超声检查与血清CA125检测在卵巢恶性肿瘤诊断中的价值

Diagnostic value of ultrasound and serum levels of CA125 in ovarian cance

目的探讨超声检查与血清肿瘤标志物CA125检测在卵巢恶性肿瘤诊断中的价值。方法收集我院2012年10月至2013年12月收治的卵巢肿瘤患者113例,其中恶性53例,良性60例,于术前1周内均行超声检查及血清CA125检测。采用倾向得分匹配法(propensity score matching,PSM)均衡组间协变量,获得34对匹配成功的患者并对其诊断结果与病理检查进行比较。结果 CA125检测在卵巢恶性肿瘤诊断中的灵敏性、特异性、阳性预测值(positive predictive value,PPV)、阴性预测值(negative predictive value,NPV)、准确性分别为88.2%、61.8%、69.8%、84.0%、75.0%;超声检查在卵巢恶性肿瘤诊断中的灵敏性、特异性、PPV、NPV、准确性分别为85.3%、88.2%、87.9%、85.7%、86.8%;超声检查联合CA125检测在卵巢恶性肿瘤诊断中的灵敏性、特异性、PPV、NPV、准确性分别为94.1%、64.7%、72.7%、91.7%、79.4%。超声检查单独应用的特异性明显高于CA125检测及二者联合检查的特异性,差异有统计学意义(P均<0.05);而灵敏性、PPV、NPV及准确性在两两检查比较中的差异均无统计学意义(P均>0.05)。结论 CA125检测联合超声检查并不能提高卵巢恶性肿瘤的诊断符合率。

Objective To explore the value of ultrasound and serum levels of CA125 in ovarian cancer diagnosis. Methods A consecutive series of 113 patients with ovarian tumor treated between October 2012 and December 2013 were analyzed. Patients included 53 cases of malignancy and 60 cases of benign tumors; all were diagnosed based on ultrasound and serum levels of CA125 one week before surgery,and then definitively diagnosed based on postoperative pathology. To adjust for baseline differences between the two groups, propensity-score matching was used to generate 34 pairs of patients. Results Serum CA125 assay showed the following diagnostic performance：sensitivity,88.2%;specificity,61.8%,PPV,69.8%;NPV,84.0%;and accuracy,75.0%. The corresponding values for ultrasound were 85.3%,88.2%,87.9%,85.7% and 86.8%. The corresponding values for the combination of serum CA125 assay and ultrasound were 94.1%,64.7%,72.7%,91.7% and 79.4%. Ultrasound alone showed significantly higher specificity than either serum CA125 alone or the combination of both methods （P〈0.05）. However,sensitivity,PPV,NPV and accuracy were similar across all three diagnostic methods（P〉0.05）. Conclusion Combining ultrasound with serum CA125 assay does not improve diagnostic accuracy.