血清多指标联合经阴道彩超对上皮性卵巢恶性肿瘤的研究  

Study of Multiple Serological Indicators Combined with Transvaginal Color Doppler Ultrasound on Epithelial Ovarian Malignant Tumors

作　　者：王萍[1] 洪波[2] 郭鹏[3] Wang Ping;Hong Bo;Guo Peng(Department of Ulrasound,Anshun People's Hospital,Anshun,Guizhou 561000,China;Nuclear Medicine,Anshun People's Hospital,Anshun,Guizhou 561000,China;Department of Gynecology,Anshun People's Hospital,Anshun,Guizhou 561000,China)

机构地区：[1]贵州省安顺市人民医院超声科,贵州省安顺市561000 [2]贵州省安顺市人民医院核医学科,贵州省安顺市561000 [3]贵州省安顺市人民医院妇科,贵州省安顺市561000

出　　处：《中国超声医学杂志》2022年第5期561-565,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨多项血清学指标联合经阴道彩超对上皮性卵巢恶性肿瘤的诊断灵敏度及准确率。方法选取贵州省安顺市人民医院初诊为卵巢肿物的163例患者,所有患者均行血清附睾蛋白4(HE4)、糖类抗原125(CA125)、糖类抗原199(CA199)检测和经阴道彩超检查。以病理结果为金标准,对比卵巢良性肿瘤与恶性肿瘤患者的检测结果,并分析三项血清学指标联合经阴道彩超对上皮性卵巢恶性肿瘤的诊断效能。结果与良性组相比,恶性组的血清HE4、CA125、CA199水平及超声评分明显更高(F=129.780、129.157、30.304、36.460,P<0.001)。与Ⅰ~Ⅱ期上皮性卵巢癌患者相比,Ⅲ~Ⅳ期上皮性卵巢癌患者的血清HE4、CA125、CA199水平及超声评分明显更高(t=2.849、2.225、3.356、2.667,P<0.05)。卵巢恶性肿瘤风险算法(ROMA)指数、CA199和超声评分单独诊断上皮性卵巢癌的(AUC)值分别为0.965、0.759、0.843,约登指数(YI)值分别为0.867、0.438、0.594,CA199单用对上皮性卵巢癌的诊断准确性相对偏低。联合诊断上皮性卵巢癌的AUC值为0.991,YI值为0.920,其诊断效能明显高于ROMA指数、CA199和超声评分单用(AUC=0.965、0.759、0.843,P<0.05;YI=0.867、0.438、0.594,P<0.05)。结论血清HE4、CA125、CA199联合经阴道彩超对上皮性卵巢恶性肿瘤有较高的诊断灵敏度及准确性,其能为上皮性卵巢恶性肿瘤的早期诊治提供有效指导。Objective To explore the sensitivity and accuracy of multiple serological indicators combined with transvaginal color Doppler ultrasound in the diagnosis of epithelial ovarian cancer.Methods 163 patients with initially diagnosed ovarian tumor in anshun people’s hospital,guizhou anshun were selected.All patients were examined by serum human epididymis protein 4(HE4),carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA199)and transvaginal color Doppler ultrasound.The pathological results were regarded as the gold standard,the examination results of benign and malignant ovarian tumors were compared,and the diagnostic efficacy of three serological indicators combined with transvaginal color Doppler ultrasound for epithelial ovarian cancer was analyzed.Results Compared with benign group,the levels of serum HE4,CA125,CA199 and ultrasonic score in malignant group were significantly higher(F=129.780,129.157,30.304,36.460,P<0.001).Compared with patients with stageⅠ-Ⅱepithelial ovarian cancer,patients with stageⅢ-Ⅳepithelial ovarian cancer had significantly higher serum HE4,CA125 and CA199 levels and ultrasound scores(t=2.849,2.225,3.356,2.667,P<0.05).The area under curve(AUC)values of risk of ovarian malignancy algorithm(ROMA)index,CA199 and ultrasound score in the diagnosis of epithelial ovarian cancer were 0.965,0.759 and 0.843 respectively.The values of the youden index(YI)are 0.867,0.438 and 0.594.The accuracy of CA199 alone in the diagnosis of epithelial ovarian cancer was relatively low.Compared with using alone,the AUC value of combined diagnosis of epithelial ovarian cancer is 0.991 and the value of YI is 0.920,which significantly improves.Compared with ROMA index,CA199 and ultrasound score alone,the combination of the three items had higher diagonostic efficiency in the diagnosis of epithelial ovarian cancer(AUC=0.965,0.759,0.843,P<0.05;YI=0.867,0.438,0.594,P<0.05).Conclusions Serum HE4,CA125,CA199 combined with transvaginal color Doppler ultrasound has high sensitivity and accuracy in the diagno

关 键 词：糖类抗原125 上皮性卵巢恶性肿瘤 经阴道彩超 附睾蛋白4 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.31[医药卫生—诊断学]