子宫内膜-肌层交界区超声联合肿瘤标志物对子宫腺肌病的诊断价值  

Diagnostic Value of Endometrial-Myometrial Interface Ultrasound Combined with Tumor Markers in Adenomyosis

作　　者：方群 任强 刘英 沈亚梅 Fang Qun;Ren Qiang;Liu Ying;Shen Yamei(Fuyang Women and Children's Hospital,Fuyang,Anhui 236000,China)

机构地区：[1]阜阳市妇女儿童医院,安徽省阜阳市236000

出　　处：《中国超声医学杂志》2024年第7期783-787,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨子宫内膜-肌层交界区(EMI)超声指标联合血清糖类抗原125(CA125)、糖类抗原199(CA199)对子宫腺肌病(AM)的诊断价值。方法回顾性分析110例AM患者(设为AM组)与同期110例健康体检女性(设为非AM组)临床资料。两组均行二维与三维超声检查,获取EMI形态与平均厚度,并测定血清CA125、CA199水平。比较两组EMI超声指标,血清CA125、CA199差异,观察上述指标对AM的诊断价值。并分析AM发病影响因素,建立EMI超声指标,血清CA125、CA199的回归诊断模型,判定模型拟合优度与诊断效能。结果AM组EMI平均厚度、形态异常比例,血清CA125、CA199水平均高于非AM组(P<0.05);受试者工作特征(ROC)曲线分析发现,EMI平均厚度,EMI形态,血清CA125、CA199水平均对AM的诊断具有一定价值,曲线下面积(AUC)分别为0.860、0.664、0.892、0.874;二元Logistic回归分析显示,EMI平均厚度,EMI形态,血清CA125、CA199均是AM发病相关因素(P<0.05)。ROC曲线分析发现,回归诊断模型对AM的诊断AUC为0.974(95%CI:0.954~0.993,P<0.001),约登指数取最大值0.864时,诊断灵敏度为90.91%,特异度为95.45%,准确度为93.18%,阳性预测值为95.24%,阴性预测值为91.30%。结论EMI超声指标联合血清CA125、CA199检测可提高AM诊断效能,为疾病诊断提供支持。Objective To investigate the diagnostic value of endometrial-myometrial interface(EMI) ultrasound index combined with serum carbohydrate antigen 125(CA125) and carbohydrate antigen 199(CA199) in adenomyosis(AM).Methods The clinical data of 110 AM patients(the AM group) and 110 healthy women(the non-AM group) were retrospectively analyzed.Two-dimensional and three-dimensional ultrasound examinations were performed in both groups to obtain EMI morphology.The average thickness of EMI,serum CA125 and CA199 levels were measured.The differences of EMI ultrasound indexes,serum CA125 and CA199 between the two groups were compared,and the diagnostic value of the above indexes for AM was observed.The influencing factors of AM were analyzed,and the regression diagnostic models of EMI ultrasound index,serum CA125 and CA199 were established to determine the goodness of fit and diagnostic efficacy of the model.Results The average thickness of EMI,the proportion of morphological abnormalities,the levels of serum CA125 and CA199 in the AM group were higher than those in the non-AM group(P<0.05).The receiver operating characteristic(ROC) curve showed that the average thickness of EMI,EMI morphology,serum CA125 and CA199 levels had certain value in the diagnosis of AM,with area under the curve(AUC) of 0.860,0.664,0.892 and 0.874,respectively.Binary Logistic regression analysis showed that the average thickness of EMI,EMI morphology,serum CA125 and CA199 were all related factors of AM(P<0.05).ROC curve showed that the AUC of the regression model for diagnosis of AM was 0.974(95%CI:0.954-0.993,P<0.001),and the maximum Youden index was 0.864.The diagnostic sensitivity was 90.91%,the specificity 95.45%,the accuracy 93.18%,the positive predictive value 95.24%,and the negative predictive value was 91.30%.Conclusions EMI ultrasound index combined with serum CA125 and CA199 detection can improve the diagnostic efficacy for AM and provide support for disease diagnosis.

关 键 词：子宫内膜-肌层交界区 三维超声 糖链抗原125 糖链抗原199 子宫腺肌病 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R711.71[医药卫生—诊断学]