Comparison of plasma amino acid profile-based index and CA125 in the diagnosis of epithelial ovarian cancers and borderline malignant tumors
Comparison of plasma amino acid profile-based index and CA125 in the diagnosis of epithelial ovarian cancers and borderline malignant tumors
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DOI：
10.1007/s10147-016-1035-4
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发表时间：
2017-02-01
影响因子：
3.3
通讯作者：
Hirahara, Fumiki
中科院分区：
文献类型：
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作者：
Miyagi, Etsuko;Maruyama, Yasuyo;Hirahara, Fumiki
背景我们之前开发了一种新的基于血浆氨基酸谱的指数（API）来检测卵巢癌、宫颈癌和子宫内膜癌。在此，我们将API与血清癌抗原125（CA125）进行比较，以区分上皮性卵巢恶性肿瘤和良性肿瘤。方法对卵巢肿瘤患者进行术前检测API和CA125，随后将其分为59例上皮性卵巢癌、21例上皮性交界性恶性肿瘤和97例良性肿瘤（包括40例子宫内膜异位囊肿）。使用受试者工作特征（ROC）曲线评估API的诊断准确性和截止点。结果ROC曲线下面积显示API和CA125在区分恶性/交界性恶性和良性肿瘤方面的性能相当（均为0.77），并且API在区分恶性/交界性恶性病变和子宫内膜异位囊肿方面优于CA125（API，0.75 vs. CA125，0.59；p < 0.05）。在 API 截止水平为 6.0 时，API 和 CA125 在检测癌症和边缘恶性肿瘤（API，0.71 vs. CA125，0.74；p = 0.84）或单独癌症（API，0.73 vs. CA125，0.85；p = 0.12）方面具有相同的阳性率。然而，与CA125 (0.65; 95% CI, 0.48-0.79)相比，API对良性子宫内膜异位囊肿的检出率显着较低(0.35; 95 % CI, 0.21-0.52) (p < 0.05)。 结论 API是一种有效的新型肿瘤标志物，可检测卵巢癌和交界性恶性肿瘤，假阳性率较低。子宫内膜异位症。有必要使用本研究中确定的 API 截止值进行大规模前瞻性临床研究，以验证 API 的实际临床用途。
Background We previously developed a new plasma amino acid profile-based index (API) to detect ovarian, cervical, and endometrial cancers. Here, we compared API to serum cancer antigen 125 (CA125) for distinguishing epithelial ovarian malignant tumors from benign growths.Methods API and CA125 were measured preoperatively in patients with ovarian tumors, which were later classified into 59 epithelial ovarian cancers, 21 epithelial borderline malignant tumors, and 97 benign tumors including 40 endometriotic cysts. The diagnostic accuracy and cutoff points of API were evaluated using receiver operating characteristic (ROC) curves.Results The area under the ROC curves showed the equivalent performance of API and CA125 to discriminate between malignant/borderline malignant and benign tumors (both 0.77), and API was superior to CA125 for discrimination between malignant/borderline malignant lesions and endometriotic cysts (API, 0.75 vs. CA125, 0.59; p < 0.05). At the API cutoff level of 6.0, API and CA125 had equal positive rates of detecting cancers and borderline malignancies (API, 0.71 vs. CA125, 0.74; p = 0.84) or cancers alone (API, 0.73 vs. CA125, 0.85; p = 0.12). However, API had a significantly lower detection rate of benign endometriotic cysts (0.35; 95 % CI, 0.21-0.52) compared with that of CA125 (0.65; 95 % CI, 0.48-0.79) (p < 0.05).Conclusions API is an effective new tumor marker to detect ovarian cancers and borderline malignancies with a low false-positive rate for endometriosis. A large-scale prospective clinical study using the cutoff value of API determined in this study is warranted to validate API for practical clinical use.