Research About The Value Of Serum CA125 And HE4 To The Diagnosis Of Ovarian Epithelial Carcinoma

Objective:To study the value of serum CA125 and HE4 to the diagnosis of ovarian epithelial carcinoma.Methods:The level of the serum CA125 and HE4preoperative or postoperative is retrospective compared which is collected in the patients who were the first time underwent operation in The First Affiliated Hospital of Guangxi Medical University for "pelvic mass" from 2014 April to 2015October, of the cases including ovarian epithelial carcinoma group(40 cases),ovarian benign epithelial tumor (48 cases), ovarian non-epithelial benign tumor group(100 cases)and the control group(80 cases).In addition, the relationship between serum CA125 or HE4 and the clinical pathology together with the treatment of ovarian epithelial carcinoma is analyzed.Results:1、The level of serum CA125 and HE4 before treatment in ovarian epithelial carcinoma group (2091.00±3755. 10U/ml and 529.80± 492.49 PM) is significantly higher than those of the ovarian benign epithelial tumor group (25.81±21.24 U/ml and 54.90±8.99 PM), ovarian non-epithelial benign tumor group (53.93±123.79 U/ml and 50.25±10.28 PM) and the control group (17.89±16.08 U/ml and 49.16±10.94 PM), with statistically significant difference (P<0.05). There is no statistical significance in the comparison among groups of the other three groups (P>0.05).2、In the ovarian epithelial carcinoma group, the level of serum CA125 and HE4 is increased with elevated pathological stage (stage Ⅰ< stage Ⅱ< stage Ⅲ< stageⅣ), with the Spearman correlation coefficient of 0.657、0.571; elevated histological grade (G1< G2< G3), with the Spearman correlation coefficient of 0.397、0.537; associated with lymph node metastasis (without lymph node metastasis< with lymph node metastasis), with the Spearman correlation coefficient of 0.505、0.171; associated with pleural effusion (without pleural effusion< with pleural effusion), with the Spearman correlation coefficient of 0.376、0.398; associated with the presence of malignant cells in ascetic fluid (without evidence of malignant cells< with evidence of malignant cells), with the Spearman correlation coefficient of 0.644、0.427; and increased with elevated age bracket (20-30< 30-40< 40-50< 50-60< 60-70 years old), with the Spearman correlation coefficient of 0.316、0.398. In addition, the level of serum CA125 is associated with ascitic fluid (without ascitic fluid< with ascitic fluid), with the Spearman correlation coefficient of 0.371. The relationship between whether serum CA125 or HE4 and menopause is not evident(P>0.05).3、As reference to the control group, the area under the ROC curve of serum CA125 combined with HE4 to the diagnosis of ovarian epithelial carcinoma is 0.966, higher than that of CA125 alone(0.955)and HE4 alone(0.923). According to the ROC curve, when serum CA125 is 60.17 (U/ml) or HE4 is 77.46 (PM), their Youden index is the biggest.4、he diagnostic sensitivity of serum CA125 combined with HE4 is 90.9%, greater than CA125 alone (81.8%) or HE4 alone (78.8%), while the specificity (96.3%) is lower than CA125 alone (97.5%) or HE4 alone (98.8%), the positive predictive value (92.9%) is lower than CA125 alone (94.7%) or HE4 alone (97.0%) and the negative predictive value (98.7%) is greater than CA125 alone (95.1%) or HE4 alone (92.9%).5、In the ovarian epithelial carcinoma group, the preoperative serum CA125 and HE4 level of the patients who can’t obtain optimal cytoreduction (3783.11±2354.17 U/ml and 1022.56±469.04 PM) is significantly higher than those who can (1141.29±1622.19 U/ml and 420.64±436.70 PM) (P<0.05). As reference to the group of suboptimal cytoreduction, the area under the ROC curve of serum CA125 combined with HE4 to the diagnosis of the optimal cytoreduction is 0.859, higher than that of CA125 alone(0.768) and HE4 alone(0.727). According to the ROC curve, when serum CA125 is set at 741.10 (U/ml) with sensitivity of 77.8% and specificity of 75.9%, or HE4 is set at 494.85 (PM) with sensitivity of 77.8% and specificity of 82.8%, their Youden index is the biggest.6、Compared with preoperative serum level of CA125 and HE4, the level postoperative is significantly decreased (P<0.05).Conclusion:1、The level of serum CA125 and HE4 rises obviously in the ovarian epithelial carcinoma.2、The level of serum CA125 and HE4 can indicate the ovarian malignant degree, and is closely related with the pathological stages.3、The diagnosibility of CA125 combined with HE4 to the ovarian epithelial carcinoma is better than whichever alone of them. Its high sensitivity and negative predictive value can improve the ability of screening for ovarian epithelial carcinoma.4、There is certain guiding significance for determining wheather the optimal cytoreduction can be obtained preoperatively according to the serum level of CA125 and HE4 for the ovarian epithelial carcinoma, and the combined diagnosis is meaningful than the separate diagnosis.5、Detecting the level of serum CA125 and HE4 can be a way to evaluate surgical curative effect.