and Pre-ROMA index were 0.574 and 0.573(P<0.05),but CA125 had nostatistically significent(P>0.05).⑤As the control of ovarian cysts patients and normal control group,the area under the receiver operating characteristic curve(ROC)of HE4,Post-ROMA and CA125 were 0.677,0.665 and 0.641(P<0.05).Conclusion ①The sensitivity of CA125 to the diagnosis of post-ovarian cancer was higher than that to the diagnosis of pre-ovarian cancer.②HE4 had good clinical diagnostic performance to pre-and post-ovarian cancer.Compared to CA125,the spectivity of HE4 was higher.③Detectionof HE4 combined CA125 and ROMA had good clinical diagnostic performance to pre-and post-ovarian cancer,especially they could increase the sensitivity and negative predicitive value of HE4 or CA125 alone to pre-ovarian cancer.

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备注/Memo

备注/Memo:
作者简介:邢瑞青(1982-),女,住院医师,主要从事临床免疫学检验及临床相关疾病的研究工作,E-mail:xrqing210b@163.com。 通讯作者:彭道荣(1962-),女,副主任技师,主要从事临床免疫学检验及临床相关疾病的研究工作,E-mail: myspdr@fmmu.edu.cn。
更新日期/Last Update: 2016-12-20