阴道二维超声联合人附睾蛋白检测对卵巢癌病理分型诊断及预后预测价值分析  

Analysis on the value of HE4 combined with 2D ultrasound for vagina in diagnosing the pathological classification of ovarian cancer and predicting its prognosis

作　　者：张文娟 王万里[2] 励银环 赵媛 魏丽霞 Zhang Wenjuan;Wang Wanli;Li Yinhuan;Zhao Yuan;Wei Lixia(Department of Function,Hengshui Maternal and Child Health Care Hospital,Hengshui 053000,China;Department of Ultrasound,Hengshui People's Hospital(Harrison International Peace Hospital),Hengshui 053000,China)

机构地区：[1]衡水市妇幼保健院功能科,衡水053000 [2]衡水市人民医院(哈励逊国际和平医院)超声科,衡水053000

出　　处：《中国医学装备》2025年第4期74-78,共5页China Medical Equipment

基　　金：河北省卫生健康委(20241814)。

摘　　要：目的:探讨阴道二维超声联合人附睾蛋白4(HE4)检测对卵巢癌病理分型诊断及预后预测价值。方法:分析2018年4月至2023年7月衡水市妇幼保健院及衡水市人民医院收治的100例卵巢癌患者临床资料,其中上皮性卵巢癌98例,非上皮性卵巢癌2例。术前抽取患者清晨空腹静脉血,采用酶联免疫吸附法检测血清HE4水平。于术前1周进行阴道二维超声检查,测定卵巢动脉阻力指数(RI)、搏动指数(PI)、收缩期峰值流速(PSV)和舒张末期流速(EDV)。所有患者完成末次化疗后即开始随访,根据生存情况,将其分为死亡组(27例)和存活组(73例)。Cox回归风险模型分析卵巢癌患者预后影响因素。结果:上皮性卵巢癌患者血清HE4水平[449.37(28.57,2382.24)]pmol/L显著高于非上皮性卵巢癌患者[55.38(17.33,79.64)]pmol/L,差异有统计学意义(U=24.752,P<0.05)。上皮性卵巢癌患者的RI、PSV、PI超声参数大于非上皮性卵巢癌患者(t=3.640,2.152,2.588,P<0.05)。HE4联合阴道二维超声鉴别诊断上皮性和非上皮性卵巢癌的受试者工作特征(ROC)曲线下面积(AUC)为0.936(95%CI:0.821~1.000),大于各指标单独检查。死亡组患者年龄≥60岁、国际妇产科联盟(FIGO)分期为Ⅲ~Ⅳ期、有周围浸润的占比高于存活组,血清HE4水平528.75(34.79,1932.43)pmol/L高于存活组138.23(21.49,872.59)pmol/L,差异有统计学意义(U=25.963,P<0.05),PSV和EDV值大于存活组,RI和PI小于存活组,差异有统计学意义(t=10.844、17.744、19.085、13.099,P<0.05)。FIGO分期为Ⅲ~Ⅳ期、有周围浸润、HE4水平≥398.74 pmol/L、RI<0.31、PI<0.54、PSV≥26.12 cm/s、EDV≥16.47 cm/s是卵巢癌患者预后的危险因素(HR=2.682、2.347、2.296、2.518、2.235、2.124、1.958,P<0.05)。结论:HE4联合阴道二维超声可提高卵巢癌病理分型的诊断准确性,并可作为预测卵巢癌患者预后的重要工具。Objective:To investigate the value of human epididymal protein 4(HE4)combined with two-dimensional(2D)ultrasound for vagina in diagnosing the pathological classification of ovarian cancer and predicting its prognosis.Methods:The clinical data of a total of 100 patients with ovarian cancer who admitted to Hengshui Maternal and Child Health Care Hospital and Hengshui People's Hospital from April 2018 to July 2023 were retrospectively analyzed,including 98 cases with epithelial ovarian cancer and 2 cases with non-epithelial ovarian cancer.The fasting venous blood pre operation of patients was extracted in morning.The serum HE4 level was detected by enzyme-linked immunosorbent assay(ELISA).The 2D ultrasound examination was performed one week before surgery to measure the resistance index(RI),pulse index(PI),peak systolic flow velocity(PSV)and end-diastolic flow velocity(EDV)of ovarian artery.All patients were followed up immediately after they completed the last chemotherapy.All of patients were divided into a death group(n=27)and a survival group(n=73)according to their survival situation.Cox regression risk model was used to analyze prognostic influence factors of patients with ovarian cancer.Results:The serum HE4 level[449.37(28.57,2382.24)]pmol/L in patients with epithelial ovarian cancer was significantly higher than that[55.38(17.33,79.64)]pmol/L in patients with non-epithelial ovarian cancer(U=24.752,P<0.05).The RI,PSV and PI of ultrasonic parameters of patients with epithelial ovarian cancer were higher than those of patients with non-epithelial ovarian cancer(t=3.640,2.152,2.588,P<0.05),respectively.The area under curve(AUC)of the receiver operating characteristic(ROC)curve of HE4 combined with 2D ultrasound for vagina was 0.936(95%CI:0.821-1.000)in identifying epithelial and non-epithelial ovarian cancer,which was larger than that of alone each examination.The ratio of the age≥60 years old,the ratio of the III-IV staging of Federation International of Gynecology and Obstetrics(FIGO),and the ratio of exist

关 键 词：卵巢癌 人附睾蛋白4 阴道二维超声 病理分型 预后 

分 类 号：R445.1[医药卫生—影像医学与核医学]