血清肿瘤标志物联合阴道超声血流参数鉴别卵巢浆液性囊性腺瘤与囊腺癌的诊断价值  

Diagnostic value of serum tumor markers combined with vaginal ultrasound blood flow parameters in differentiating ovarian serous cystic adenoma from cystadenocarcinoma

作　　者：石冬青 郝荣 安晓玲 郭江红 SHI Dongqing;HAO Rong;AN Xiaoling;GUO Jianghong(Department of Medical Ultrasound Center,Northwest Women's and Children's Hospital,Xi'an 710000,China;Department of Ultrasound,Xi'an New Chang An Maternity Hospital,Xi'an 710000,China;Department of Ultrasound,Xi'an Gaoxin Hospital,Xi'an 710070,China)

机构地区：[1]西北妇女儿童医院医学超声中心,陕西西安710000 [2]西安新长安妇产医院超声科,陕西西安710000 [3]西安高新医院超声科,陕西西安710070

出　　处：《医学影像学杂志》2024年第10期112-115,124,共5页Journal of Medical Imaging

基　　金：陕西省重点研发计划项目(编号:2022SF-593)。

摘　　要：目的探讨血清肿瘤标志物糖类抗原125(CA125)、人附睾蛋白4(HE4)联合阴道超声血流参数鉴别卵巢浆液性囊性腺瘤与浆液性囊腺癌的诊断价值。方法选取76例卵巢浆液性囊性腺瘤患者与73例卵巢浆液性囊腺癌患者,分别作为卵巢浆液性囊性腺瘤组、卵巢浆液性囊腺癌组。检测所有患者CA125、HE4水平,阴道超声检查记录阴道超声血流参数相关指标;Logistic回归分析卵巢浆液性囊腺癌的相关因素;采用受试者工作特征曲线(ROC)分析CA125、HE4联合阴道超声血流参数鉴别卵巢浆液性囊性腺瘤与浆液性囊腺癌的诊断价值。结果卵巢浆液性囊腺癌组血清CA125、HE4水平高于卵巢浆液性囊性腺瘤组,差异有统计学意义(P<0.05)。卵巢浆液性囊腺癌组阻力指数(RI)低于卵巢浆液性囊性腺瘤组,舒张末期流速(EDV)高于卵巢浆液性囊性腺瘤组,差异有统计学意义(P<0.05)。多因素logistics回归分析显示CA125、HE4、EDV是发生卵巢浆液性囊腺癌的危险因素,RI是发生卵巢浆液性囊腺癌的保护因素(P<0.05)。ROC结果显示CA125、HE4、RI、EDV及联合诊断的曲线下面积(AUC)为0.863、0.815、0.835、0.899、0.965;联合诊断优于单独诊断(Z=3.595、4.736、4.089、2.410,P<0.05)。结论血清肿瘤标志物CA125、HE4联合阴道超声血流参数鉴别卵巢浆液性囊性腺瘤与浆液性囊腺癌具有较高的诊断效能。Objective To explore the diagnostic value of serum tumor markers carbohydrate antigen 125(CA125),human epididymal protein 4(HE4)combined with vaginal ultrasound blood flow parameters in differentiating ovarian serous cystic adenoma from cystadenocarcinoma.Methods We selected 76 cases of ovarian serous cystic adenoma and 73 cases of ovarian serous cystadenocarcinoma who were treated in our hospital from November 2020 to November 2023 as the ovarian serous cystic adenoma group and ovarian serous cystadenocarcinoma group,respectively.The levels of CA125 and HE4 were detected in all patients,and the parameters of vaginal ultrasound blood flow were recorded by transvaginal ultrasound.Logistic regression analysis was used to analyze the factors related to ovarian serous cystadenocarcinoma.Receiver operating characteristic curve(ROC)analysis of CA125,HE4 combined with transvaginal ultrasound blood flow parameters was employed to differentiate the diagnostic value of ovarian serous cystic adenoma from cystadenocarcinoma.Results Serum levels of CA125 and HE4 in patients with serous cystadenocarcinoma of ovary were higher than those in patients with serous cystadenoma of ovary(P<0.05).The resistance index(RI)of ovarian serous cystadenocarcinoma group was lower than that of ovarian serous cystadenoma group,and the end diastolic velocity(EDV)was higher than that of ovarian serous cystadenoma group(P<0.05).Multivariate logistics regression analysis showed that CA125,HE4 and EDV were the risk factors for ovarian serous cystadenocarcinoma,and RI was the protective factor for ovarian serous cystadenocarcinoma(P<0.05).ROC results showed that serum CA125,HE4,RI,EDV and AUC of combined diagnosis were 0.863,0.815,0.835,0.899 and 0.965.Combined diagnosis was better than single diagnosis(Z=3.595,4.736,4.089,2.410,P<0.05).Conclusion Serum tumor markers CA125 and HE4 combined with vaginal ultrasound blood flow parameters have high diagnostic efficiency in differentiating ovarian serous cystic adenoma from cystadenocarcinoma.

关 键 词：血清肿瘤标志物 阴道超声血流参数 卵巢浆液性囊性腺瘤 卵巢浆液性囊腺癌 超声检查 

分 类 号：R588.6[医药卫生—内分泌] R445.1[医药卫生—内科学]