| Objective:To study the serum concentration of HE4in women who were ovarian cancer, or ovarian beningn tumor, or healthy,and compare the serum concentration of HE4with that of CA125. Analyzed the relationship between the serum concentration of HE4and age, menopausal state, stage of ovarian cancer, or clinical-pathological feature, in order to explore the value of the serum concentration of HE4for the differential diagnosis and early diagnosis of ovarian cancer.Methods:By examining the serum oncology markers,analyze the concentration of HE4and CA125in ovarian cancer group(77cases), ovarian beningn tumor group(167cases), and healthy control group(50cases). It’s positive if the oncology marker is higher than the normal value,or any of them is higher while combined test. We use SPSS13.0to deal with the results who were abnormal distribution,and compare the median of serum HE4and CA125by Mann-Whitney test and Kruskal-Wallis H test. Make the ROC curve by building the logistic regression model.Results:1. Median of HE4in ovarian cancer group was higher than that in ovarian beningn tumor group and healthy control group (respectively, p<0.001).2. Median of serum HE4in the older age-group (≥50year-old) was higher than that in the younger age-group (p<0.001).3. For premenopause woman, median of serum HE4was lower than that for postmenopause woman among ovarian beningn tumor group, healthy group and ovarian cancer group (respectively,p=0.053,p=0.061,p=0.004).4. Median of serum HE4in late-stage ovarian cancer (stage Ⅲ+stage3Ⅳ) was higher than that of early-stage ovarian cancer (stageⅠ+stageⅡ)(p<0.001). Among the different tissue types of ovarian cancer, the median of serum HE4in serous ovarian cancer is the highest, and was higher than that in ovarian cancer with other tissue types (p<0.001).5. For premenopause woman, differentiated from ovarian cancer, the ROC-AUC by serum HE4alone had no difference from that by HE4combined with CA125(p=0.688). Under the same specificity, the sensitivity of HE4was higher than CA125or CA125combined with HE4. For postmenopause woman, the ROC-AUC by HE4alone had difference from that by HE4combined with CA125(p=0.024). Under the same specificity, the sensitivity of HE4combined with CA125was higher than HE4or CA125alone.6. For premenopause woman, diagnosed ovarian cancer in early stage, the ROC-AUC by serum HE4alone had no difference from that by HE4combined with CA125(p=0.432). Under the same specificity, the sensitivity of ROC-AUC by HE4was the highest. For postmenopause woman, the ROC-AUC by serum HE4alone had no difference from that by HE4combined with CA125(p=0.059). Under the same specificity, the sensitivity of ROC-AUC by HE4combined with CA125was the highest.Conclusions:The median of HE4in ovarian cancer group is much higher than that in healthy control group and benign ovarian tumor group. The concentration of HE4was normal in healthy control group and benign ovarian tumor group, which showed that the concentration of HE4was elevated just in the serum of ovarian cancer. The concentration of HE4in serum is positive correlated to age, and it’s much correlated to premenopause and postmenopause in ovarian cancer. The median of serum HE4in late-stage ovarian cancer was higher than that in early-stage ovarian cancer. In different tissue types of ovarian cancer, the concentration of HE4was the highest in the serous ovarian cancer, showing that the expression of HE4in serous ovarian cancer was much higher than other malignant tumors. Which was quite meaningful in ovarian cancer diagnosis, and the prognosis evaluation before surgery, and guiding the clinical treatment as well. To differential diagnose the benign from the malignant ovarian tumor, the level of HE4could be the basis of differential diagnose the endometriosis from malignant ovarian tumor. HE4was more specific than CA125in differential diagnose the malignant ovarian tumor, and it would be more sensitive by combining with CA125. To diagnose the early-stage ovarian cancer, serum HE4was the most sensitive in premenopause women; while serum HE4combined with CA125was the most sensitive in postmenopause women. It demonstrated that HE4could raise the accuracy rate in early-stage ovarian cancer diagnosis. It also revealed that none marker could be expressed highly in all tissue types, because of the heteroplasmy of ovarian cancer. Combining the other markers who had complementary expression chart may elevate the sensitivity of ovarian cancer diagnosis. |
PDF Full Text Request