经阴道超声联合血清SLPI、SMRP检测对卵巢肿瘤良恶性的诊断价值  

Diagnostic value of transvaginal ultrasound combined with serum SLPI and SMRP detection for benign and malignant ovarian tumors

作　　者：华菁 杨永康[2] 邹立君[1] 康汝光[2] 师帅[2] Hua Jing;Yang Yongkang;Zou Lijun;Kang Ruguang;Shi Shuai(Department of Ultrasound,Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Shaanxi Province,Xianyang 712000,China)

机构地区：[1]陕西中医药大学第二附属医院超声科,咸阳712000 [2]陕西中医药大学第二附属医院妇科,咸阳712000

出　　处：《疑难病杂志》2024年第6期714-718,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：西安市卫生健康委员会中医药科研项目(SZL202211)。

摘　　要：目的探究经阴道超声(TVUS)联合血清分泌性白细胞肽酶抑制因子(SLPI)、可溶性间皮素相关肽(SMRP)检测对卵巢肿瘤良恶性的诊断价值。方法选择2022年1月—2023年6月陕西中医药大学第二附属医院妇科诊治的卵巢肿瘤患者120例,根据病理诊断结果分为良性组(70例)和恶性组(50例);使用彩色多普勒超声诊断仪对患者进行灰度超声检查和彩色多普勒超声检查并记录各项参数,ELISA检测血清SLPI、SMRP水平;多因素Logistic回归分析方法分析卵巢肿瘤良恶性的影响因素;ROC曲线分析TVUS联合SLPI、SMRP对卵巢肿瘤良恶性的诊断价值。结果良性组中TVUS阴性59例(84.3%)、阳性11例(15.7%),恶性组中阳性33例(66.0%),阴性17例(34.0%)(χ^(2)=31.759,P<0.001);恶性组病灶最大直径、收缩期最高峰值血流速度(Vs)、舒张期最低峰值血流速度(Vd)高于良性组(t/P=6.074/<0.001,3.247/0.002,3.048/0.003);与良性组比较,恶性组血清SLPI、SMRP水平较高(t=7.515,7.818,P<0.001)。多因素Logistic回归分析结果表明,SLPI高、SMRP高、Vs高、Vd高为卵巢恶性肿瘤的独立危险因素[OR(95%CI)=1.625(1.066~2.477),1.834(1.053~3.194),1.375(1.033~1.831),1.624(1.059~2.490)];ROC曲线分析结果表明,TVUS、血清SLPI、SMRP及三者联合诊断卵巢肿瘤良恶性的AUC分别为0.751、0.820、0.813、0.948,三者联合诊断的AUC优于各自单独诊断(Z=5.468、3.441、3.517,P均<0.001)。结论SLPI、SMRP在卵巢恶性肿瘤患者血清中表达上升,是恶性肿瘤发生的影响因素,TVUS联合血清SLPI、SMRP诊断卵巢肿瘤良恶性具有较高的价值,可用于临床实践。Objective To explore the diagnostic value of transvaginal ultrasound(TVUS)combined with serum secretory leukocyte peptidase inhibitor(SLPI)and soluble mesothelin-related peptide(SMRP)in benign and malignant ovarian tumors.Methods From January 2022 to June 2023,120 patients with ovarian tumor diagnosed and treated in the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine were selected and divided into benign group(70 cases)and malignant group(50 cases)according to the pathological diagnosis results.The patients were examined by gray-scale ultrasound and color Doppler ultrasound with color Doppler ultrasound diagnostic instrument,and the parameters were recorded.The levels of SLPI and SMRP were detected by ELISA.Multivariate Logistic regression analysis was used to analyze the influencing factors of benign and malignant ovarian tumors;ROC curve analysis of TVUS combined with SLPI and SMRP in the diagnosis of benign and malignant ovarian tumors.Results In the benign group,there were 59 cases(84.3%)of benign and 11 cases(15.7%)of malignant TVUS,17 cases(34.0%)of benign and 33 cases(66.0%)of malignant(χ^(2)=31.759,P<0.001).The maximum diameter of lesion,the highest systolic equivalent blood flow velocity(Vs)and the lowest diastolic peak blood flow velocity(Vd)in malignant group were higher than those in benign group(t/P=6.074/<0.001,3.247/0.002,3.048/0.003).Compared with the benign group,the levels of SLPI and SMRP in the malignant group were higher(t=7.515,7.818,P<0.001).High SLPI,high SMRP,high Vs and high Vd are independent risk factors for ovarian malignant tumor[OR(95%CI)=1.625(1.066-2.477),1.834(1.053-3.194),1.375(1.033-1.831),1.624(1.059-2.490)].The AUC of serum TVUS,SLPI,SMRP and their combination in the diagnosis of benign and malignant ovarian tumors were 0.751,0.820,0.813 and 0.948,respectively.The AUC of the combined diagnosis of TVUS,SLPI,SMRP and their combination was better than that of their individual diagnosis(Z=5.468,3.441 and 3.517,P<0.001).Conclusion The increased ex

关 键 词：卵巢肿瘤良恶性 经阴道超声 分泌性白细胞肽酶抑制因子 可溶性间皮素相关肽 诊断价值 

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]