TVCDS联合血清CA125、CA199水平检测对早期子宫内膜癌患者阳性检出率的影响

Effect of TVCDS combined with serum ca125 and ca199 levels on positive detection rate in patients with early endometrial carcinoma

目的:探讨经阴道彩色多普勒超声(TVCDS)联合血清糖链抗原125(CA125)、糖链抗原199(CA199)水平检测在早期子宫内膜癌患者中应用价值。方法:选取榆林市第二医院2015年6月至2017年7月收治的39例早期子宫内膜癌患者作为观察组,另取38例同期健康体检者作为对照组,均行TVCDS检查及血清CA125、CA199水平检测,观察比较两组血清CA125、CA199水平,并统计诊断结果。结果:观察组血清CA125、CA199水平均高于对照组,差异具有统计学意义(P <0. 05); TVCDS+血清CA199+血清CA125阳性检出率为94. 87%(37/39)、诊断准确率为91. 03%(71/77)、特异度为89. 47%(34/38)均高于各单一检测,误诊率为10. 53%(4/38)、漏诊率为7. 50%(2/39)均低于各单一检测,差异具有统计学意义(P <0. 05);ⅠC及ⅠB期患者子宫内膜厚度及阻力指数均大于ⅠA期,ⅠC期大于ⅠB期,随着临床分期增高子宫内膜厚度增厚、阻力指数增高,差异具有统计学意义(P <0. 05)。结论:TVCDS联合血清CA125、CA199应用于早期子宫内膜癌鉴别诊断中,阳性检出率、诊断准确率、特异度均较高,误诊、漏诊率低。

Objective：To investigate the application value of transvaginal color Doppler ultrasonography （TVCDS） combined with serum carbohydrate antigen 125 （CA125） and carbohydrate antigen 199 （CA199） levels in early endometrial carcinoma. Methods ： A total of 39 early endometrial cancer patients in our hospital from June 2015 to July 2017 were selected as the observation group, another 38 healthy persons were selected as the control group. All the subjects were examined by TVCDS and the serum CA125, CA199 levels were detected. The serum levels of CA125 and CA199 in the two groups were observed and the diagnosis results were statistically analyzed. Results ：The serum levels of CA125 and CA199 of the observation group were higher than those of the control group, with statistically significant differences （ P 〈 0.05 ）. The positive detection rate of TVCDS ＋ combined serum CA199 ＋ serum CA125 ＋ was 94.87% （37/39）, the diagnostic accuracy was 91.03% （71/77）, and the specificity was 89.47% （34/38）, which were higher than those of single detection; the misdiagnosis rate and the rate of missed diagnosis was 10.53% （4/38） and 7.50% （2/39） respectively, lower than those of the single detection, all with statistically significant differences （ P 〈 0.05 ）. The endometrial thickness and resistance index in patients with stage I C and I B were greater than those in stage I A, and with the increase of clinical stage, the thickness of endometriunl and the resistance index were increased, with statistically significant difference （ P 〈 0. 05 ）. Conclusions ：Joint application of TVCDS and serum CA125 and CA199 detection in the differential diagnosis of early endometrial cancer is of high positive detection rate, accuracy and specificity and low misdiagnosis and missed diagnosis rate.