Value of serum HE4, CYFRA21-1, CA199 in the diagnosis of ovarian benign and malignant tumor

Abstract

Objective To investigate the diagnosis significance of human epididymis (HE4), cytokeratin-19-fragment (CYFRA21-1), carbohydrate antigen 199 (CA199) on the malignant ovarian tumor, and to evaluate the value of individual and combined detection in judging high risk ovarian cancer. Methods The serum HE4, CYFRA21-1, CA199 levels of 45 patients with primary ovarian cancer, 56 patients with benign ovarian tumor and 50 healthy check-up women in our hospital were detected by electrochemiluminescence immunoassay (ECL). The positive rates and coincidence rates of them were analyzed and the diagnostic value of them were compared. Results HE4 and CYFRA21-1 levels of ovarian cancer group were significantly higher compared with the benign tumor group and healthy control group and the differences were statistically significant (Z=-8.61, P<0.001; Z=-8.39, P<0.001; Z=-8.60, P<0.001; Z=-8.39, P<0.001), however there is no difference between benign tumor group andcontrol group(Z=-1.31, P=0.189; Z=-1.29, P=0.191). The difference of CA199 between benign tumor group and control group was statistically significant (Z=-8.79, P<0.001). For the malignant tumors, the specificity and positive predictive value of HE4 (99.8%, 99.7%), CYFRA21-1 (99.0%, 96.7%) were very high and the diagnostic accordance rates were relatively high (93.4%, 88.7%), but the sensibilities of them were lower compared with CA199.CA199 was increased both in benign and malignant ovarian tumors with different degrees, but the specificity was not very high (85.8%), and the positive predictive value and the diagnosis accordance rate were low (70.6%, 84.1%). The combined detection of HE4, CYFRA 21-1 and CA199 could improve the sensitivity and of the diagnosis of ovarian cancer (100%) and accuracy (89.4%). Conclusions HE4 and CYFRA21-1 only increas in malignant ovarian tumors, and they are mainly used for the diagnosis of ovarian cancer; CA199 level is increased both in benign and malignant ovarian tumors, but the extent is different and it can be used for distinguishing and diagnosing of benign and malignant ovarian tumors. Combining the three indexes can improve the sensitivity and accuracy of the diagnosis of ovarian cancer, and has an important significance for the early diagnosis and treatment of ovarian cancer. Key words: Ovarian neoplasms; Keratins; Antigens, tumor-associated, carbohydrate; human epididymis protein 4