磁共振成像联合肿瘤标志物对卵巢交界性肿瘤与Ⅰ期上皮性卵巢癌的诊断价值

Differential diagnosis value of borderline ovarian tumor and stage I epithelial ovarian cancer：using MRI combined with tumor markers

目的：探讨 MRI 联合肿瘤标志物对卵巢交界性肿瘤与Ⅰ期上皮性卵巢癌的术前鉴别诊断价值，提高术前确诊率。方法选择经病理检查证实的56例卵巢交界性肿瘤（BOT）患者为 BOT 组，47例Ⅰ期上皮性卵巢癌（EOC）患者为 EOC 组，回顾性分析两组疾病的临床特征、肿瘤标志物、MRI 影像特征的差异。结果 BOT 组、EOC 组发病年龄分别为（39．45±11．83）岁、（44．38±12．44）岁，两组差异有统计学意义（t ＝－2．05，P ＜0．05）。两组肿瘤部位、大小、分隔数差异均无统计学意义（均 P ＞0．05）。EOC 组 MRI 实性成分最大径（76．0±54．9）mm 和分隔厚度（6．2±3．5）mm，均大于 BOT 组[（49．0±47．2）mm、（3．6±3．5）mm]，两组差异均有统计学意义（t ＝－2．642、－3．784，均 P ＜0．05）；EOC 组厚分隔的出现率（59．6％）高于 BOT 组（37．5％）（χ2＝4．992，P ＜0．05）。两组血清 CA125、CA199含量差异均无统计学意义（均 P ＞0．05）；BOT 组、EOC 组血清 HE4含量分别为（86．9±82．2）pmol／L、（166．3±87．1）pmol／L，两组差异有统计学意义（t ＝－4．723，P ＜0．05）。MRI 提示肿瘤实性成分最大径和分隔厚度联合 HE4含量鉴别两组肿瘤的 AUC、灵敏度、特异度分别为0．820、72．3％、80．4％。结论发病年龄大小、MRI 中肿瘤实性成分大小、分隔厚度及血清HE4含量的高低有助于鉴别 BOT 和Ⅰ期 EOC。

Objective To explore the value of MRI combined with tumor markers in the differential diagnosis of borderline ovarian tumor（BOT）and stage I epithelial ovarian carcinoma（EOC）,increase the rate of preoperative diagnosis.Methods Fifty -six patients with BOT（BOT group）and forty -seven patients with stage I EOC（EOC group）confirmed pathologically underwent tumor markers and MRI examination were selected.The MRI imaging features and tumor markers level were compared between the two groups.Results BOTand EOC group onset age were （39.45 ±11.83）,（44.38 ±12.44）years old respectively,two groups had statistically significant difference（t =2.05,P 〈0.05）.The location of tumor,size,number of septation had no differences between the two groups（all P 〉0.05）.However,the solid components were larger （76.0 ±54.9）mm and the septations were thicker （6.2 ± 3.5）mm in EOC group than in BOT group （49.0 ±47.2）mm,（3.6 ±3.5）mm（t =-2.642,-3.784,all P 〈0.05）,and solid components and thick septations were more frequently seen in EOC group（59.6%）than 37.5% in BOT group（χ2 =4.992,P 〈0.05）.The serum CA125 and CA199 levels between the two groups had no statistically significant differences（all P 〉0.05）.The serum HE4 levels between BOT group[（86.9 ±82.2）pmol/L]and EOC group[（166.3 ±87.1）pmol/L]had statistically significant difference （t =-4.723,P 〈0.05）.MRI prompt tumors maximum diameter and thickness of the separated solid ingredients combined serum HE4 levels to identify two groups of AUC of the tumor and its sensitivity,specificity were 0.820,72.3%,80.4%,respectively.Conclusion The fea-tures like younger,increased solid components,thickened septum and higher serum HE4 level may be helpful in the＆amp;nbsp;differential diagnosis of BOT and stage I EOC.