腹水液基细胞学特征结合血清CA-125、HE4及影像学表现对诊断卵巢癌的意义  

Significance of ascites cytological features combined with serum CA-125,HE4 and imaging findings in diagnosis of ovarian cancer

作　　者：李洁[1] 张昀 南鹏飞[1] 柳雨 隋燕霞[1] LI Jie;ZHANG Yun;NAN Peng-fei;LIU Yu;SUI Yan-xia(Department of Pathology,the First Affiliated Hospital of Xi’an Jiaotong University,Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院病理科,西安710061

出　　处：《诊断病理学杂志》2021年第7期532-535,共4页Chinese Journal of Diagnostic Pathology

基　　金：国家自然科学基金(No.81702577);陕西省自然科学基础研究计划(No.2018JQ8035)。

摘　　要：目的探讨腹水液基细胞学特征结合血清CA-125、HE4及影像学表现在诊断上皮性卵巢癌中的意义。方法收集19例腹水细胞学诊断为上皮性卵巢癌,并经随后的卵巢切除标本进一步证实为上皮性卵巢癌,同时收集患者术前血清CA-125、HE4值及影像学表现,并复习相关文献。结果在腹水液基细胞涂片上,癌细胞排列紧密,可排列成桑葚样、腺腔样特殊结构,三维立体结构清晰;癌细胞体积增大,异型性明显,核浆比增高,可见核仁,胞质中可见黏液空泡,将核挤向一边。19例患者血清CA-125水平均升高,范围为1 379~36 725 U/mL;同时19例患者血清HE4水平均升高,范围为431~996 Pmol/L。19例患者术前均行盆腔CT检查,结果提示盆腔肿块,可以见到较多的实性软组织,呈现小结节或者乳头状突起,大小不均匀;盆腹腔中-大量积液。结论腹水液基细胞学形态结合患者CT特殊表现及血清中异常升高的CA-125、HE4水平,可提高上皮性卵巢癌诊断的准确性。Objective To investigate the significance of ascites fluid-based cytology combined with serum CA-125,HE4 and imaging findings in the diagnosis of epithelial ovarian cancer.Methods Ninteen cases of epithelial ovarian cancer were diagnosed by ascites cytology and confirmed by subsequent ovarian resection;at the same time,the serum CA-125,HE4 and imaging findings were collected and the related literature was reviewed.Results In the smear of ascites fluid-based cells,the cancer cells were closely arranged,which formed special structures like mulberry and gland cavity,with clear three-dimensional structure.The cancer cell volume increased,the heteromorphism was obvious,the ratio of nucleoplasm increased,the nucleolus and mucus vacuole were noted in the cytoplasm,squeezing the nucleus to one side.The serum CA-125 level was increased in 19 patients,ranging from 1379 to 36725 U/mL,while the serum HE4 level was increased in 19 patients,ranging from 431 to 996 pmol/L.All the 19 patients underwent pelvic CT examination before operation,the results showed that there were more solid soft tissues,small nodules or papillary protuberances in pelvic masses,and the size was uneven,moderate to massive effusion in pelvic and abdominal cavity.Conclusion Combined the abnormally high levels of CA-125 and HE4 in serum with the ascites liquid-based cytology and imaging findings can improve the accuracy of diagnosis of epithelial ovarian cancer.

关 键 词：液基细胞学 腹水 糖类抗原CA-125 附睾蛋白4 上皮性卵巢癌 

分 类 号：R737.31[医药卫生—肿瘤]