摘要
目的:探讨三维超声联合血清人附睾蛋白4(HE4)和糖类抗原125(CA125)水平检测对卵巢良、恶性肿瘤鉴别诊断价值。方法:选取医院收治的108例卵巢肿瘤患者,根据病理结果将其中61例良性卵巢肿瘤患者作为良性组,47例恶性卵巢肿瘤患者作为恶性组,所有患者均经病理结果确诊为卵巢肿瘤,比较两组患者良恶性肿瘤血管形成指数(VI)、血流指数(FI)和血管形成-血流指数(VFI)值,对两组患者血清CA125、HE4水平进行比较,比较两组患者子宫动脉血流动力学参数,统计三维超声,血清HE4、CA125检测结果,并对三维超声,血清HE4、CA125和联合诊断效能进行比较。结果:卵巢肿瘤良性组患者VI、FI和VFI值均明显低于恶性组,差异有统计学意义(t=32.226,t=9.427,t=31.659;P<0.05)。卵巢肿瘤良性组患者血清CA125、HE4水平明显低于恶性组,差异有统计学意义(t=56.347,t=48.572;P<0.05)。卵巢肿瘤良性组患者子宫动脉血流搏动指数(RI)和阻力指数(PI)均低于恶性组,血流速度(PSV)和舒张末期流速(EDV)均高于恶性组,差异有统计学意义(t=5.591,t=6.454,t=14.741,t=16.104;P<0.05)。三维超声检出卵巢肿瘤49例,其中真阳性35例;血清HE4检出卵巢肿瘤54例,其中真阳性37例;血清CA125检出卵巢肿瘤55例,其中真阳性36例,联合诊断检出卵巢肿瘤55例,其中真阳性45例。三维超声、HE4及CA125联合诊断卵巢肿瘤的灵敏度、特异度和准确率均高于3种方法单独诊断,其灵敏度、特异度和准确率差异有统计学意义(x^(2)_(灵敏度)=8.392,x^(2)=6.113,x^(2)=7.230;x^(2)_(特异度)=0.829,x^(2)=2.330,x^(2)=3.664;x^(2)_(准确率)=6.259,x^(2)=7.040,x^(2)=9.576;P<0.05)。结论:三维超声联合HE4、CA125水平检测对于提高卵巢肿瘤良恶性诊断和鉴别水平、加强对肿瘤表面结构和血管客观评价、提高诊断灵敏度、特异度和准确度以及减少漏诊和误诊均具有临床诊断价值。
Objective:To explore the diagnostic value of three-dimensional(3D)ultrasound combined with serum human epididymis protein 4(HE4)and carbohydrate antigen 125(CA125)levels in identifying benign and malignant tumors of ovary.Methods:108 patients with ovarian tumors admitted to hospital were selected.According to the pathological results,61 patients with benign ovarian tumors were divided into benign group and 47 patients with malignant ovarian tumors were divided into malignant group.All patients were confirmed as ovarian tumors by pathological results.The vascularization index(VI),flow index(FI)and vascularity flow index(VFI)of benign and malignant tumors between two groups were compared.And the serum CA125 and HE4 levels of the two groups were compared.And the dynamic parameters of blood flow of uterine artery of the two groups were compared.The results of 3D ultrasound,serum HE4 and CA125 were analyzed by statistics method,and the efficiencies of 3D ultrasound,serum HE4,CA125 and combined diagnosis were compared.Results:The values of VI,FI and VFI in benign group were significantly lower than those in malignant group,and the differences of them between two groups were statistically significant(t=32.226,t=9.427,t=31.659,P<0.05),respectively.The serum levels of CA125 and HE4 in benign group were significantly lower than those in malignant group(t=56.347,t=48.572,P<0.05),respectively.The pulsatility index(PI)and resistance index(RI)of benign group were significantly lower than those of malignant group,and the peak systolic velocity(PSV)and end-diastolic velocity(EDV)of benign group were significantly higher than those of malignant group(t=5.591,t=6.454,t=14.741,t=16.104,P<0.05),respectively.49 cases of ovarian tumors were confirmed by 3D ultrasound,of which 35 cases were true positivity.54 cases of ovarian tumors were confirmed by serum HE4,of which 37 cases were true positives.55 cases of ovarian tumors were confirmed by serum CA125,of which 36 cases were true positives.In addition,the 55 cases of ovarian tumors were confirmed by combined diagnosis,of which 45 cases were true positives.The sensitivity,specificity and accuracy of the combined diagnosis of 3D ultrasound,HE4 and CA125 were higher than those of each alone diagnosis,and the differences of sensitivity and accuracy between two groups were statistically significant(x^(2)_(sensitivity)=8.392,x^(2)=6.113,x^(2)=7.230,x^(2)_(specificity)=0.829,x^(2)=2.330,x^(2)=3.664,x^(2)_(accuracy rate)=6.259,x^(2)=7.040,x^(2)=9.576,P<0.05),respectively.Conclusion:The combination of 3D ultrasound and the detections of HE4 and CA125 level has clinical application value in improving the levels of diagnosis and identification of benign and malignant tumor of ovary,strengthening the objective evaluations of tumor surface structure and blood vessels,improving diagnostic sensitivity,specificity and accuracy,and reducing missed diagnosis and misdiagnosis.
作者
焦蕊丽
郑华
徐佳圆
白会敏
JIAO Rui-li;ZHENG Hua;XU Jia-yuan(Department of Gynecology and Obstetrics,Maternal and Child Health Care Hospital of Chaoyang District of Beijing,Beijing 100021,China;不详)
出处
《中国医学装备》
2021年第7期88-93,共6页
China Medical Equipment
基金
国家自然科学基金面上资助项目(81972424)“整合素αVβ1/αVβ3-PI3K通路在外泌体介导的卵巢肿瘤低侵袭细胞向高侵袭细胞转化中的作用及相关机制的研究”。
