C反应蛋白、糖类抗原125、糖类抗原19-9对卵巢子宫内膜异位囊肿和盆腔炎性包块的鉴别诊断价值  

Differential diagnostic value of C-reactive protein,carbohydrate antigen 125,and carbohydrate antigen 19-9 in ovarian endometriotic cyst and pelvic inflammatory mass

作　　者：吴红琴 冯亚玲 顾浩 陈嘉颖 袁华 WU Hongqin;FENG Yaling;GU Hao;CHEN Jiaying;YUAN Hua(Department of Maternal and Child Health,Affiliated Women’Hospital of Jiangnan University,Jiangsu Province,Wuxi214000,China)

机构地区：[1]江南大学附属妇产医院妇幼保健科,江苏无锡214000

出　　处：《中国医药导报》2024年第19期101-105,共5页China Medical Herald

基　　金：江苏省妇幼健康重点学科项目(SFY3-FB2021)。

摘　　要：目的探讨血清C反应蛋白(CRP)、糖类抗原125(CA125)、糖类抗原19-9(CA19-9)对卵巢子宫内膜异位囊肿(OEC)和盆腔炎性包块(PIM)的鉴别诊断价值。方法选取2021年12月至2023年12月江南大学附属妇产医院诊治的85例OEC患者为OEC组、60例PIM患者为PIM组。分析PIM发生的影响因素,构建logistic回归模型,采用Bootstrap方法进行内部验证,受试者操作特征曲线评估模型的诊断价值。两组各抽取15例为验证集,进行外部验证。结果PIM组中性粒细胞计数、白细胞计数、中性粒细胞与淋巴细胞比值、CRP水平高于OEC组,CA125、CA19-9水平低于OEC组,差异有统计学意义(P<0.05)。CRP、CA125、CA19-9是PIM发生的影响因素(P<0.05);由此构建的二元回归方程为Logit(P)=1.343+0.315×CRP水平-0.039×CA125水平-0.093×CA19-9水平。校准曲线的平均绝对误差为0.026,校准曲线与理想曲线贴合良好。回归模型诊断PIM的曲线下面积高于各单独指标检测。验证集数据诊断PIM的灵敏度为93.33%,特异度为80.00%,阳性预测值为82.35%,阴性预测值为92.31%,准确度为86.67%。结论CRP、CA125、CA19-9是PIM发生的影响因素。基于三者构建的回归模型能有效鉴别OEC和PIM,有助于进一步制订治疗方案。Objective To explore the differential diagnostic value of serum C-reactive protein(CRP),carbohydrate antigen 125(CA125),and carbohydrate antigen 19-9(CA19-9)in ovarian endometriosis cyst(OEC)and pelvic inflammatory mass(PIM).Methods A total of 85 patients with OEC and 60 patients with PIM treated at Affiliated Women’Hospital of Jiangnan University from December 2021 to December 2023 were selected as the OEC group and the PIM group.The influencing factors of PIM occurrence were analyzed,logistic regression model was constructed,internal validation was performed using the Bootstrap method,and the diagnostic value of the model was assessed by receiver operating characteristic curve.A total of 15 cases from each of two groups was taken as the validation set for external validation.Results The levels of neutrophil count,white blood cell count,neutrophil-to-lymphocyte ratio,and CRP in PIM group were higher than those in OEC group,and the levels of CA125 and CA19-9 were lower than those in OEC group,and the differences were statistically significant(P<0.05).CRP,CA125,and CA19-9 were influencing factors in PIM occurrence(P<0.05);the resulting binary regression equation was constructed as Logit(P)=1.343+0.315×CRP level-0.039×CA125 level-0.093×CA19-9 level.The mean absolute error of the calibration curve was 0.026,and the calibration curve fittde well with the ideal curve.The area under the curve of the regression model to diagnose PIM was higher than each individual index test.The sensitivity of the validation set data for diagnosing PIM was 93.33%,the specificity was 80.00%,the positive predictive value was 82.35%,the negative predictive value was 92.31%,and the accuracy was 86.67%.Conclusion CRP,CA125,and CA19-9 are the influencing factors for PIM occurrence.The regression model constructed based on the three can effectively identify OEC and PIM,which helps to further develop the treatment plan.

关 键 词：子宫内膜异位症 盆腔炎性疾病 C反应蛋白 糖类抗原125 糖类抗原19-9 

分 类 号：R711.7[医药卫生—妇产科学]