Serum human epididymis protein 4 and risk for ovarian malignancy algorithm as new diagnostic and prognostic tools for epithelial ovarian cancer management.
Serum human epididymis protein 4 and risk for ovarian malignancy algorithm as new diagnostic and prognostic tools for epithelial ovarian cancer management.
复制标题
血清人类附睾蛋白4和卵巢恶性算法的风险是上皮卵巢癌管理的新诊断和预后工具。
DOI：
10.1158/1055-9965.epi-11-0635
复制
发表时间：
2011-12
期刊：
影响因子：
--
通讯作者：
Ravaggi A
中科院分区：
文献类型：
--
作者：
Bandiera E;Romani C;Specchia C;Zanotti L;Galli C;Ruggeri G;Tognon G;Bignotti E;Tassi RA;Odicino F;Caimi L;Sartori E;Santin AD;Pecorelli S;Ravaggi A
The aim of this work was to analyze the diagnostic and prognostic value of serum human epididymis protein 4 (HE4) and Risk for Ovarian Malignancy Algorithm (ROMA) in epithelial ovarian cancer (EOC). Preoperative serum samples of 419 women (140 healthy controls, 131 ovarian benign cysts, 34 endometriosis, 114 EOC) were tested for CA125 and HE4 using fully automated methods (Abbott ARCHITECT) and validated cut-off values. For the discrimination of benign masses from EOC, in pre-menopausal women the sensitivity and specificity were 92.3% and 59.4% for CA125, 84.6% and 94.2% for HE4, and 84.6% and 81.2% for ROMA while in post-menopausal women the sensitivity and specificity were 94.3% and 82.3% for CA125, 78.2% and 99.0% for HE4, 93.1% and 84.4% for ROMA. In patients with EOC, elevated CA125, HE4 and ROMA levels were associated with advanced FIGO stage, sub-optimally debulking, ascites, positive cytology, lymph node involvement and advanced age (all p≤0.05). Elevated HE4 and ROMA (both p≤0.01), but not CA125 (p=0.0579), were associated with undifferentiated tumours. In multivariable analysis, elevated HE4 and ROMA (all p≤0.05) were independent prognostic factors for shorter overall survival, disease free survival and progression free survival. This study underlines the high specificity of HE4 in discriminating endometriosis and ovarian benign cysts from EOC and the high sensitivity of CA125 in detecting EOC. We demonstrated HE4 and ROMA as independent prognostic factors. Multicenter studies are needed to draw firm conclusions about the applicability of HE4 and ROMA in clinical practice.
