The Study Of The Clinical Value Of HE4 And CA125 Combined Detection In Ovarian Cancer

Objective: To investigate the role of HE4 and CA125 combined detection in the diagnosis and prognosis of ovarian cancer.Method: A complete ovarian resection was collected from January 2010 to December 2012 in 204 tumor hospitals of Liaoning province. According to the pathological results after surgery, ovarian carcinoma was 124 cases(Agroup), 41 cases of borderline ovarian tumor(B group), and 39 cases of ovarian cyst added as well as ovarian epithelial cyst(C group). The age of the group was 29 to 82 years old, and the median age was 46 years old. Patient serum HE4 and CA125 detection analysis, m RNA level of detection of the specimen bank in tissue samples by RT-PCR method, combined with the cases of clinical stage, pathological type, metastasis, prognosis and other clinical data were statistically analyzed.Result: 1.Determination of serum HE4, group A was higher than that of group B with significant difference(χ2=108.530,P<0.001); Positive group A is higher than that of group C with significant difference(χ2=115.861,P<0.001); Group B compared with group C, they don’t have significant difference(χ2=0.463,P=0.496). 2.Determination of serum CA125, Positive group A is higher than that of group B was significant difference(χ2=89.941,P<0.001); Positive group A is higher than that of group C with significant difference(χ2=91.576,P<0.001); Group B compared with C group. They don’t have significant difference(χ2=0.000,P=1.000). 3.In the malignant group(A group), the results of HE4 and CA125 were compared, there was no obvious difference between them(χ2=0.400,P=0.527). The sensitivity of HE4 detection for diagnosis of ovarian cancer was 91.1%, and the specificity was 97.5%, while the sensitivity and specificity of CA125 for diagnosis of ovarian cancer were 88.7% and 91.3% respectively. When combined detection, the sensitivity of parallel method is close to 100%, specificity is 89%, sensitivity of the serial method is 80.8%, and specificity is close to 100%. 4.In early ovarian cancer, the positive rate of serum HE4 was significantly higher than that of the positive rate of CA125(χ2=4.955, P=0.026), with significant difference; In advanced ovarian carcinoma, the positive rate of serum HE4 was significantly lower than that of the positive rate of CA125(χ2=4.403,P=0.036), with significant difference; Positive rate of HE4 in early and advanced ovarian carcinoma without significant difference(χ2=0.114,P=0.736); Positive rate of CA125 in early ovarian cancer was significantly higher than that of advanced ovarian cancer with significant difference(χ2=12.997, P<0.001).Serum HE4 and CA125 quantitative analysis of early and advanced ovarian cancer patient shows, there are no significant difference in the two groups of HE4(t=3.52,P=0.001); CA125 in A2 group was significantly higher than that of group A1 with statistical significance(t=7.78,P<0.001). In the metastasis group, the positive rate of serum HE4 is higher than the positive rate of CA125, but both of them had no significant difference(χ2=3.207,P=0.073); Positive rate of HE4 is compared between the metastatic and non metastatic group, although metastasis group has the higher positive rate of HE4, both of them have no significant difference(χ2=1.739,P=0.187), There is no difference for CA125 in transfer and non metastasis group(χ2=1.498,P=0.221). 5.Semi-quantitative determination of m RNA HE4 levels in ovarian cancer tissues were detected by RT-PCR, and the results showed that the expression of m RNA in the metastasis group was higher than that in the non metastasis group. The expression of HE4 m RNA in the survival and death group did not change significantly.Conclusion: 1.The positive rate of serum HE4 and CA125 in ovarian malignant, borderline and normal controls was studied. Serum HE4 and CA125 can be used as markers for the identification of benign and malignant ovarian tumors. 2.Further determination research of combined two tumor markers------serum HE4 and CA125 shows, according to the different clinical needs, combined detection of serum HE4 and CA125 two tumor markers, were fewer false positive rate and false negative rate, suitable for ovarian cancer screening and clinical diagnosis. 3.HE4 detection for early detection and diagnosis of ovarian cancer has clinical significance, meanwhile, in this study, staging there has clear guidance value when CA125 determination is done for ovarian cancer. 4.Semi-quantitative detection of HE4 m RNA in ovarian cancer tissues is done by RT-PCR, we found that m RNA expression levels were significantly higher than those in non metastasis group. However, the expression of HE4 m RNA in the survival and death group did not change significantly.