经阴道彩色多普勒超声结合血清CA_(125)诊断卵巢恶性肿瘤的价值  

Evaluation of transvaginal ultrasonograph and color doppler ultrasonography and serum CA_(125) for the diagnosis of malignant ovarian tumor

作　　者：朱建龙[1] 殷舫[2] 洪向丽[2] 徐惠英[2] 冯令达[1] 陆惠娟[3] 邵敬於[1] 

机构地区：[1]上海市第一妇婴保健院妇科,上海200040 [2]上海市第一妇婴保健院超声室,上海200040 [3]上海市第一妇婴保健院病理科,上海200040

出　　处：《中国癌症杂志》2006年第5期390-393,共4页China Oncology

摘　　要：背景与目的:经阴道彩色多普勒超声及血清CA125术前单独诊断卵巢恶性肿瘤的准确率较低,为了提高卵巢恶性肿瘤术前诊断的准确率。本文探讨经阴道彩色多普勒超声结合CA125诊断卵巢恶性肿瘤以及术前鉴别卵巢良恶性肿瘤的价值。方法:对165例盆腔肿块的患者,术前应用阴道超声进行评分,同时加用彩色多普勒超声检查的R I值,以及临床测定的CA125值。术后对照病理结果,了解诊断符合率。结果:阴道超声对盆腔肿块评分,B超积分>9分的57例的患者中,病理检查证实为恶性肿瘤55例,诊断符合率96.5%,B超积分≤9的108例患者中,病理检查证实为良性肿瘤的有105例,诊断符合率为97.2%。R I<0.5的病例有58例,56例诊断为恶性肿瘤,诊断符合率为96.6%,R≥I0.5的病例有107例,105例诊断为良性肿瘤,良性肿瘤的诊断符合率为98.1%;69例CA125>35u/m l的恶性肿瘤病例有55例,诊断符合率为79.7%。96例CA125为35u/m l的良性肿瘤有93例,诊断符合率为96.9%。超声评分和血流R I值结合CA125综合分析肿块的良恶性,B超积分>9和R I<0.5、CA125>35u/m l共有54例,病理检查为恶性52例,诊断符合率为96.3%,B超积分为9和R I≥0.5、CA125<35u/m l共有93例,病理检查为良性93例,诊断符合率为100%。结论:B超积分>9和R I<0.5、CA125>35u/m l是卵巢恶性肿瘤的临床特异表现,是目前临床鉴别卵巢良恶性肿瘤较好的手段。Background and purpose： Neither transvaglnal uhrasonograph and color Doppler ultrasonography nor serum CA125 alone were accurate for the diagnosis of malignant ovarian tumors. This study is focused on evaluating the accuracy of transvaginal uhrasonograph combined with serum CA125 for the diagnosis of ovarian cancer and its role in diseriminating benign from malignant ovarian tumors. Methods： 165 patients who had pelvic masses were examined by transvaginal ultrasonography to quantify mass scoring and by Doppler uhrasonography to measure RI value of peripheral blood flow of mass, and the serum CA125 was also documented. All of the data has been used to analysed for correlation with the pathological diagnosis. Results： With 〉9 pelvic mass uhrasonography scoring, 55 of 57 cases （96.5%） were diagnosed as malignant tumors. With scoring ≤9. 105 of 108 cases （97.2%） were diagnosed as benign tumors. In terms of RI value, if it was 〈 0.5, 56 of 58 eases （96.6%） were malignant tumors, if RI/〉0.5, 105 of 107 cases （98.1%） were benign tumors. 55 of 69 cases （79.7%） were proved as malignant tumors if CA125 was 〉35u/ml. 93 of 96 cases（96.9%） proved as benign tumors with CA125 ≤ 35u/ml. If the combination of uhrasonography scoring, RI value and the level of serum CA125 were used to diagnosis, 52 of 54 patients with malignant tumors were diagnosed, the sensitivity for the diagnoses of malignancy was 96.3%. 93 of 93 cases with benign tumor were diagnosed, the sensitivity was 100% for benign tumors. Conclusions： Uhrasongraphy mass scoring 〉9 , RI 〈 0.5 of mass peripheral blood flow and CA125 〉 35u/mol were observed in most of the malignant tumors. The combination of all three methods would give more accuracy for the diagnosis in terms of differentiation of benign tumor from malignant ovarian tumor.

关 键 词：卵巢恶性肿瘤 B超 彩色多普勒超声 CA125 

分 类 号：R737.31[医药卫生—肿瘤] R730.4[医药卫生—临床医学]