经阴道三维超声联合CA125、CA199、NLR及PLR检测对绝经后子宫内膜癌的诊断效能  

Diagnostic Efficacy of Transvaginal Three-Dimensional Ultrasound Combined with CA125,CA199,NLR and PLR in Postmenopausal Endometrial Carcinoma

作　　者：倪晓鸽[1] 朱琳娜[2] 房玉珠[3] 时婕 李思玥 NIXiao-ge;ZHU Lin-na;FANG Yu-zhu;SHI Jie;LI Si-yue(Department ofObstetrics and Gynecology,People's Hospital Affliated to Jiangsu University,Zhenjiang,Jiangsu,212000,China;Department ofUltrasonography,People's Hospital Affiliated to Jiangsu University,Zhenjiang,Jiangsu,212000,China;Department of Clinical Laboratory,People's Hospital Affiliated to Jiangsu University,Zhenjiang,Jiangsu,212000,China)

机构地区：[1]江苏大学附属人民医院妇产科,江苏镇江212000 [2]江苏大学附属人民医院超声科,江苏镇江212000 [3]江苏大学附属人民医院检验科,江苏镇江212000

出　　处：《现代生物医学进展》2023年第9期1771-1775,共5页Progress in Modern Biomedicine

基　　金：江苏省自然科学基金面上项目(BK20161653)。

摘　　要：目的:探讨经阴道三维超声联合糖类抗原125(CA125)、糖类抗原199(CA199)、中性粒细胞/淋巴细胞比值(NLR)及血小板/淋巴细胞比值(PLR)检测对绝经后女性子宫内膜癌(EC)的诊断效能。方法:回顾性分析本院2019年5月至2022年5月收治的因绝经后出血就诊的92例疑似子宫内膜肿瘤患者的病历资料,经手术病理证实,EC患者48例(EC组)、子宫内膜良性病变患者44例(良性组)。比较两组CA125、CA199、NLR及PLR水平,对比两组子宫内膜血管指数(VI)、血流指数(FI)、血管-血流指数(VFI)、子宫内膜容积(EV)变化及血流信号分布情况。绘制受试者工作特征(ROC)曲线分析经阴道三维超声联合CA125、CA199、NLR及PLR检测对绝经后EC的诊断效能。结果:EC组CA125、CA199、NLR及PLR水平均高于良性组(P<0.05)。EC组三维超声参数VI、FI、VFI及EV均高于良性组(P<0.05)。EC组血流信号Ⅱ级占比25.00%,Ⅲ级占比70.83%;良性组血流信号Ⅱ级占比88.64%,Ⅲ级占比2.27%。EC组血流信号Ⅱ级占比低于良性组,血流信号Ⅲ级占比高于良性组(P<0.05)。两组血流信号0级、Ⅰ级比较无差异(P>0.05)。ROC结果显示五项检查联合检测曲线下面积(AUC)值为0.944(95%Cl:0.902~0.985),具有更优的诊断效能(敏感度为89.10%、特异度为91.80%)。结论:CA125、CA199、NLR及PLR检测联合经阴道三维超声检查诊断绝经后EC效果显著,可为临床诊断提供参考。Objective:To investigate the diagnostic efficacy of transvaginal three-dimensional ultrasound combined with carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA199),neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)in postmenopausal women with endometrial carcinoma(EC).Methods:The medical records of 92 patients with suspected endometrial tumors due to postmenopausal bleeding who were admitted to our hospital from May 2019 to May 2022 were retrospectively analyzed,confirmed by surgery and pathology,48 patients of EC(EC group),44 patients of benign endometrial lesions(benign group).The levels of CA125,CA199,NLR and PLR in the two groups were compared,and the changes of endometrial vascular index(VI),blood flow index(FI),vascular blood flow index(VFI),endometrial volume(EV)and blood flow signal distribution were compared between the two groups.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of transvaginal three-dimensional ultrasound combined with CA125,CA199,NLR and PLR in postmenopausal EC.Results:The levels of CA125,CA199,NLR and PLR in EC group were higher than those in benign group(P<0.05).The three-dimensional ultrasound parameters VI,FI,VFI and EV in EC group were higher than those in benign group(P<0.05).The proportion of blood flow signal grade II was 25.00%,and the proportion of blood flow signal grade II was 70.83%in EC group.The proportion of blood flow signal grade II was 88.64%,and the proportion of blood flow signal grade II was 2.27%in benign group.The proportion of blood flow signal grade II in EC group was lower than that in benign group,and the proportion of blood flow signal grade III was higher than that in benign group(P<0.05).There was no difference between the two groups in blood flow signals grade O,and grade I(P<0.05).The ROC results showed that the area underthe curve(AUC)value of the combined detection of five examinations was 0.944(95%Cl:0.902~0.985),which had better diagnostic efficacy(sensitivity was 89.10%,spec

关 键 词：子宫内膜癌 经阴道三维超声 CA125 CA199 NLR PLR 诊断效能 

分 类 号：R737.33[医药卫生—肿瘤]