血清肿瘤标志物在卵巢恶性肿瘤诊断中的ROC曲线分析

ROC Curve Analysis of Serum Tumor Markers in the Diagnosis of Ovarian Malignant Tumors

摘要: 目的：探讨血清血管内皮生长因子(VEGF)、人附睾蛋白4 (HE4)、糖类抗原125 (CA125)、糖类抗原724 (CA724)在卵巢恶性肿瘤中的诊断价值。方法：回顾性分析郑州大学人民医院2020至2021年的卵巢恶性肿瘤患者106例，按术后常规病理结果将其分为上皮性肿瘤组97例、生殖细胞肿瘤组5例、性索间质肿瘤组4例。测定各组患者血清VEGF、HE4、CA125、CA724水平，绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC)，计算各血清标志物的敏感性和特异性，比较单项及联合检测对卵巢恶性肿瘤的诊断价值。结果：ROC曲线显示在上皮性卵巢癌与非上皮性卵巢癌的鉴别诊断及FIGO分期的鉴别诊断中，血清VEGF、HE4、CA125、CA724的4项指标的联合检测的AUC明显高于单项检测、2项及3项指标的联合检测，且敏感度和特异性更高，差异有统计学意义(P < 0.05)。结论：血清VEGF、HE4、CA125及CA724的水平与卵巢恶性肿瘤的发生发展密切相关，可作为卵巢恶性肿瘤鉴别诊断的检测指标，且联合检测诊断效能更高，对卵巢恶性肿瘤的早期诊断具有重要意义。

Abstract: Objective: To investigate the diagnostic value of serum vascular endothelial growth factor (VEGF), human epididymis protein 4 (HE4), carbohydrate antigen 125 (CA125), and carbohydrate antigen 724 (CA724) in ovarian malignant tumors. Methods: 106 patients with ovarian malignant tumors in the People’s Hospital of Zhengzhou University from 2020 to 2021 were retrospectively analyzed. According to the postoperative routine pathological results, they were divided into 97 cases of epi-thelial tumors, 5 cases of germ cell tumors, and 4 cases of sex cord-stromal tumors. The levels of VEGF, HE4, CA125, and CA724 in the serum of patients in each group were measured, the ROC curve of subjects was drawn, the area under the curve (AUC) was calculated, and the sensitivity and speci-ficity of serum markers were calculated, and the diagnostic value of single and combined detection for ovarian malignant tumors was compared. Results: The ROC curve showed that in the differential diagnosis of epithelial ovarian cancer and non-epithelial ovarian cancer and the differential diagno-sis of FIGO staging, the AUC of the combined detection of serum VEGF, HE4, CA125, CA724 was sig-nificantly higher than that of the single detection, the combined detection of two and three indica-tors, and the sensitivity and specificity were higher, with a statistically significant difference (P < 0.05). Conclusion: The levels of VEGF, HE4, CA125, and CA724 in serum are closely related to the occurrence and development of ovarian malignant tumors, which can be used as the detection indi-cators for differential diagnosis of ovarian malignant tumors, and the combined detection has high-er diagnostic efficacy, which is of great significance for the early diagnosis of ovarian malignant tu-mors.