HE4、CA125及ROMA指数在早期浆液性卵巢癌诊断中的价值
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摘要
[目的]探讨HE4、CA125及ROMA指数在早期浆液性卵巢癌中的诊断价值。[方法]回顾性分析2013年7月至2015年6月期间于新疆医科大学第三附属医院初治的术后诊断为原发性浆液性卵巢癌(卵巢癌组)103例、卵巢子宫内膜异位症患者135例和单纯性囊肿患者119例的病历资料,分析术前血清HE4、CA125水平及ROMA指数对早期浆液性卵巢癌的诊断价值。[结果](1)HE4和ROMA指数的阳性率随着临床分期的升高而升高,其在Ⅰ期的阳性率为68%和88%,均低于CA125的阳性率(92%)。(2)三者在早期卵巢癌中的阳性率明显高于在卵巢良性疾病中的阳性率(P<0.01)。(3)HE4+ROMA指数联合特异性,阳性预测值、阴性预测值和诊断准确度率最高。[结论 ]HE4+ROMA指数联合检测提高早期浆液性卵巢癌诊断的敏感度,降低漏诊率,有助于卵巢癌的早期诊断。
引文
[1]Xie X,Gou WL.Obstetrics and Gynecology[M].Beijing:People’s Medical Publishing House,2015.326-328.[谢幸,苟文丽.妇产科学[M].北京:人民卫生出版社,2015.326-328.]
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[3]Cristina A,Filomena M C,EIci I,et al.A comparison of CAl25,HE4,ROMA,and risk malignancy index(RMI)for the classification of ovarian masses[J].Clinics,2012,67(5):437-441.
[4]Kadija S,Stefanovic A,Jeremic K,et al.The utility of HE4,CA125,and ROMA in ovarian cancer and endometriosis[J].Int J Gynecol Cancer,2012,22(2):238-244.
[5]Bao JY,Zhang WJ.Clinical application of CA125 in malignant tumor[J].Journal of Practical Oncology,2013,27(2):181-184.[包金英,张文杰,CA125在恶性肿瘤中的临床应用[J].实用肿瘤杂志,2013,27(2):181-184.]
[6]Havrilesky LJ,Whitehead CM,Rubatt JM,et al.Enaluation of biomarker panels for early stage ovarian cancer detection and monitoring for disease recurrence[J].Gynecol Oncol,2008,110(3):374-382.
[7]Das C,Mukhopadhyay M,Ghosh T,et al.Correlation of cytohistlogical expression and serum level of ca125 in ovarian neoplasm[J].J Clin Diagn Res,2014,8(3):41-43.
[8]Kirchhoff C,Habben I,Ivell R,et al.A major human epididymis specific c DNA encodes a protein with sequence homology to extra-eellular proteinase inhabitors[J].Biol Reprod,1991,45(2):350-357.
[9]Galgano MT,Hampton GM,Frierson HF Jr.Comprehensive analysis of HE4 expression in normal and malignant human tissues[J].Modern Pathology,2006,19(6):847-853.
[10]Fujiwara H,Suzuki M,Takeshima N,et al.HE4 and ROMA as diagnostic tools of typeⅠand typeⅡepithelial ovarian cancer in Japanese women[J].Tumor Biol,2015,3(6):1045-1053.
[11]Zhang XH.The detection of serum HE4 and CA125 and the application of ROMA model in the diagnosis of malignant ovarian cancer[J].Practical Cancer Medicine,2015,3(1):17-19,24.[张先华.血清HE4和CA125检测及ROMA模型在恶性卵巢癌诊断中的应用[J],实用癌症医学,2015,3(1):17-19、24.]
[12]Lin JY,Qin JB,Li XY,et al.Diagnostic value of HE4compared with mesothelin for ovarian cancer:a systematic review and meta analysis[J].Asian Pac J Cancer Prev,2012,13(11):5427-5432.
[13]Wu L,Hui H,Zhou YS,et al.The diagnostic value of serum CA125 and HE4 alone or combined in the diagnosis of ovarian cancer[J].Shandong Medical Journal,2016,56(29):91-93.[吴磊,惠慧,周云松,等.血清CA125、HE4单独或联合检测在卵巢癌中的诊断价值[J].山东医药,2016,56(29):91-93.]
[14]Liu KS,Chen J,Sun EH,et al.Diagnostic value of serum human epidymis secretory protein4,CA125 and rik model of ovarian malignancy algorithm(ROMA)in ovarian cancer[J].Chin J Clin Healthc,2016,19(1):58-60.[刘康生,陈娟,孙二虎,等.血清人附睾上皮分泌蛋白4、CA125和卵巢恶性肿瘤风险模型在卵巢癌疾病中的诊断价值[J].中国临床保健杂志,2016,19(1):58-60.]
