CT联合血清肿瘤标记物在鉴别卵巢交界性肿瘤和良性上皮性肿瘤中的应用  

Application of CT combined with serum tumor markers in identification of borderline ovarian tumors and benign epithelial ovarian tumors

作　　者：石新琳[1] 张维[1] 郭大静[1] 陈婷[1] 孙冬[1] 彭睿[1] 

机构地区：[1]重庆医科大学附属第二医院放射科,重庆400010

出　　处：《重庆医学》2017年第25期3496-3499,共4页Chongqing medicine

基　　金：国家临床重点专科建设项目(国卫办医函[2013]544号)

摘　　要：目的探讨CT联合血清肿瘤标记物在卵巢交界性肿瘤(BOT)和卵巢良性上皮性肿瘤(BET)中的鉴别诊断价值。方法回顾性分析经手术和病理证实的28例BOT和41例BET患者的CT资料,收集术前血清糖类抗原-125(CA125)、人附睾分泌蛋白4(HE4)、癌胚抗原(CEA)的检测结果,比较两组肿瘤的CT影像特点和血清肿瘤标记物的水平。结果两种肿瘤实性成分、厚分隔、壁结节的出现率差异有统计学意义(χ~2=25.135、5.240、5.066,P<0.05);血清CA125水平的差异有统计学意义(Z=3.202,P<0.05),但血清HE4、CEA水平的差异无统计学意义(Z=0.330、1.122,P>0.05);血清CA125水平鉴别两种肿瘤的最佳临界值、敏感性、特异性分别为42.45U/mL、53.6%、85.4%;实性成分、厚分隔诊断两种肿瘤的总确诊率为78.5%;实性成分、厚分隔、血清CA125水平诊断两种肿瘤的总确诊率为81.2%。结论卵巢上皮性肿瘤出现实性成分、厚分隔及血清CA125水平升高有助于鉴别BOT和BET。Objeetive To investigate the differential diagnostic value of computed tomography （CT） combined with serum tumor markers in borderline ovarian tumors （BOT） and benign epithelial ovarian tumors （BET）. Methods The CT data in 28 patients with BOT and 41 patients with BET,both eonfirmed by surgery and pathological, were analyzed retrospectively. Their preoperative serum carbohydrate antigen 125 （CA125）, human epididymis secretory protein 4 （HE4） and carcinoembryonic antigen （CEA） detection results were collected. The CT images features and serum tumor markers levels were compared between the two groups. Results The difference in the appearance rate of tumor solid composition,thick septum and wall nodule between the two groups had statistical significance （x^2 = 25. 135,5. 240,5. 066 ,P〈0.05）. The serum CA125 level had statistical difference between the two groups （Z=3. 202 ,P〈0.05） ,while serum HE4 and CEA levels had no statistically significant difference between the two groups（Z= 0. 330,1. 122, P〉0.05）. The optimal critical value, sensitivity and specificity of serum CA125 level in differential diagnosis of two kinds of tumor was 42.45 U/mL, 53.6 % and 85.4 %. The overall diagnostic rate of solid composition and thick septum for diagnosing the two kinds of tumor was 78.5%. The overall diagnostic rate of solid composition,thick septum and CA125 level for diagnosing the two kinds of tumor was 81. 2%. Conclusion The appearance of solid composition, thick septum and serum CA125 level increase in epithelial ovarian tumor may help to identify BOT and BET.

关 键 词：卵巢肿瘤 体层摄影术 X线计算机 生物学标记 肿瘤 

分 类 号：R730.44[医药卫生—肿瘤] R737.31[医药卫生—临床医学]