超声联合CA125、CA199诊断早期上皮性卵巢癌的临床价值

The clinical value of ultrasound with CA125,CA199 on the diagnosis of early epithelial ovary cancer

目的:探讨彩色多普勒超声联合肿瘤标记物CA125、CA199诊断早期上皮性卵巢癌的临床价值。方法:对135例早期上皮性卵巢癌患者(A组)及248例卵巢良性肿瘤患者(B组)在术前采用化学发光免疫法检测肿瘤标记物CA125、CA199,应用超声观察两组患者的二维图像,并用超声Finkler评分系统对两组患者进行超声评分,同时进行彩色多普勒超声观察肿瘤内部及表面的血管分布情况,并计算阻力指数(RI),所得结果与术后病理结果对比分析,观察其诊断价值。结果:(1)A组患者的超声评分、CA125、CA199值明显升高,而RI值却明显降低。两组比较,差异有显著性(P<0.05)。(2)以超声评分≥7判断为恶性,敏感性为88.1%,特异性为87.9%;以RI<0.6判断为恶性,敏感性为72.6%,特异性为80.6%。(3)以肿瘤标记物CA125>21 U/ml和/或CA199>33 U/ml判断为恶性,敏感性为80.7%,特异性为77.8%。(4)3种方法联合检测,敏感性为97.0%,特异性为95.2%。结论:超声、肿瘤标记物CA125、CA199联合检测可提高早期上皮性卵巢癌诊断的敏感性和特异性,有助于早期上皮性卵巢癌的发现。

Objective： To study the clinical value of the colour doppler ultrasound with the tumor markers CA125,CA199 on diagnosing the early epithelial ovary cancer. Methods： 135 patients with early epithelial ovary cancer （group A） and 248 patients with benign ovary tumor （group B）were tested with tumor markers CA125,CA199 preoperatively by automated chemiluminescence assay.The two-dimensional pictures were observed by the ultrasound and the mark were given to the two groups by ultrasound marking system Finkler.At the same time, the blood distribution of inner tumor and external tumor were observed by the colour doppler ultrasound and the resistance index of the ovary tumor （RI） was calculated.The results were compared with pathologic finding of surgery to observe the predictive value. Results： （1）The CA125, CA199 and the ultrasound grade point in the group A were obviously higher,but the RI was obviously lower. Contrasting the two groups,the differences were obvious （P〈0.05）. （2）If the ultrasound grade point cut-off level was 7,the sensitivity and specificity for diagnosing early epithelial ovary cancer were 88.1% and 87.9% respectively.If the RI cut-off level was 0.6,the sensitivity and specificity were 72.6% and 80.6% respectively. （3）If the tumor marker cut-off levels were 21 U/ml and 33 U/ml for CA125 and CA199 respectively. Combined the two criteria, the sensitivity and specificity were 80.7% and 77.8% respectively. （4）The sensitivity and specificity of the three methods combined in diagnosis of early epithelial ovary cancer were 97.0% and 95.2% respectively. CA 125, CA 199 can improve sensitivity be an effective diagnosis method. and specificity in diagnosis of early Ultrasound and tumor markers epithelial ovary cancer, and may