血清CA125、HE4及基于二者的ROMA、CPH-I在卵巢肿瘤良恶性鉴别诊断中的应用价值

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Abstract Objective To compare diagnostic value of carbohydrate antigen 125 (CA125), human epididymis protein 4 (HE4) and on which risk of ovarian malignancy algorithm (ROMA), Copenhagen index (CPH-I) based in differentiating malignant from benign ovarian tumors. Methods Clinical data of 719 patients with ovarian tumors, who visited Department of Obstetrics and Gynecology of Nanfang Hospital, Southern Medical University, from September 2014 to November 2016 were analyzed retrospectively. According to different prognosis, patients were divided into 92 cases of less common ovarian histopathologies (LCOHs) group, 96 cases of non-less common ovarian histopathologies (Non-LCOHs) group, 531 cases of benign ovarian tumors (BOTs) group. ROC curve were used for calculating AUC, sensitivities and specificities, so as to compare diagnostic value of CA125, HE4, ROMA and CPH-I in differentiating malignant from benign ovarian tumors. Results Among ovarian cancer, 77.1% patients in non-LCOHs group were mainly staged advanced, while those in LCOHs group, 80.4% were mainly early stage, the differences were statistically significant (P < 0.01). The age, rate of postmenstrual cases and levels of serum CA125, HE4, ROMA, CPH-I in Non-LCOHs group were higher, followed by LCOHs group and BOTs group respectively, the differences were statistically significant (P < 0.01). In differentiating Non-LCOHs from BOTs patients, AUC of CPH-I, ROMA and HE4 were both higher than CA125 (0.969, 0.968, 0.968 and 0.935), and CPH-I made highest sensitivity, followed by ROMA, CA125 and HE4 (93.8%, 92.7%, 90.6% and 88.5%). Similar AUC trend was observed in differentiating LCOHs from BOTs patients (0.735, 0.739, 0.736 and 0.642), and sensitivity of ROMA was highest and followed by CPH-I, CA125 and HE4 (44.6%, 35.9%, 32.6% and 32.6%). The specificity of CPH-I, HE4, ROMA was higher than CA125 (94.7%, 93.6%, 87.6% and 83.6%). Conclusion HE4, ROMA, and CPH-I did the comparative performance in differentiating malignant from benign ovarian tumors and both are better than CA125. In terms of predicting Non-LCOHs patients, ROMA and CPH-I are superior to CA125, and CPH-I is slightly dominant and more convenient and practical than ROMA. Both of these models perform better than HE4. Furthermore, CPH-I and HE4 has better specificities for predicting benign ovarian diseases than ROMA and the former two index made up for shortcoming of weak specificity of CA125 effectively. However, the rate of missed diagnosis in LCOHs population is still staying at a high level and further researches for more effective differential diagnosis tools are needed.

Key words： Ovarian neoplasms CA125 HE4 ROMA CPH-I Differential diagnosis

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	CHEN Yongning1 ZHANG Yadi1 CHEN Li2 LI Chanyuan1 WU Huan3 GONG Shipeng1

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CHEN Yongning1 ZHANG Yadi1 CHEN Li2 LI Chanyuan1 WU Huan3 GONG Shipeng1. Application value of serum CA125, HE4 and ROMA and CPH-I based on them in differential diagnosis of ovarian tumors[J]. 中国医药导报, 2019, 16(17): 9-12,22.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2019/V16/I17/9

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