CT联合肿瘤标志物CEA、CA125、HE4对卵巢肿瘤性质的鉴别诊断价值  

Differential Diagnostic Value of CT Combined with Tumor Markers CEA,CA125 and HE4 on the Nature of Ovarian Tumors

作　　者：姚俊阁 李冰熠 李玲玲 YAO Junge;LI Bingyi;LI Lingling(Department of Gynecology,Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang 471000,China)

机构地区：[1]郑州大学附属洛阳中心医院妇科,河南洛阳471000

出　　处：《临床医学工程》2025年第4期357-360,共4页Clinical Medicine & Engineering

基　　金：河南省医学科技攻关计划联合共建项目(项目编号:LHGJ20220952)。

摘　　要：目的探讨CT联合肿瘤标志物癌胚抗原(CEA)、糖类抗原125(CA125)、人附睾分泌蛋白4(HE4)对卵巢肿瘤性质的鉴别诊断价值。方法回顾性分析2021年5月至2023年5月我院收治的102例卵巢肿瘤性质不明确患者的临床资料,所有患者均行CT联合血清CEA、CA125、HE4水平检查,以病理结果作为金标准,分析CT联合肿瘤标志物CEA、CA125、HE4对卵巢肿瘤性质的鉴别诊断价值。结果病理结果显示,102例卵巢肿瘤患者确诊为恶性肿瘤50例(卵巢上皮癌45例,卵巢生殖细胞肿瘤3例,卵巢间质肿瘤2例),良性肿瘤52例(卵巢囊肿30例,卵巢畸胎瘤22例)。恶性组血清CEA、CA125、HE4水平均高于良性组(P<0.05)。经Kappa一致性检验结果显示,CT诊断结果与病理诊断结果一致性一般(Kappa=0.627,P<0.05);CEA水平与病理诊断结果一致性一般(Kappa=0.647,P<0.05);CA125水平与病理诊断结果一致性一般(Kappa=0.706,P<0.05);HE4水平与病理诊断结果一致性一般(Kappa=0.745,P<0.05);CT与CEA、CA125、HE4水平联合诊断与病理诊断结果一致性较好(Kappa=0.902,P<0.05)。CT、CEA、CA125、HE4单一及联合诊断卵巢癌恶性肿瘤的灵敏度分别为80.00%、86.00%、84.00%、86.00%、94.00%,特异度分别为81.13%、77.36%、84.91%、86.79%、96.15%,准确度分别为81.37%、82.35%、85.29%、87.25%、95.10%;联合诊断准确度高于各指标单一诊断,差异有统计学意义(P<0.05)。结论CT、CEA、CA125、HE4联合诊断卵巢恶性肿瘤的准确度高于各指标单一诊断,用于鉴别诊断卵巢肿瘤性质价值较高。Objective To explore the differential diagnostic value of CT combined with tumor markers carcinoembryonic antigen(CEA),glycoconjugate antigen 125(CA125),and human epididymal secretory protein 4(HE4)on the nature of ovarian tumors.Methods The clinical data of 102 patients with unclear nature of ovarian tumors admitted to our hospital from May 2021 to May 2023 were retrospectively analyzed,all patients underwent CT combined with serum CEA,CA125 and HE4 level examinations,and the differential diagnostic value of CT combined with tumor markers CEA,CA125,and HE4 on the nature of ovarian tumors was analyzed using the pathological results as the gold standard.Results Pathological results showed that 50 cases of malignant tumors(45 cases of epithelial ovarian cancer,3 cases of ovarian germ cell tumors,2 cases of ovarian stromal tumors)and 52 cases of benign tumors(30 cases of ovarian cysts,22 cases of ovarian mature cystic teratoma)were diagnosed in 102 patients with ovarian tumors.The levels of serum CEA,CA125 and HE4 in the malignant group were higher than those in the benign group(P<0.05).The results of Kappa consistency test showed that the consistency between CT diagnosis and pathological diagnosis was general(Kappa=0.627,P<0.05),the consistency between CEA level and pathological diagnosis was general(Kappa=0.647,P<0.05),the consistency between CA125 level and pathological diagnosis was general(Kappa=0.706,P<0.05),the consistency between HE4 level and pathological diagnosis was general(Kappa=0.745,P<0.05),the combined diagnosis of CT and CEA,CA125,HE4 levels was in good agreement with pathological diagnosis(Kappa=0.902,P<0.05).The sensitivities of CT,CEA,CA125 and HE4 for single and combined diagnosis of ovarian cancer malignancy were 80.00%,86.00%,84.00%,86.00%,94.00%respectively,and the specificities were 81.13%,77.36%,84.91%,86.79%,96.15%respectively,and the accuracy was 81.37%,82.35%,85.29%,87.25%,95.10%respectively;the accuracy of combined diagnosis was higher than that of single diagnosis of each index,with st

关 键 词：卵巢肿瘤性质 CT 肿瘤标志物 诊断价值 

分 类 号：R737.31[医药卫生—肿瘤]