Clinical Study Of Serum HE4、CA125、CA199 And ROMA Index In 151 Patients With Ovarian Mass

Objective:In recent years,the incidence of ovarian tumors has been increasing,but also because the ovary is located deep in the pelvic cavity,the disease is more hidden,the clinical manifestation is neither obvious nor effective screening methods.Most of the patients have been found to be late.The purpose of this clinical study was to discuss the clinical value of serum HE4,CA125,CA199 expression and ROMA index in the diagnosis of benign and malignant ovarian masses.Methods:From January 2016 to December 2017,151 patients with ovarian mass who were admitted to the department of Gynecology of affiliated Hospital of Binzhou Medical College and received surgical treatment were selected as the subjects of this clinical study.The serum levels of HE4,CA125 and CA199 were collected,and the ROMA values were calculated.The final judgment standard was the paraffin pathological results provided by the department of pathology of affiliated Hospital of Binzhou Medical College.The disease composition and age distribution characteristics of the study population were analyzed,and according to the statistical analysis results of the original data,the ovarian malignant tumor group was obtained.The expression level of serum HE4,CA125,CA199 and corresponding ROMA index in benign ovarian tumor group,ovarian endometriosis group and healthy check group were analyzed statistically and compared with ROMA index in serum of benign and malignant ovarian diseases under different menoausal conditions.Statistical analysis was made to compare the expression levels of serum HE4,CA125 and CA199 in malignant ovarian masses with different pathological types,and to calculate the sensitivity and specificity of serum HE4,CA125 and CA199 expression levels in diagnosis of benign and malignant ovarian masses.The positive predictive value,negative predictive value,Yorden index and coincidence rate were analyzed.The value of serum HE4,CA125 and CA199 expression level in diagnosis of ovarian mass was further analyzed.The sensitivity,specificity,positive predictive value,negative predictive value,Yorden index and coincidence rate of ROMA index alone in the diagnosis of benign and malignant ovarian masses were calculated.The clinical value of using ROMA index alone in diagnosis of benign and malignant ovarian masses was analyzed.By using statistical software to draw the ROC curve of the expression level of serum HE4,CA125,CA199 and ROMA index in the diagnosis of benign and malignant ovarian masses,and to calculate and compare the areas under the respective curves.Clinical value of ROMA Index in diagnosis of benign and malignant ovarian masses by analyzing the expression level of Serum HE4,CA125,CA199 and ROMA Index in patients with benign and malignant ovarian masses.Results:1.Of the 151 patients with ovarian mass,33 were malignant ovarian tumors.The age ranges from 21 to 70 years,with an average age of 51 years.Among them,14 patients were unmenopausal,accounting for 42.4 percent of the malignant ovarian masses,19 patients had menopause.The proportion of malignant ovarian masses was 57.6%.99 patients were benign ovarian tumors.The age range of the patients ranged from 13 to 75 years old,with an average age of 42 years.Among them,69 cases were unmenopausal,the proportion in benign ovarian mass was 69.7%,30 cases were menopausal,and the proportion in benign mass of ovary was 30.3%.The age range of the patients was 27 to 52 years.Average age 38 years,before menopause.2.The expression level of serum HE4,CA125and CA199 in patients with ovarian malignant tumor was higher than that in benign ovarian tumor group(P<0.05),and the expression level of serum HE4 and CA125 in patients with ovarian malignant tumor was higher than that of ovarian endometriosis group,(P<0.05),but the level of CA199 was not different(P>0.05),and CA125 and CA199 in serum were good in ovary.The expression level of patients in the tumor group was lower than that in the ovarian endometriosis group(P<0.05),but there was no difference in serum HE4 levels between the two groups(P>0.05).3.In patients with malignant ovarian tumors,The expression level of serum HE4 in postmenopausal group was higher than that in premenopausal group(P<0.05),and the expression level of serum CA125 in postmenopausal group was higher than that in premenopausal group(P<0.05).There was no significant difference in serum CA199 expression level before and after menopause(P>0.05).The levels of serum HE4 and CA125 in serous ovarian cancer patients were significantly higher than those in ovarian cancer patients with other histopathological types(P<0.05),but there was no significant difference in serum CA199 expression levels(P>0.05).4.In benign ovarian disease group,the expression of serum CA125 in postmenopausal group was higher than that in premenopausal group(P<0.05),but there was no significant difference in serum HE4 and CA199 levels before and after menopause(P>0.05).5.In the diagnosis of ovarian cancer,the sensitivity of serum HE4,CA125 and CA199 was the highest,the specificity was highest with HE4,and the positive predictive value was the highest with HE4;the negative predictive value and the Jordan index of the three kinds of tumor markers were the highest,and the coincidence rate was the highest of HE4.6.The difference of ROMA index between malignant ovarian cancer group and benign ovarian disease group was statistically significant before and after menopause(P<0.05).In premenopausal patients,the specificity,negative predictive value and coincidence rate of roma index for the diagnosis of benign and malignant ovarian masses were the highest,while in postmenopausal patients ROMA index had the highest sensitivity and positive predictive value for the diagnosis of benign and malignant ovarian masses.The Yorden index of pre-menopausal and postmenopausal state comprehensive evaluation is the highest,and ROMA index also shows its superiority in specificity and negative predictive value.7.The expression of serum HE4,CA125 and ROMA index were of value in the diagnosis of benign and malignant ovarian tumors,but the diagnostic value of CA199 was lower.The expression level of serum HE4,CA125,CA199 and ROMA index in the diagnosis of benign and malignant ovarian neoplasms is of the highest value.Conclusions:1.Detection of serum HE4 level alone can distinguish benign and malignant ovarian masses,and its diagnostic specificity and coincidence rate are higher than serum CA125,CA199.2.Compared with the levels of serum HE4,CA125 and ROMA index,the clinical value of serum CA199 expression alone in differentiating benign and malignant ovarian masses was lower.3.The expression of serum HE4 and CA125 in ovarian malignant tumors was closely related to menopausal status,but serum CA199 level was not related to menstrual state.4.ROMA index can effectively screen the patients with ovarian tumor from the patients with ovarian mass,especially for postmenopausal ovarian mass patients with a better predictive value of the risk of malignant tumor.5.Combined use of serum HE4,CA125,CA199 and ROMA index is of the highest value in the diagnosis of benign and malignant ovarian tumors.