Abstract:

Objective To discuss the diagnostic value of levels of growth stimulation expressed gene 2 protein （ST2）， carbohydrate antigen 125 （CA125）， and human epididymis protein 4 （HE4） in serum of the ovarian cancer patients， and to clarify their relationships with clinicopathological parameters of the ovarian cancer patients. Methods A total of 136 patients with ovarian benign lesions or primary ovarian malignancies in our hospital confirmed by postoperative histopathology were randomly selected， including 53 cases in ovarian benign ovarian disease group and 83 cases in ovarian cancer group. Additionally， 55 healthy female volunteers during the same period were enrolled as healthy control group. The fasting venous blood from all the subjects was collected on the first day of admission， and serum was retained； cyclic enhanced fluorescence immunoassay was used to detect ST2 levels of the subjects in various groups； chemiluminescence method was used to detect serum CA125 and HE4 levels of the subjects in various groups； receiver operating characteristic （ROC） curve was used to assess the diagnostic performance of each indicator； the Cut-off value and area under the ROC curve （AUC） were calculated， with AUC representing the diagnostic performance； Kendall’s method was used to analyze the correlations between serum ST2 levels and TNM stage， maximum tumor diameter， distant metastasis， lymphnode metastasis， peritoneal metastasis， carcinoembryonic antigen （CEA）， CA125， carbohydrate antigen 199 （CA199）， HE4， P53， and Kiel-67（Ki67） in the ovarian cancer patients. Results Compared with healthy control group， the serum CA125 level of the patients in ovarian benign ovarian disease group was significantly increased （P<0.05）. Compared with healthy control group and ovarian benign group， the serum levels of ST2， CA125， and HE4 of the patients in ovarian cancer group were significantly increased （P<0.05）. The AUC values were 0.719 （95%CI： 0.616-0.822） for ST2， 0.868 （95%CI： 0.794-0.942） for CA125， and 0.867 （95%CI： 0.793-0.942） for HE4. The combined detection of ST2+CA125+HE4 yielded an AUC of 0.894 （95%CI： 0.832-0.955）. Significant differences were observed in serum ST2， CA125， and HE4 levels among ovarian cancer patients with different TNM stages， lymph node metastasis， distant metastasis， and peritoneal metastasis （P<0.05）， while there were no significant differences in the patients with different ages or maximum tumor diameters （P>0.05）. The ST2 level in serm of the ovarian cancer patients was positively correlated with TNM stage， distant metastasis， lymph node metastasis， peritoneal metastasis， CA125 level， HE4 level， and Ki67 level （P<0.05）， but was not correlated with maximum tumor diameter， CEA， CA199 level， or P53 level （P>0.05）. Conclusion ST2， CA125， and HE4 are highly expressed in the serum of the ovarian cancer patients. Combined detection of serum ST2， CA125， and HE4 exhibits good sensitivity and specificity for ovarian cancer screening and improves diagnostic efficacy. ST2 is associated with advanced TNM stage and metastasis in ovarian cancer and may participate in the occurrence and progression of ovarian cancer.

Key words: Ovarian cancer, Growth stimulation expressed gene 2 protein, Carbohydrate antigen 125, Human epididymis protein 4, Serum