The diagnostic value of the combination of hemoglobin, CA199, CA125, and HE4 in endometriosis

J Clin Lab Anal. 2021 Sep;35(9):e23947. doi: 10.1002/jcla.23947. Epub 2021 Aug 18.

Abstract

Background: We aimed to analyze the differences in the peripheral blood cells and tumor biomarkers between the patients with endometriosis and healthy people, and establish a more efficient combined diagnostic model.

Methods: We retrospectively analyzed the differences in the peripheral blood cells and tumor biomarkers between the patients with endometriosis and healthy people. Binary logistic regression analysis was used to establish a combined diagnostic model. We plotted the receiver operator characteristic (ROC) curve to analyze the diagnostic efficiency of different diagnostic indexes.

Results: Compared with patients in the control group, patients in the endometriosis group had significantly lower eosinophil% (p = 0.045), neutrophil (p = 0.001), lymphocyte (p < 0.001), red blood cells (RBCs) (p < 0.001), and hemoglobin (HGB) (p < 0.001), and had significantly higher monocyte% (p = 0.008), monocyte-to-lymphocyte ratio (MLR) (p = 0.001), platelet-to-lymphocyte ratio (PLR) (p < 0.001), carbohydrate antigen (CA)-199 (p < 0.001), CA125 (p < 0.001), human epididymis protein (HE)-4 (p < 0.001), and the risk of ovarian malignancy algorithm (ROMA) (p < 0.001). The combined diagnostic model of HGB, CA199, CA125, and HE4 was established by binary logistic regression analysis. The ROC curve showed that the combined diagnostic model reached a sensitivity of 85.4%, a specificity of 78.83%, and an area under the curve of 0.900, which was significantly higher than that of the individual index in endometriosis diagnosis.

Conclusion: The combined diagnostic model of HGB, CA199, CA125, and HE4 may provide a new approach for the early non-invasive diagnosis of endometriosis.

Keywords: CA125; CA199; HE4; HGB; endometriosis.

MeSH terms

  • Adult
  • Algorithms*
  • Antigens, Tumor-Associated, Carbohydrate / blood*
  • Biomarkers / blood*
  • Blood Platelets / pathology
  • CA-125 Antigen / blood*
  • Case-Control Studies
  • Endometriosis / blood
  • Endometriosis / diagnosis*
  • Female
  • Hemoglobins / analysis*
  • Humans
  • Lymphocytes / pathology
  • Membrane Proteins / blood*
  • ROC Curve
  • Retrospective Studies
  • WAP Four-Disulfide Core Domain Protein 2 / analysis*

Substances

  • Antigens, Tumor-Associated, Carbohydrate
  • Biomarkers
  • CA-125 Antigen
  • Hemoglobins
  • MUC16 protein, human
  • Membrane Proteins
  • WAP Four-Disulfide Core Domain Protein 2
  • WFDC2 protein, human
  • carbohydrate antigen 199, human