Application Of Serum HE4Combined With CA125Detection In The Diagnosis Of Ovarian Tumor

Objective To detect the concentrations of serum human epididymis protein4(HE4) and CA125in patients with ovarian cancer and benign ovarian tumor and thehealthy control. To analyze the relationship between serum HE4and menopausal status,stage of ovarian cancer, tissue typing. To investigate the significance of serum CA125、HE4and ROMA Algorithm in the diagnosis of ovarian cancer.Methods ELISA method and MCLIA was used to detect the levels of serum HE4and CA125in ovarian cancer group，benign ovarian tumor group and the healthy controlgroup, and results were expressed by the form of the median. The range of normal valueof serum HE4and CA125was0-150pmol/L and0-35U/ml respectively,and markers was higher than that of the normal value is taken as positive. The levels ofSerum HE4and CA125in every group was compared statistically andROMA index was calculated. To assess the significance of serum HE4, CAl25, ROMAAlgorithm in the diagnosis of benign and malignant ovarian tumors and make thereceiver operating characteristic curve and calculate area under the curve.Results1.The level of serum HE4: the median for ovarian cancer group, benignovarian tumor group and the healthy control group was respectively249.0pmol/L,55.89pmol/L and51.74pmol/L. The level of serum HE4in the ovarian cancer groupwas higher than that of the healthy control group and benign ovarian tumor group(P<0.05). There was no statistically significant difference between the healthy controlgroup and benign ovarian tumor group for the level of serum HE4(P>0.05).2. The level of CA125: the median for ovarian cancer group, benign ovarian tumorgroup and the healthy control group was respectively628.30U/ml,35.50U/ml and15.98U/ml. The level of CA125in the ovarian cancer group was higher than that of thehealthy control group and benign ovarian tumor group (P＜0.05). There wasstatistically significant difference between the healthy control group and benignovarian tumor group for the level of serum CA125(P＜0.05). 3. Among the benign ovarian tumors, the serum level of CA125inovarian endometrial cysts was higher than that of other of ovary benign tumor(58.87u/mL vs14.68u/mL,P＜0.05), while no significant differences can be found whencomparing serum HE4(55.17pmol/L vs61.49pmol/L,P＞0.05).The level of serum HE4and CA125in patients with ovarian endometrial cyst were lower than that ofovarian cancer (P＜0.05).4. The level of serum HE4and CA125in patients with ovarian serous carcinomaand other types of ovarian cancer was262.25pmol/L,892.5U/ml and153.3pmol/L,261.0U/mlrespectively, and there was significant differences between them (P＜0.05).5. No differences between the groups for the serum HE4levels premenopause andpost-menopause (P＞0.05), while the level of CA125premenopause was higher thanthat of post-menopause (P＜0.05).6.The sensitivity of CA125, HE4, ROMA Algorithm in the diagnosis of ovariancancer were84.6%,71.8%,94.9%, specificity were48.5%,93.9%,87.9%respectively,the correct rates were68.1%,81.9%,90.3%.7.The ROC-AUC of HE4or CAl25alone and ROMA Algorithm is0.951，0.883，0.968respectively.ROC-AUC of two individual testing had no significantdifference(P=0.073),the differences among HE4and ROMA Algorithm was nosignificant difference(P=0.29),the differences among CA125and ROMA Algorithm wasstatistically significant(P=0.032).Conclusion1.The combined detection of HE4, CA125can be used as a diagnosticcriterion in differentiating ovarian endometrial cyst from ovarian malignant tumors.2.HE4has the value on the diagnosis of ovarian malignant and has the advantagesof high specificity compared with CAl25.But as a single marker its value in thedifferential diagnosis of pelvic mass is not better than that of CAl25single detection.3.ROMA Algorithm show better performance in distinguishing benign frommalignant tumors than CA125...