HE4崔恒北京大学人民医院综述.ppt

相同特异度下的敏感度 因此，HE4联合CA125可作为子宫内膜异位囊肿和卵巢癌的鉴别诊断依据 对超声显示有盆腔包块的患者： HE4和CA125水平同时升高提示卵巢癌可能； CA125升高HE4无明显升高提示卵巢子宫内膜异位可能； HE4作为卵巢癌、子宫内膜异位症和其他恶性肿瘤的标志物，正在临床发挥越来越重要的作用。随着对HE4基础研究的深入，还有可能在临床产生更加重大的意义。 THANKS * * * * * * * Let examine how ROMA performs compared with risk assessment tools currently used in clinical practice. An algorithm that is used either formally or informally by clinicians to assess risk in a patient with a pelvic mass is the Risk of Malignancy Algorithm or RMI developed by Ian Jacobs. The RMI employs an imaging score along with CA125 values and menopausal status to calculate a risk for malignancy. This is an algorithm that employs clinical findings on imaging and uses quantitative data to derive a patients risk for malignancy. We compared ROMA to the RMI which uses clinicopathologic variables to demonstrate that the performance of ROMA as a stand alone test is superior to a currently used clinical algorithm. * We found at a specificity of 75%, the ROMA had a sensitivity of 94%, compared to the RMI, which achieved a sensitivity of 85%. This difference was found to be statistically significant * When we look at early stage I II invasive EOC patients, the ROMA achieved a sensitivity of 86%, compared with a sensitivity of only 66% for the RMI. This difference approached statistical significance with a p value of 0.05 * 检测样本分布 分组 样本类型 样本数 年龄分布 1 上皮性卵巢癌 96例 25-75岁 2 健康人群 363例 17-82岁 3 其他肿瘤 （肺癌、乳腺癌、肠癌等） 98例 20-80岁 4 疑似样本 （盆腔包块患者） 305例 12-87岁 5 干扰样本（高胆红素、高脂） 110例 13-79岁 6 良性疾病 （高血压、妇科炎症等） 95例 21-82岁 7 交界性肿瘤 10例 25-87岁 合计 1077例 中国人群CUT-OFF值的评价 临床检测正常健康人群样本363例，HE4浓度检测值范围为：22.8-106.0pM 73.7pM：中国健康人组（P95）的参考值。 150pM：试剂盒提供的参考值。 各中心健康人CUT-OFF值的评价 中心分布 CUT-OFF(P95) 第1分中心 78.3pM 第2分中心 67.8pM 第3分中心 72.6pM 中国健康人群 73.7pM 各分中心评价中国健康人群的CUT-OFF值基本一致，可以选择73.7pM作为中国 正常健康人群的参考范围。 不同的CUT－OFF值对卵巢恶性肿瘤的诊断能力 CUT－OFF 灵敏度 特异性 总符合率 阳性预检值 阴性预检值 73.7pM 91.7％ 84.4％ 85.1％ 36.8％