新型卵巢癌标记物HE研究进展.pptVIP

表 患者被ROMA划分为高危组和低危组的分布 HE4联合CA125鉴别诊断子宫内膜异位症和卵巢癌 HE4的编码基因WFDC2主要在卵巢子宫内膜样癌、子宫内膜癌中有表达, 并且在正常的子宫内膜腺体中也有表达，但是在子宫内膜异位病灶中是否有表达尚不明确， 我们实验室最检测了57例卵巢子宫内膜异位症患者血浆中HE4和CA125的浓度。数据结果与49例卵巢癌，60例卵巢良性肿物，50例健康对照作对比，初步探讨血清人附睾分泌蛋白4(HE4)和CA125水平检测在鉴别诊断子宫内膜异位症和卵巢癌的价值。 （1）CA125在各组中的中位数 （2）HE4在各组中的中位数 在子宫内膜异位症中 在卵巢癌中 HE4和CA125无相关性 HE4和CA125有相关性 卵巢子宫内膜异位囊肿以正常为参照 卵巢子宫内膜异位囊肿以良性肿物为参照 HE4:ROC-AUC0.5无诊断意义 HE4:ROC-AUC0.5无诊断意义 卵巢癌以卵巢子宫内膜异位囊肿为参照 HE4:ROC-AUC=0.933 HE4和CA125联合诊断 CA125可以排除良性卵巢肿物和盆腔子宫内膜异位症，但是不能鉴别卵巢子宫内膜异位囊肿和卵巢癌 HE4对卵巢癌有高度的敏感性，因此可以将卵巢子宫内膜异位囊肿和卵巢癌区分开 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 stat