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目的评价应用卵巢癌风险预测模型(ROMA)在卵巢上皮性癌发病风险预测中的价值。方法临床回顾并随访139例原发性卵巢上皮性癌患者(卵巢癌组)和123例卵巢良性肿瘤患者(卵巢良性肿瘤组),用酶联免疫吸附(ELISA)法(化学发光法)测定受试者手术前血清人附睾蛋白4(HE4)和CA125水平,用卵巢癌风险评估软件计算ROMA指数,以卵巢良性肿瘤为参照并绘制ROC曲线,通过计算最大曲线下面积(AUC)来评价HE4、CA125、ROMA指数的诊断价值。结果卵巢良性肿瘤组患者血清HE4、CA125和ROMA指数水平均在正常范围内,而卵巢癌组患者3项指标的中位水平分别为268.30 pmol/L、243.40 U/ml和81.60%,两组间差异有统计学意义(P<0.01)。与卵巢良性肿瘤组患者比较,卵巢癌组患者ROMA指数的敏感性和阴性预测值最高(93.1%和91.32%),HE4特异性和阳性预测值及准确性最高,分别为98.9%和98.71%及90.467%。以卵巢良性肿瘤患者为参照人群绘制ROC曲线,HE4、CA125、ROMA指数的最大AUC分别为0.916、0.853、0.952。结论联合检测血清HE4、CA125并计算ROMA指数有助于预测卵巢肿瘤患者卵巢癌的风险性,从而提高早期诊断卵巢癌的可行性。
Objective To evaluate the value of using ovarian cancer risk prediction model (ROMA) in predicting the risk of epithelial ovarian cancer. Methods A total of 139 patients with primary epithelial ovarian cancer (ovarian cancer group) and 123 patients with benign ovarian tumor (benign ovarian tumor group) were retrospectively reviewed and followed up. The levels of IL-6 and IL-10 were detected by enzyme-linked immunosorbent assay (ELISA) The preoperative serum levels of human epididymis 4 (HE4) and CA125 were calculated. The ROMA index was calculated using ovarian cancer risk assessment software. The ROC curve was drawn from benign ovarian tumors and the area under the maximum curve (AUC) CA125, ROMA index of diagnostic value. Results The serum levels of HE4, CA125 and ROMA in patients with benign ovarian tumors were within the normal range, while the median levels of 3 indicators in patients with ovarian cancer were 268.30 pmol / L, 243.40 U / ml and 81.60%, respectively The difference was statistically significant (P <0.01). The sensitivity and negative predictive value of ROMA index in ovarian cancer patients were the highest (93.1% and 91.32%), and the specificity and positive predictive value and accuracy of HE4 were the highest (98.9% and 98.71%, respectively) and those in ovarian benign tumor patients 90.467%. The ROC curves were drawn from patients with benign ovarian tumors as the reference population. The maximum AUC of HE4, CA125 and ROMA indices were 0.916, 0.853 and 0.952, respectively. Conclusions Combined detection of serum HE4, CA125 and calculation of ROMA index is helpful to predict the risk of ovarian cancer in patients with ovarian cancer and thus improve the feasibility of early diagnosis of ovarian cancer.