[15]Chan KK,Chen CA,Nam JH,et al.The use of HE4 in the prediction of ovarian cancer in Asian women with a pelvic-mass[J].Gynecol Oncol,2013,128(12):239-244.
[16]Li ZJ,Zhang YQ,Xu XF,et al.Clinic value of HE4,CA125 combined with risk of ovarian malignancy algorithm(ROMA)in the diagnosis for ovarian cancer[J].Journal of Chinese Oncology,2013,19(3):219-222.
[2]Wang Y,Wei W.Diagnostic value of serum human epididymis secretory protein 4 combined with CA125 in diagnosis of ovarian cancer[J].Chinese Journal of Laboratory Diagnosis,2013,17(11):2079-2081.[王莹,续薇.血清人附睾分泌蛋白4联合CA125检测对卵巢癌的诊断价值[J].中国实验诊断学,2013,17(11):2079-2081.]
[3]Cristina A,Filomena M C,EIci I,et al.A comparison of CAl25,HE4,ROMA,and risk malignancy index(RMI)for the classification of ovarian masses[J].Clinics,2012,67(5):437-441.
[4]Kadija S,Stefanovic A,Jeremic K,et al.The utility of HE4,CA125,and ROMA in ovarian cancer and endometriosis[J].Int J Gynecol Cancer,2012,22(2):238-244.
[5]Bao JY,Zhang WJ.Clinical application of CA125 in malignant tumor[J].Journal of Practical Oncology,2013,27(2):181-184.[包金英,张文杰,CA125在恶性肿瘤中的临床应用[J].实用肿瘤杂志,2013,27(2):181-184.]
[6]Havrilesky LJ,Whitehead CM,Rubatt JM,et al.Enaluation of biomarker panels for early stage ovarian cancer detection and monitoring for disease recurrence[J].Gynecol Oncol,2008,110(3):374-382.
[7]Das C,Mukhopadhyay M,Ghosh T,et al.Correlation of cytohistlogical expression and serum level of ca125 in ovarian neoplasm[J].J Clin Diagn Res,2014,8(3):41-43.
[8]Kirchhoff C,Habben I,Ivell R,et al.A major human epididymis specific c DNA encodes a protein with sequence homology to extra-eellular proteinase inhabitors[J].Biol Reprod,1991,45(2):350-357.
[9]Galgano MT,Hampton GM,Frierson HF Jr.Comprehensive analysis of HE4 expression in normal and malignant human tissues[J].Modern Pathology,2006,19(6):847-853.
[10]Fujiwara H,Suzuki M,Takeshima N,et al.HE4 and ROMA as diagnostic tools of typeⅠand typeⅡepithelial ovarian cancer in Japanese women[J].Tumor Biol,2015,3(6):1045-1053.
[11]Zhang XH.The detection of serum HE4 and CA125 and the application of ROMA model in the diagnosis of malignant ovarian cancer[J].Practical Cancer Medicine,2015,3(1):17-19,24.[张先华.血清HE4和CA125检测及ROMA模型在恶性卵巢癌诊断中的应用[J],实用癌症医学,2015,3(1):17-19、24.]
[12]Lin JY,Qin JB,Li XY,et al.Diagnostic value of HE4compared with mesothelin for ovarian cancer:a systematic review and meta analysis[J].Asian Pac J Cancer Prev,2012,13(11):5427-5432.
[13]Wu L,Hui H,Zhou YS,et al.The diagnostic value of serum CA125 and HE4 alone or combined in the diagnosis of ovarian cancer[J].Shandong Medical Journal,2016,56(29):91-93.[吴磊,惠慧,周云松,等.血清CA125、HE4单独或联合检测在卵巢癌中的诊断价值[J].山东医药,2016,56(29):91-93.]
[14]Liu KS,Chen J,Sun EH,et al.Diagnostic value of serum human epidymis secretory protein4,CA125 and rik model of ovarian malignancy algorithm(ROMA)in ovarian cancer[J].Chin J Clin Healthc,2016,19(1):58-60.[刘康生,陈娟,孙二虎,等.血清人附睾上皮分泌蛋白4、CA125和卵巢恶性肿瘤风险模型在卵巢癌疾病中的诊断价值[J].中国临床保健杂志,2016,19(1):58-60.]
[15]Chan KK,Chen CA,Nam JH,et al.The use of HE4 in the prediction of ovarian cancer in Asian women with a pelvic-mass[J].Gynecol Oncol,2013,128(12):239-244.
[16]Li ZJ,Zhang YQ,Xu XF,et al.Clinic value of HE4,CA125 combined with risk of ovarian malignancy algorithm(ROMA)in the diagnosis for ovarian cancer[J].Journal of Chinese Oncology,2013,19(3):219-222.