ROMA 值在卵巢癌高危人群筛查中的初步应用

摘要

Objective To observe the application effect of the risk of ovarian malignancy algorithm(ROMA)in screening ovarian cancer among high risk population.Methods The human epididymis protein 4(HE4)and carbohydrate antigen 125 (CA125 )were detected in 1 753 cases of high risk for overian cancer,56 cases of ovarian cancer(positive control)and 60 healthy people,patients. Then the ROMA value was calculated in combination with the subject′s menstruation status.The detection results were analyzed and compared among groups.The high risk group for ovarian cancer devided according to the ROMA value was further performed the confirmatory test and the low risk group was monitored by follow up.The detection rates of ovarian cancer were compared be-tween the two subgroups.Results In the high risk population,the diagnostic performance of the ROMA value for ovarian cancer was superior to that of the single HE4 or CA125;the ROMA value had statistically significant difference between the high risk sub-group in the high-risk population with ovarian cancer or the healthy control group(P <0.05);in 1 753 cases of high risk popula-tion,37 cases were included in the high risk subgroup,in which 3 cases of ovarian cancer were screened out and in clinical early stage.The detection rate of ovarian cancer in the high risk subgroup was 8.1%.No case of ovarian cancer was detected out in the low risk subgroup.Conclusion The ROMA value is conducive to early screening for ovarian cancer in the high risk population, which can save the medical cost and increase the detection rate.%目的：观察卵巢恶性肿瘤风险模型（ROMA 值）在卵巢癌高危人群筛查中的应用效果。方法对60例健康人群，1753例高危人群以及56例卵巢癌患者（阳性对照组）进行人附睾蛋白4（HE4）和糖链抗原125（CA125）检测，结合受试者月经状态计算 ROMA 值，分析比较各组结果。对高危人群中 ROMA 值划分出的高风险组进行进一步确诊试验，低风险组进行随访监测，比较两组卵巢癌的检出率。结果在高危人群中，ROMA 值对卵巢癌的诊断性能优于单一的 HE4或 CA125；高危人群中高风险组的 ROMA 值与卵巢癌组、健康对照组差异有统计学意义（P ＜0．05）；1753例高危人群中37例被划入高风险组，高风险组共筛查出3例卵巢癌，均处于临床早期，高风险组中卵巢癌的检出率约为8．1％，低风险组未检出卵巢癌。结论 ROMA 值有利于卵巢癌高危人群的早期筛查，便于节约医疗成本，提高检出率。