卵巢恶性风险计算法预测盆腔包块患者卵巢癌风险

摘要

Objective:This study aims to evaluate the performance of the predictive model risk of ovarian malignancy algorithm (ROMA) using serum human epididymis protein 4 (HE4) and CA125 for discriminating benign from malignant pelvic masses. Meth-ods:The electrochemical luminescence method was carried out before and after the menopause prediction model (ROMA) to detect se-rum HE4 and CA125 levels of patients admitted in hospital for surgery of pelvic masses or ovarian cyst. Patients were classified into high-and low-risk groups to evaluate the value of the applied prediction model. Results:Of the 1683 patients evaluated, 1448 had pel-vic benign disease and 235 had pelvic malignancy, including 106 EOC. In the pathological diagnosis of patients with benign pelvic masses, 1356 cases were classified into the low-risk group with a specificity of 93.6%. A total of 121 cases of pelvic malignant tumors with sensitivity of 80.7%and 20 cases of border ovarian epithelial tumor with sensitivity of 28.2%were categorized in the high-risk group. EOC cases (93) were also classified in the high-risk group, with sensitivity of 87.7%. The cases that were not classified in the high-risk group included 2 of mucous adenocarcinoma and 11 of clear cell carcinoma. Five cases of non-epithelial ovarian malignant tu-mor patients were classified into the high-risk group with a sensitivity of 38.5%. Thirty-five cases of ovarian malignant tumor patients with a sensitivity of 85.3% and one case of metastatic ovarian cancer patient with a sensitivity of 25.0% were categorized in the high-risk group. Conclusions: ROMA can be successfully applied in pelvic malignant tumor patients to classify them into high-risk group. Most EOC patients belong to the high-risk group. ROMA can be used in patients with malignant EOC, especially during prelimi-nary screening.%目的：探讨血清人附睾蛋白4（Human epididymis protein 4 HE4）和癌抗原125（CA125）联合检测（卵巢恶性风险计算法ROMA）预测盆腔包块患者上皮性卵巢癌（EOC）风险。方法：采用电化学发光法检测因盆腔包块或卵巢囊肿住院拟行手术的患者血清HE4和CA125水平，根据是否绝经，采用ROMA方法计算卵巢癌预测概率（PP），绘制受试者工作曲线（ROC），分别确定绝经前后临界值，并将患者划分至高危组和低危组，评估预测模型的应用价值。结果：评估了1683例患者，其中1448例盆腔良性疾病，235例盆腔恶性肿瘤，包括106例EOC。在经病理确诊为良性盆腔包块患者中有1356例被划分至低危组，特异性93.6%；盆腔恶性肿瘤中121例划分至高危组，敏感度80.7%；卵巢交界性上皮瘤20例划分至高危组，敏感度28.2%；EOC中93例划分至高危组，敏感度87.7%，未划分至高危组包括黏液性腺癌2例，透明细胞癌11例。卵巢非上皮性恶性肿瘤患者中5例划分至高危组，敏感度38.5%；非卵巢恶性肿瘤患者中35例划分至高危组，敏感度85.3%；转移性卵巢癌患者中1例划分至高危组，敏感度25.0%。结论：ROMA较成功地将盆腔恶性肿瘤患者划分至高危组，其中EOC患者大部分被正确地划分至高危组，ROMA在诊断恶性肿瘤尤其是EOC方面具有较高的应用价值。