Efectividad de he4 como biomarcador tumoral de cáncer de ovario en SOLCA Guayaquil, algoritmo diagnóstico
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2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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El interés en la detección temprana del cáncer de ovario como mecanismo para lograr la reducción de la mortalidad ha crecido con el descubrimiento de biomarcadores tumorales séricos asociados a tumores malignos. En el presente estudio de casos se evaluaron 53 pacientes entre abril de 2015 y marzo de 2016 con masas pélvicas, incluyendo 32 (60,4%) mujeres postmenopáusicas y 21 (39, 6%) mujeres premenopáusicas. Valores de sensibilidad, especificidad, valor predictivo positivo y negativo (VPP, VPN), razón de probabilidad positiva y negativa (LR+,LR-), y pruebas estadísticas para determinar la relación entre los estados menopáusicos, y los grupos de estudio (benigno, maligno y control) de CA125, HE4 y ROMA fueron calculados con un intervalo de confianza del 95 %. Todo resultado con nivel de significancia p < .05 fue aceptado como estadisticamente significante, HE4 presentó un factor medio diferenciable que permite distinguir masas pélvicas malignas de benignas (Log2 HE4:7,19 (maligno) vs. 5.71 (benigno); control 5.79), igualmente, HE4 + ROMA presentan mayor sensibilidad y especificidad que las combinaciones CA125 + HE4 y CA125 + I. ROMA (S:86% vs. 64%; E: 97% vs. 93%, respectivamente), de igual forma HE4 + ROMA presentan mayores niveles de VPP, VPN, LR+ y la menor LR- (95%, 91%, 27.43 y 0.15, respectivamente). En conclusión, los resultados sugieren que HE4 y ROMA en combinación o solos, servirían como biomarcadores eficientes para la diferenciación de masas pélvicas en estadios tempranos y si se adiciona el estatus menopáusico, afianzaría los resultados obtenidos, permitiendo desarrollar un algoritmo diagnóstico idóneo, para la diferenciación del cáncer de células epiteliales en estadios tempranos en el pais
The interest in early detection of ovarian cancer as a mechanism to achieve mortality reduction has grown with the discovery of serum tumor biomarkers associated with malignant tumors. In the present case study, 53 patients were evaluated between April 2015 and March 2016 with pelvic masses, including 32 (60.4%) postmenopausal women and 21 (39.6%) premenopausal women. Sensitivity values, specificity, positive and negative predictive value (PPV, NPV), positive and negative likelihood ratio (LR +, LR-), and statistical tests to determine the relationship between menopausal states, and study groups (benign, malignant and control) of CA125, HE4 and ROMA were calculated with a confidence interval of 95%. Any result with level of significance p <.05 was accepted as statistically significant, HE4 presented a differentiable mean factor that allows to distinguish malignant pelvic masses from benign (Log2 HE4: 7.19 (malignant) vs. 5.71 (benign), control 5.79) , likewise, HE4 + ROMA present greater sensitivity and specificity than combinations CA125 + HE4 and CA125 + I. ROME (S: 86% vs. 64%; E: 97% vs. 93%, respectively), likewise HE4 + ROMA have higher levels of VPP, VPN, LR + and the lowest LR- (95%, 91%, 27.43 and 0.15, respectively). In conclusion, the results suggest that HE4 and ROMA in combination or alone, would serve as efficient biomarkers for the differentiation of pelvic masses in early stages and if the menopausal status is added, it would strengthen the results obtained, allowing the development of a suitable diagnostic algorithm, for the Cancer differentiation of epithelial cells in early stages in the country
The interest in early detection of ovarian cancer as a mechanism to achieve mortality reduction has grown with the discovery of serum tumor biomarkers associated with malignant tumors. In the present case study, 53 patients were evaluated between April 2015 and March 2016 with pelvic masses, including 32 (60.4%) postmenopausal women and 21 (39.6%) premenopausal women. Sensitivity values, specificity, positive and negative predictive value (PPV, NPV), positive and negative likelihood ratio (LR +, LR-), and statistical tests to determine the relationship between menopausal states, and study groups (benign, malignant and control) of CA125, HE4 and ROMA were calculated with a confidence interval of 95%. Any result with level of significance p <.05 was accepted as statistically significant, HE4 presented a differentiable mean factor that allows to distinguish malignant pelvic masses from benign (Log2 HE4: 7.19 (malignant) vs. 5.71 (benign), control 5.79) , likewise, HE4 + ROMA present greater sensitivity and specificity than combinations CA125 + HE4 and CA125 + I. ROME (S: 86% vs. 64%; E: 97% vs. 93%, respectively), likewise HE4 + ROMA have higher levels of VPP, VPN, LR + and the lowest LR- (95%, 91%, 27.43 and 0.15, respectively). In conclusion, the results suggest that HE4 and ROMA in combination or alone, would serve as efficient biomarkers for the differentiation of pelvic masses in early stages and if the menopausal status is added, it would strengthen the results obtained, allowing the development of a suitable diagnostic algorithm, for the Cancer differentiation of epithelial cells in early stages in the country
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Proteína epididimal humana 4 (he4), Antígeno CA125, Algoritmo de riesgo de malignidad ovárica (ROMA), Neoplasias ováricas, Perimenopausia, Posmenopausia, Hospital SOLCA de Guayaquil, Cantón Guayaquil, Ecuador