超声联合血清CEA和Cyfra21-1鉴别卵巢单房肿瘤良恶性质价值  

Value of ultrasonography combined with the levels of serum carcino-embryonic antigen and cytokerantin 19-fragment for differentiating benign or malignant of ovarian unilocular tumors

作　　者：应剑萍 张燕利[1] 杨春林[1] YING Jianping;ZHANG Yanli;YANG Chunlin(Yuyao Peoples Hospital,Zhejiang Province,315400)

机构地区：[1]浙江省余姚市人民医院,315400

出　　处：《中国计划生育学杂志》2022年第7期1655-1658,共4页Chinese Journal of Family Planning

摘　　要：目的:分析超声、血清癌胚抗原(CEA)及细胞角蛋白19片段抗原21-1(Cyfra21-1)对卵巢单房肿瘤良恶性质的鉴别价值.方法:选取2019年1月-2020年12月于本院妇科收治的卵巢单房囊实不均性包块的患者185例,均行超声检查、血清CEA和Cyfra21-1检测.以病理结果为诊断标准,分析上述3项指标对卵巢恶性肿瘤的诊断效能及良恶性质的鉴别价值.结果:恶性肿瘤组血清CEA、Cyfra21-1水平均高于良性肿瘤组(P<0.001);超声、血清CEA和Cyfra21-1联合检查与病理诊断的符合率为94.6%,Kappa值为0.88,诊断卵巢恶性肿瘤的灵敏度为92.3%、特异度为95.8%,阳性预测值92.3%、阴性预测值95.8%,高于各指标单项检查(P<0.05);血清CEA、Cyfra21-1、超声检查各单项的诊断灵敏度、特异度、阳性预测值、阴性预测值无差异(P>0.05);受术者工作特征曲线显示,超声、CEA、Cyfra21-1联合检查对卵巢单房肿瘤良恶性质的鉴别效能良好,而各单项检查鉴别效能一般;对直径<5cm、≥5cm的卵巢肿瘤,3项联合鉴别恶性肿瘤的灵敏度及特异度均高于单项检查(P<0.05),对直径<5cm的卵巢肿瘤,血清CEA、CyG fra21-1鉴别恶性肿瘤的灵敏度及特异度高于超声检查(P<0.05),对直径≥5cm的卵巢肿瘤,血清CEA、Cyfra21-1、超声检查鉴别恶性肿瘤的灵敏度及特异度无差异(P>0.05).结论:超声联合血清CEA、Cyfra21-1检查对卵巢单房囊实不均性肿瘤性质的鉴别诊断能力优于单项检查,特别是对肿瘤直径较小的鉴别能力提高.Objective: To analyze the value of ultrasonography combined with the levels of serum carcino-embryonic antigen(CEA) and cytokerantin 19-fragment(Cyfra21-1) for differentiating benign or malignant of ovarian unilocular tumors serum. Methods: From January 2019 to December 2020, 185 patients with unilocular cystic and nonhomogeneous mass of ovary were selected as the research subjects, and these patients were examined by ultrasonography, and were detected of serum CEA and Cyfra21-1. Based on the pathological results as the gold standard, the values of ultrasonography combined with the levels of serum CEA and Cyfra21-1 for differentiating benign or malignant of ovarian unilocular tumors were analyzed. Results: The levels of serum CEA and C yfra21-1 of the patients with benign of ovarian unilocular tumors were significantly higher than those of the patients with benign of ovarian unilocular tumors(P<0.001). The coincidence rate of the results by ultrasonography combined with the levels of serum CEA and CyFRA21-1 for diagnosing malignant of ovarian unilocular tumors and the pathological diagnosis was 94.6%. The Kappa value, the sensitivity, the specificity, the positive predictive value, and the negative predictive value of the ultrasonography combined with the levels of serum CEA, CyFRA21-1 for diagnosing malignant of ovarian unilocular tumors were 94.6%, 0.88, 92.3%, 95.8%, 92.3%, and 95.8%, respectively, which were significantly higher than those of ultrasonography, serum CEA level, or serum C yfra21-1 level alone(P<0.05). There were no significant differences in the sensitivity,the specificity,the positive predictive value,and the negative predictive value for diagnosing malignant of ovarian unilocular tumors among ultrasonography,serum CEA level,and serum Cyfra21-1level(P>0.05).The receiver operation characteristic curve showed that ultrasonography combined with the levels of serum CEA and Cyfra21-1had better differentiation efficacy for benign or malignant ovarian unilocular tumors,while the efficacy of ultrasono

关 键 词：卵巢单房肿瘤 良恶性鉴别 不同直径肿瘤 超声 血清癌胚抗原 血清细胞角蛋白19片段抗原21-1 效能 

分 类 号：R737.31[医药卫生—肿瘤]