CA125、CA199联合超声检查在卵巢恶性肿瘤诊断中的价值

Value of Combined Measurement of CA125, CA199 and Ultrasonography in the Diagnosis of Ovarian Malignant Tumor

[目的]探讨血清CA125、CA199联合超声检查在卵巢恶性肿瘤诊断中的价值.[方法]对2005年1月至2009年12月在本院住院的103例卵巢肿瘤患者进行血清CA125、CA199检测及超声检查,并分别以血清CA125〉35 u/mL、CA125〉100 u/mL;CA199〉37 u/mL、CA199〉70 u/mL;阻力指数RI〈0.5、RI〈0.6作为阳性结果,比较各种指标对卵巢恶性肿瘤预测的敏感性、特异性、阳性预测值和阴性值.[结果]卵巢恶性肿瘤患者血清CA125、CA199水平明显高于良性肿瘤组.多普勒血流显像恶性肿瘤组RI显著低于良性肿瘤组,且两组相比差异有显著性（P〈0.05）, 超声联合血清CA125、CA199检查的敏感性可提高到90.9%,阴性预测值为90.1%,阳性预测值为96.1%,特异性为95.8%,与单独使用时比较均有提高.[结论]血清CA125 CA199联合多普勒超声血流显像可明显提高卵巢恶性肿瘤诊断的敏感性和特异性.

[Objective]To explore the value of combined measurement of serum CA125, CA199 and ultra- sonography for the diagnosis of ovarian malignant tumor. [Methods]A total of 103 inpatients with ovarian tumor in our hospital from Jan. 2005 to Dec. 2009 were enrolled in this study. Serum CA125 and CA199 were measured. Ultrasonograpby was performed. The negative results were CA125 〉35u/ml, CA125 〉100u/ml, CA199 〉37u/ml, CA199 〉70u/ml, RI〈0. 5 and RI〈0.6, respectively. The sensitivity, specificity, positive and negative predictive values of all indexes for the prediction of ovarian malignant tumor were compared. [Results] The levels of serum CA125 and CA199 in ovarian malignant tumor group were obviously higher than those in ovarian benign tumor group. Resistance index of Doppler flow imaging in ovarian malignant tumor group was obviously lower than that in ovarian benign tumor group, and there was significant difference between two groups（ P 〈0.05）. The sensitivity of ultrasonography combined with serum CA125 and CA199 measurement increased up to 90.9%. Its negative and negative predictive value was 90.1% and 96.1%, respectively, and its specificity was 95.8%. Compared with simple measurement, the indexes of combined measurement were increased. [Conclusion] Combined measurement of CA125 ,CA199 and Doppler flow imaging can obviously improve the diagnostic sensitivity and specificity of ovarian malignant tumor.