| Objective: To investigate the clinical value of Serum Amyloid A(SAA),Carbohydrate Antigen 125(CA125)and Human Epididymis Protein 4(HE4)in the diagnosis of ovarian tumors.Methods: From January 2018 to March 2020,115 hospitalized patients with "ovarian mass" as the admission diagnosis for surgical treatment in Affiliated Zhongshan Hospital Dalian University were collected,including 56 patients in the ovarian malignant tumor group.Benign ovarian tumor group in 59 cases.A total of 60 women who underwent physical examination in outpatient clinic were selected as the control group.Venous blood was collected on an empty stomach in the morning 1 day before operation in the ovarian malignant tumor group and the benign ovarian tumor group,and venous blood was collected on an empty stomach in the morning on the day of physical examination in the healthy control group.Serum concentrations of SAA were determined by double-antibody sandwich enzyme-linked immunosorbent assay(ELISA),and serum concentrations of CA125 and HE4 were determined by electrochemical luminescence.The expression levels and detection positive rates of three markers in serum of three groups were compared and analyzed.To compare the expression levels of three markers in patients with ovarian malignancy at different surgical and pathological stages;The sensitivity,specificity and receiver operating characteristic curve(ROC)of the three markers in the diagnosis of ovarian malignancy were compared,and the diagnostic efficacy of the three markers in the diagnosis of ovarian malignancy was discussed.Results:1.In the ovarian malignant tumor group,the ovarian benign tumor group and the healthy control group,the median serum SAA expression level was 109.2mg/L,4.2mg/L and 4.8mg/L,respectively.The median expression level of serum CA125 was127.6U/ml,17.1U/ml and 16.3U/ml,respectively.The median levels of serum HE4 were 128.4pmol/L,43.1pmol/L and 35.2pmol/L,respectively.Serum levels of SAA,CA125 and HE4 in the ovarian malignant tumor group were higher than those in the benign ovarian tumor group and the healthy control group,and the differences were statistically significant(<0.05),the serum levels of SAA,CA125 and HE4 in the benign ovarian tumor group were not significantly different from those in the healthy control group(P>0.05).The positive rates of serum SAA,CA125 and HE4 were 83.9%,91.1%,67.9% and 98.2%,respectively.The positive rates of serum SAA,CA125 and HE4 in the benign ovarian tumor group were 5.1%,25.0%,10.20% and 39.0%,respectively.The positive rates of SAA,CA125 and HE4 were 5.0%,10.0%,3.3% and13.3%,respectively.The positive rate of serum SAA,CA125,HE4 and three combined tests in the ovarian malignant tumor group was higher than that in the benign ovarian tumor group and the healthy control group,and the difference was statistically significant(P<0.05),the positive rate of serum CA125 and three combined tests in the benign ovarian tumor group was higher than that in the healthy control group,and the difference was statistically significant(P<0.05),the positive rate of serum SAA and HE4 in the benign ovarian tumor group was slightly higher than that in the healthy control group,with no statistically significant difference(P>0.05).2.The median concentrations of SAA,CA125 and HE4 were 18.8mg/L,70.4U/ml and 58.8pmol/L,respectively,in the early stage of ovarian malignancy(stage I-II)group.The median concentrations of SAA,CA125 and HE4 in the advanced stage(stage III-IV)group were 149.3mg/L,356.0U/ml and 289.5pmol/L,respectively.The expression levels of SAA,CA125 and HE4 in the advanced group were higher than those in the early group,with statistically significant differences(P<0.05).There was a weak positive correlation between serum SAA expression leveland surgical pathological staging in patients with ovarian malignancy(r=0.31,P<0.05),there was a moderately positive correlation between CA125 expression level and surgical pathological stage(r=0.53,P<0.05),there was a strong positive correlation between HE4 expression level and surgical pathological stage(r=0.66,P<0.05).3.The three markers SAA,CA125 and HE4 were combined in different ways,and the diagnostic efficacy of each combination on ovarian tumor was analyzed by ROC.The results showed that(table 5,figure 4): the diagnostic efficacy of each combination on ovarian tumor was relatively high(P<0.05).SAA had the highest diagnostic efficiency(sensitivity 83.9%,specificity 94.9%,AUC=0.93,95%CI =0.88-0.98,P<0.05).In the combination of combined detection,the AUC of the combined detection was higher than that of the single detection,and the difference was statistically significant(P<0.05),the diagnostic efficiency of combined detection increased.The sensitivity of the two combined tests was higher than that of the single test,and the difference was not statistically significant(P>0.05),the specificity was lower than that of single test,and the difference was not statistically significant(P>0.05).The three combined tests had the highest diagnostic efficiency(sensitivity was 98.2%,specificity was 74.0%,AUC=0.99,95%CI =0.98-1.00,P<0.05).At this time,the sensitivity was higher than that of single detection and combined detection of each marker,and the difference was statistically significant(P<0.05).The specificity was lower than that of single test and combined test for each marker,and the difference was statistically significant(P<0.05).Conclusion:1.The expression levels and positive rates of serum SAA,CA125 and HE4 in the ovarian malignant tumor group were higher than those in the benign ovarian tumor group and the healthy control group.2.The expression levels of serum SAA,CA125 and HE4 in the ovarian malignant tumor group were positively correlated with surgical pathological stage.3.SAA combined with CA125 and HE4 was more effective in the diagnosis of ovarian malignancy. |
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