The diagnostic value of HE4,CA125 combined with ROMA indexes and transvaginal ultrasonography in pelvic mass

LIU Xiumei; HE Wei; WANG Xiuyan

doi:10.3969/j.issn.1002-7386.2018.14.015

Abstract：Objective To investigate the diagnostic value of HE4, CA125 combined with ROMA index and transvaginal ultrasonography in pelvic mass. Methods A total of 202 patients with pelvic masses were divided into benign pelvic mass group (n=114) and malignant pelvic mass group (n=88) according to the results of operation and pathological diagnosis. The patients in malignant pelvic mass group were all the patients with ovarian cancer. At the same time,the other 58 healthy subjects who received physical examination were enrolled as control group. Transvaginal ultrasonography was performed for the three groups. The serum levels of HE4 and CA125 were measured, and the ROMA indexws were calculated according to menstrual status. Moreover the sensitivity and specificity of vaginal ultrasonography scores,detection of HE4, CA125 and ROMA index in diagnosis of pelvic malignant tumor were statistically analyzed and compared among the three groups. Results The diagnose accordance rate of ultrasonography in diagnosis of uterine fibroids and adenomyosis was the highest (100% ). There were no significant differences in the diagnose accordance rate of inflammatory masses, ovarian cysts, teratomas and cystadenoma of ovary mucosa between ultrasonography examination and pathological diagnosis results ( P >0. 05). The vaginal ultrasonography scores, serum levels of HE4, CA125 and ROMA indexes in malignant pelvic mass group were significantly higher than those in benign pelvic mass group and control group(P<0. 05). Moreove the serum level of CA125 in benign pelvic mass group were significantly higher than those in control group (P<0. 05), however there were no significant differences in vaginal ultrasonography scores, serum levels of HE4 and ROMA indexes between benign pelvic mass group and control group (P<0. 05). The specificity and predictive value of CA125 in diagnosis of ovarian malignant tumor were lower,however,and the sensitivity of HE4 was lower,and specificity and accuracy of ROMA index were lower,however, the sensitivity, specificity and positive predictive value by combination detection were higher,hich were 96. 67% ,97. 36% , 98.01%,respectively (P<0. 05). Conclusion The combination detection of serum levels of CA125,HE4, ROMA index combined with vaginal ultrasonography has higher sensitivity and specificity in screening of ovarian cancer in patients with pelvic masses,therefor,which can be regarded as important means in early screening of ovarian cancer.