Difference of human epididymis protein 4 and carbohydrate antigen 125 in patients with ovarian cancer before and after menopause / 中国综合临床

ABSTRACT

Objective:To compare the difference of human epididymis protein 4(HE4) and carbohydrate antigen 125(CA125) indexes before and after menopause in ovarian cancer patients, and to evaluate the efficacy of risk of ovarian malignancy algorithm(ROMA) index in early diagnosis.Methods:The clinical data of 236 patients with ovarian cancer (malignant ovarian tumor group) who were hospitalized in Cancer Hospital of China Medical University from April 2018 to September 2019 were retrospectively analyzed, and 312 benign patients treated at the same period were selected as the control group (benign ovarian tumor group). On the basis of clinical pathological section confirmation, the serum samples were collected to detect HE4 and CA125, and the ROMA index was calculated according to the formula.The differences of HE4, CA125 and ROMA indexes before and after menopause, as well as the diagnostic efficacy of ROC survival curve of the three were compared, and the relationship between the different clinical characteristics of ovocarcinoma patients was evaluated to comprehensively analyze the early diagnostic effect of ROMA index.Results:In the serum of patients with malignant ovarian cancer, HE4, CA125 and ROMA index were abnormally high expression, and the difference between HE4 before(263.2(128.4, 385.6) pmol/L) and after menopause(354.8(179.5, 554.2) pmol/L) was statistically significant( Z=2.09, P=0.037). Through fitting the ROC curve the AUC of premenopausal ROMA index was 0.939, and the AUC of postmenopausal ROMA index was 0.933, which were higher than HE4 (0.937, 0.906) and CA125 (0.913, 0.924), and their corresponding Youden correct diagnostic indexes were 0.800 and 0.742 respectively, which were higher than HE4 (0.788, 0.653) and CA125 (0.498, 0.565). The two categories of HE4 were associated with the occurrence of peritoneal effusion (the percentage of postmenopausal and premenopausal HE4<140 nmol/L and premenopausal HE4<70 nmol/L were 25.77%, 74.23% and 74.23% respectively), and the difference was statistically significant (χ 2=10.155, P=0.006). CA125 was associated with the classification of the largest diameter of parenchymal tumor and the occurrence of peritoneal effusion (all P<0.05). ROMA index was associated with menopause or not, classification of maximum diameter of mass, classification of maximum diameter of parenchymal tumor and occurrence of ascites, and the differences were statistically significant (all P<0.05). Conclusion:ROMA index has a good diagnostic efficiency in the diagnosis of malignant ovarian cancer, especially premenopausal patients with good diagnostic efficiency, for early diagnosis of ovarian cancer has a certain guiding value, the follow-up will further carry out confirmatory research.