Diagnostic Value Of Combined Detection Of Carbohydrate Antigen 125 And Human Epididymis Protein 4 In Epithelial Ovarian Cancer

Objective:To explore the diagnostic value of serum carbohydrate antigen 125 and human epididymis protein 4 alone or in combination for ovarian epithelial cancer.Methods:The patients who underwent surgery for the attachment of the tumor in the Shanxi Provincial Cancer Hospital from January 2012 to December 2017 were enrolled.According to the postoperative pathological results,494 cases of ovarian epithelial cancer group and 462 cases of benign ovarian disease group.The serum CA125 and HE4 were detected by electrochemiluminescence and Enzyme-linked Immunosorbent Assay(ELISA)method.The diagnostic value of both alone and combined detection for ovarian epithelial cancer was analyzed.Results:1.The median serum CA125 in ovarian benign disease group and ovarian epithelial cancer group were 16.3 U/ml and 273.34 U/ml,and the median value of HE4 was 39.54pmol/L and 199.08 pmol/L,respectively.Serum CA125 And HE4 levels were higher in the ovarian epithelial cancer group than in the ovarian benign disease group(P<0.05);2.Serum CA125 was significantly different between the ovarian benign disease group and the ovarian epithelial cancer group(P<0.05),while HE4 was only significantly different between the ovarian epithelial cancer group(P<0.05).3.There was a positive correlation between serum CA125 and HE4 levels in ovarian epithelial cancer group(r=0.481,P=0.000);4.Among the 494 patients with ovarian epithelial cancer,the effect of age was only statistically significant on HE4 level(P=0.000);5.Serum CA125 and HE4 levels were higher in the advanced(III,IV)ovarian epithelial cancer than in the early stage(I,II)(P<0.05),and compared with the moderately differentiated and highly differentiated ovarian epithelial cancer,The level of low differentiation epithelial cancer was the highest(P<0.05);6.The specificity and positive predictive value of serum HE4 for the diagnosis of ovarian epithelial cancer were higher than CA125(93.51%vs 63.42%;92.29%vs 69.27%),the difference was statistically significant(X~2=123.74,P<0.001;X~2=72.264,P<0.001),and the sensitivity was lower than CA125,but the difference was not statistically significant(X~2=2.606,P=0.062);When both CA125 and HE4 were positive indicates positive results,compared with CA125,their specificity and positive predictive value were significantly increased(99.57%vs 63.42%;99.32%vs 69.27%),the difference was statistically significant(X~2=200.13,P<0.001;X~2=107.06,P<0.001);When one of CA125 and HE4 was positive for positive results,sensitivity and negative predictive values were significantly higher than CA125(90.69%vs 77.13%;85.21%vs 72.17%;X~2=33.65,P<0.001;X~2=17.36,P<0.001),but the specificity decreased(57.36%vs 63.42%;X~2=3.55,P<0.05);7.For patients with serum CA125 and HE4 levels separated,167 patients with benign ovarian disease,89 patients with ovarian epithelial cancer,and a higher proportion of patients with benign ovarian disease(65.23%)in patients with CA125(+)HE4(-)The proportion of patients with ovarian epithelial cancer was 34.77%,of which 41.57%(37/89)were in early patients.In patients with CA125(-)HE4(+),There were 28 patients with benign ovarian diseases and 67 patients with ovarian epithelial cancer.On the contrary,the proportion of patients with ovarian epithelial cancer was 70.53%,among which 74.62%(50/67)were patients with early ovarian cancer;8.Serum CA125(-)HE4(-)in 46 patients with ovarian epithelial cancer,of which early patients accounted for 84.78%(39/46),while serum CA125(+)HE4(+)patients with ovarian epithelial cancer 292 cases,of which early ovarian epithelial cancer only accounted for 18.49%(54/292).Conclusions:Serum CAl25 and HE4 were significantly elevated in ovarian epithelial cancer,and positively correlated with ovarian epithelial cancer;Serum levels of CAl25 and HE4 could indicate the malignant degree of ovarian cancer,which was closely related to thepathological stage and degree of differentiation;The level of CA125 was significantly different between the two groups,and the level of HE4 was only different in the ovarian epithelial cancer group;The diagnostic efficacy of CAl25 combined with HE4 in thediagnosis of ovarian epithelial cancer was better than the separate diagnosis,and higher specificity and positive predictive value can improve the ability of diagnose ovarianepithelial cancer;in CA125(+)HE4(-)patients,the proportion of patients with benign ovarian disease is higher,while in CA125(-)HE4(+)patients,the proportion of patients with ovarian epithelial cancer is higher,which provides a basis for the choice of surgical methods.