阴道超声联合肿瘤标志物检测诊断早期卵巢癌的意义

Significance of transvaginal ultrasound combined with tumor markers in the diagnosis of early ovarian cancer

目的探讨阴道超声联合肿瘤标志物检测诊断早期卵巢癌的意义。方法选取2014年4月至2017年8月间西北妇女儿童医院收治的50例卵巢癌患者为恶性组,选取同期100例卵巢良性病变患者为良性组。两组患者均行阴道超声检查,并检测血清人附睾蛋白4(HE4)和糖原蛋白CA125水平,比较分析联合应用诊断卵巢癌的效果。结果恶性组患者阴道超声TUV评分、HE4和CA125水平均值均高于良性组,差异均有统计学意义(均P<0.05);随着恶性程度增加,卵巢癌患者三个项目平均值均升高(均P<0.05)。单独检测HE4诊断卵巢癌,效果较阴道超声好,HE4结合阴道超声对卵巢癌检测的灵敏度和特异度,较单一阴道超声和单一HE4检测及阴道超声联合CA125检测更高,差异均有统计学意义(均P<0.05)。阴道超声、CA125和HE4同时检测诊断卵巢癌的灵敏度与特异度较阴道超声联合HE4检测,差异无统计学意义(P>0.05)。结论阴道超声联合HE4检测诊断卵巢癌效能较好,在病情监测中有一定意义。

Objective To investigate the significance of transvaginal ultrasound combined with tumor markers in the diagnosis of early ovarian cancer. Methods A total of 50 patients with ovarian cancer treated at Northwest Women＇s and Children＇s Hospital from April 2014 to August 2017 were selected as the malignant group. At the same time,100 patients with benign ovarian lesions were selected as the benign group. All the participants underwent transvaginal ultrasound examination and the serum levels of human Epididymisprotein 4（ HE4） and cancer antigen 125（ CA125） were detected. The diagnostic efficacy of combined use for ovarian cancer was compared and analyzed. Results The average levels of transvaginal ultrasound,HE4 and CA125 in the malignant group was higher than in the benign group（ all P〈0. 05）.With the increase of malignancy,the average value of the above three items increased（ all P〈0. 05）. The diagnostic efficacy of HE4 alone is better than transvaginal ultrasound（ P〈0. 05）. The sensitivity and specificity of HE4 combined with transvaginal ultrasound detection were higher than detection of transvaginal ultrasound or single detection of HE4 for ovarian cancer（ all P〈0. 05）. There was no significant difference in the sensitivity and specificity between transvaginal ultrasound combined with HE4 and CA125 and transvaginal ultrasound combined with HE4（ P〉0. 05）. Conclusion Transvaginal ultrasound combined with HE4 is effective in the diagnosis of ovarian cancer and has some significance in the monitoring of the disease.