Over Kanserinin Erken Tanı ve Takibinde Ca 125 ve He4 ün Sensitivitesi ve Spesifitesinin Karşılaştırılması

Abstract

CA 125 is the most widely used tumour marker in ovarian and endometrial cancer. Unfortunately, it has low sensitivity for detection of gynecological cancers in the early stages and gives false positive results in some benign gynecological disorders. HE4 (Human Epididymis secretory protein 4), is suggested to be used as a potential new biomarker for ovarian cancer. The aim of this study is to evaluate HE4, in comparison with CA 125 and the Risk of Ovarian Malignancy Algorithm (ROMA) in benign and malignant gynaecological diseases, additionally to determine the reference range for healthy Turkish women. CA 125 and HE4 serum levels were determined in 96 patients with benign gynaecological diseases, 71 patients with gynaecological cancer (47 ovarian cancers and 24 endometriyal Ca) and in 70 healthy women, using a chemiluminescent enzyme immunoassay on the Architect® Analyzer (Abbott Laboratories, Chicago, IL). HE4 had significantly higher concentrations in ovarian and endometriyal cancer than benign disorders (p<0.005). Tumour marker sensitivity in ovarian cancer was 82.1 % for HE4, 64.3 % for CA 125 and 89.7 % for ROMA at 90 % spesifity. A significantly higher area under the ROC curve was obtained with HE4 and ROMA than CA 125 in the differential diagnosis of ovarian cancer. Tumour marker sensitivity in endometriyal cancer was 64 % for HE4, 18 % for CA 125 and 59 % for ROMA at 90 % specifity. A significantly higher area under the ROC curve was obtained with HE4 than ROMA and CA 125 in the differential diagnosis of endometrium cancer. According to these results, it is more convenient to use ROMA index instead of HE4 or CA 125 alone for the diagnosis of ovarian Ca in postmenapousal women. HE4 is a better tumor marker than CA 125 for the diagnosis of endometriyal Ca in postmenapousal women. It was observed that HE4 values increase by age and HE4 reference range for healthy Turkish women was determined as 22-88 pmol/L.