Monitoring Of Platinum Chemotherapy Response In Epithelial Ovarian Carcinoma By Serum CA125 And HE4 Levels

Objective: To assess the role of HE4 in predicting platinum response during first-line chemotherapy in ovarian cancer.Methods: Were retrospectively analyzed between December 2016 and February 2018 shengjing hospital affiliated to China medical university during the period of diagnosis and treatment of gynecologic tumor ward of 31 cases of patients with epithelial ovarian cancer treatment during the clinical data and treatment of the end of the follow-up information within the next six months,including: patients' age,pathological type,stage,when the number of chemotherapy before,treatment and follow-up serum HE4 and CA125 level and the follow-up of the abdomen and chest imaging results,during the initial chemotherapy in the process of HE4 and CA125 monitoring to the lowest level.18 cases of cisplatin chemotherapy in patients with sensitive type,13 cases of platinum chemotherapy resistant type,analysis of serum HE4 and CA125 level,which is mainly composed of platinum and its dynamic change and the curative effect of ovarian epithelial carcinoma first-line chemotherapy.Results: 1)the serum HE4 level of the patients before treatment,the group with the platinum chemotherapy resistance group was higher than that of the platinum chemotherapy group(925.61pmol/L vs.328.35pmol/L,P=0.0013).When the boundary value point was 715.7pmol/L,the sensitivity was 69.23%,the specificity was 94.99%,the positive predictive value(PPV)was 90.0%,the negative predictive value(NPV)was81%,and the area under the curve(AUC)was 0.799.2)the serum CA125 level before treatment,the drug resistance group was higher than the sensitive group(965.6U/L vs.662.37U/L,P=0.047).When the boundary value point was 652.3U/L,the sensitivity was61.54%,the specificity was 77.78%,the PPV was 66.7%,the NPV was 73.7%,and the AUC was 0.697.3)serum HE4 levels were observed during follow-up,and the drug resistance group was significantly higher than the sensitive group(453.04pmol/L vs.60.33pmol/L,P<0.001).When the threshold value was 64.87pmol/L,the sensitivity was92.31%,the specificity was 83.33%,PPV was 80.0%,NPV was 93.7% and AUC was0.957.4)during follow-up,the serum CA125 resistance group was higher than the sensitive group(280.96U/L vs.12.5u/L,P<0.001).The sensitivity of the effect of platinum-type chemotherapy was 92.31%,72.22%,PPV 70.6%,NPV 92.9%,and AUC0.893.During follow-up,the AUC of serum HE4 was also greater than that of CA125,and HE4 had a better prognosis than CA125 in the treatment of platinum-based chemotherapy.5)analysis of serum HE4 level after 3 times of chemotherapy,and it was concluded that platinum group chemotherapy resistance group was significantly higher than that of platinum group chemotherapy group(358.9pmol/L vs.64.89pmol/L,P<0.001).Three times after chemotherapy serum HE4 predictable platinum chemotherapy effect,when the boundary value point 77.13 pmol/L,the sensitivity was76.92%,and the specific degree of 83.33%,positive predictive value(PPV)of 76.9%,negative predictive value(NPV)of 83.3%,area under the curve(AUC)is 0.880.6)the serum CA125 resistance group was higher than the sensitive group(173.18U/L vs.20.43U/L,P<0.001)after 3 times of chemotherapy.When the threshold value was17.32U/L,the sensitivity of the predicted platinum chemotherapy was 69.23%,the specificity was 88.89%,PPV was 81.8%,NPV was 80%,and AUC was 0.833.The AUC of serum HE4 level after 3 chemotherapy was higher than that of CA125.7)during the initial chemotherapy,the serum HE4 level was detected at the lowest point,and the platinum chemotherapy resistance group was higher than the platinum chemotherapy sensitive group(67.05pmol/L vs.50.93pmol/L,P<0.001).When the boundary value was55.2pmol/L,the sensitivity was 100%,the specificity was 75.3%,the positive predictive value(PPV)was 76.5%,the negative predictive value(NPV)was 100%,and the area under the curve(AUC)was 0.951.8)the lowest level of serum CA125 was detected,and the resistance group was higher than the sensitive group(15.06U/L vs.8.49U/L,P<0.001).When the boundary value point was 10.87U/L,the sensitivity reached 100%,the specificity reached 75.3%,PPV was 92.9%,NPV was 100%,and AUC was0.968.The lowest value of CA125 and HE4 in the initial chemotherapy was greater than10.87U/L and 55.2pmol /L respectively,indicating that the drug resistance may be large.For above P<0.05 all factors for Logistic multifactor regression analysis,the results showed that serum HE4 levels before treatment,the initial chemotherapy in the process of HE4 and CA125 lowest and platinum chemotherapy drug resistance have close relationship(P<0.05).Conclusions: 1.The index of all affect the prognosis of ovarian cancer single factor regression analysis,it is concluded that: before the treatment and follow-up,3 times after chemotherapy in patients with serum CA125 level and the level of HE4 HE4 and CA125 levels in the process of the chemotherapy and reach the lowest level,can predict the platinum chemotherapy curative effect.However,the predictive ability of serum CA125 level in patients with pretreatment,follow-up and 3 patients after chemotherapy was lower than that of serum HE4.2.The above P<0.05 factors of multi-factor regression analysis,it is concluded that: serum HE4 levels before treatment,the initial chemotherapy in the process of HE4 and CA125 reach the lowest level,associated with ovarian cancer platinum chemotherapy curative effect,can be used to predict the.The low levels of CA125 and HE4 in the pretreatment of high serum HE4 and initial chemotherapy were relatively high,indicating the possibility of resistance to platinum chemotherapy.