TVCDS与RI指数联合血清CA125、CA199水平检测对卵巢癌患者诊断效能的影响

The effect of TVCDS and RI index combined with serum CA125 and CA199 levels detection on the diagnostic efficacy of ovarian cancer

目的探究经阴道彩色多普勒超声（TVCDS）与多普勒超声阻力指数（RI指数）联合血清糖类抗原125（CA125）、糖类抗原199（CA199）水平检测对卵巢癌患者诊断效能的影响。方法选取2014年1月至2017年2月本院卵巢癌早期患者44例（A组），卵巢良性肿瘤患者38例（B组），均经术后病理学证实，另选取同期健康体检者40例（C组）。均行TVCDS检查，以化学发光免疫分析法测定血清CA125、CA199水平。比较三组血清CA125、CA199水平及A组、B组TVCDS血流参数[收缩期峰值流速（PSV）、舒张末期流速（EDV）、RI指数1，分析TVCDS（RI）、血清CA125、CA125水平单独及联合诊断早期卵巢癌敏感度、特异度、准确度、漏诊率、误诊率。结果经单因素方差分析，三组间血清CA125、CA199水平比较，差异有统计学意义（P〈0．05），A组血清CA125、CA199水平明显高于B组、C组，差异有统计学意义（P〈0．05）；A组PSV、EDV高于B组，RI低于B组，差异具有统计学意义（P〈0．05）；联合检测早期卵巢癌敏感度93．18％（41，44）、特异度97．37％（37／38）、准确度95．12％（78／82），均高于TVCDs（RI）、血清CA125、CA199水平单独检测，差异具有统计学意义（P〈0．05）；联合检测漏诊率6．82％（3／44）、误诊率2．63％（1／38），均低于TVCDS（RI）、血清CA125、CA199水平单独检测，差异具有统计学意义（P〈0．05）。结论TVCDS与RI指数联合血清CA125、CA199水平检测卵巢癌患者，能及早发现恶性肿瘤，具有较高诊断价值，且能减少漏诊、误诊情况，值得临床推广应用。

Objective To explore the effect of transvaginal color Doppler sonography （TVCDS） and Doppler ultrasound resistance index （RI index） combined with serum carbohydrate antigen 125 （CA125） and carbohydrate antigen 199 （CA199） levels detection on the diagnostic efficacy of ovarian cancer. Methods 44 patients with ovarian cancer （group A） and 38 patients with benign ovarian tumor （group B） in our hospital from January 2014 to February 2017 were selected, all cases were confirmed by the pathology. Another 40 healthy subjects were selected at the same period （group C）. TVCDS examination was performed and serum levels of CA125 and CA199 were measured by chemiluminescence immunoassay. Serum CA125, CA199 levels in the three groups, TVCDS blood flow parameters [systolic peak flow velocity （PSV）, end diastolic flow velocity （EDV）, and RI index] in group A and B were compared. The sensitivity, specificity, accuracy, missed diagnosis rate, and misdiagnosis rate of TVCDS （R/）, serum CA125 and CA199 levels separate and combined diagnosis of early ovarian cancer were analyzed. Results Single factor analysis of variance showed that the differences of serum CA125 and CA199 levels among the three groups were statistically significant （P〈0.05）. The serum levels of CA125 and CA199 in group A were significantly higher than those in group B and group C, with statistically significant differences （P〈0.05）. The PSV and EDV in group A were higher than those in group B, and RI was lower than that in group B, with statistically significant differences （P〈0.05）. The sensitivity of combined detection for early ovarian cancer was 93.18% （41/44）, the specificity was 97.37% （37/38）, the accuracy was 95.12% （78/82）, which were higher than those of TVCDS （RI）, serum CA125, CA199 levels separate detection, with statistically significant differences （P〈0.05）. The rate of missed diagnosis of combined detection was 6.82% （3/44）, and the rate of misdiagnosis was 2.63% （1/38）, which were lower than those of TVCDS （RI）, serum CA125 and CA199 levels separate detection, with statistically significant differences （P〈0.05）. Conclusion TVCDS and RI index combined with serum CA125 and CA199 levels can detect early malignant tumor in patients with ovarian cancer, which has high diagnostic value, and can reduce the missed diagnosis and misdiagnosis, worthy of clinical application.