螺旋CT在卵巢癌术后监测中的价值

Spiral CT in the Monitoring of Treated Ovarian Cancer

目的 :探讨卵巢癌术后复发和转移的螺旋 CT表现特征 ;比较螺旋 CT检查、血清 CA12 5检测和临床体检的诊断价值。方法 :32例卵巢癌术后 ,随访资料完整的连续性病例 ,回顾性分析卵巢癌术后复发的 CT征象 ,用诊断性试验评价螺旋 CT检查、血清 CA12 5检测和临床体检的敏感性、特异性和准确性。结果 :32例卵巢癌术后处于临床缓解期的病例中 ,经手术和临床证实 2 2例出现复发或转移 ,螺旋 CT正确诊断了其中 18例 (82 % )。癌灶主要表现为结节、分叶状肿块或腹膜增厚 ,可被造影剂强化。在全部 32例中 ,螺旋 CT诊断卵巢癌术后复发和转移的敏感性 82 %、准确性 81%、阴性预测值 6 7% ,优于血清 CA12 5检测 (分别为 5 5 %、6 6 %和 47% ) (P<0 .0 5 )和临床体检 (分别为 2 7%、41%和 30 % )(P<0 .0 5 )。结论 :螺旋

Objective:To investigate the spiral CT features of treated ovarian cancer with recurrent or metastatic tumor and to compare the diagnostic value of spiral CT,serum CA125 level,and physical examination.Methods:32 cases of treated ovarian cancer with complete clinical follow up information were included into the study.We retrospectively observed and analyzed the CT features.Diagnostic test was used to evaluated the sensitivity,specificity and accuracy of spiral CT,serum CA125 level and physical examination.Results:Twenty two out of 32 patients in clinical remission had recurrent or metastatic tumor proved at laparotomy or clinical follow up.Spiral CT imaging correctly demonstrated tumor in 18 of 22 patients(82%)and displayed nodular lesion,lobulated mass or peritoneal thickening with local enhancement.In all 32 patients,spiral CT had a sensitivity of 82%, accuracy 81% ,and negative predictive value 67% and were superior to serum CA125 level (55%,66% and 47%,respectively)( P <0.05)and physical examination(27%,41% and 30%,respectively)( P <0.05)in the depiction of recurrent or metastatic tumor.Conclusion:Spiral CT imaging may be helpful for monitoring patients condition with treated ovarian cancer.