血清CA125联合超声评分诊断及鉴别诊断卵巢良恶性肿瘤的价值研究

The value of serum CA125 combined with ultrasonic score in diagnosis and differential diagnosis of benign and malignant ovarian tumors

目的研究血清CA125联合超声评分诊断及鉴别诊断卵巢良恶性肿瘤的,为临床诊治提供参考。方法选取该院于2015年11月至2017年11月收治的184例卵巢恶性肿瘤患者作为恶性组。另选取同期收治的216例卵巢良性肿瘤患者作为良性组。两组患者术前一周均行腹部超声联合阴道超声检查并进行Finkler超声评分,同时空腹抽取静脉血检测血清CA125水平。对比两组患者的Finkler评分及阳性率,CA125水平及阳性率,联合诊断的特异度、敏感度、阴性预测值及阳性预测值,并研究联合诊断不同分期卵巢癌阳性率。结果两组对比,恶性组患者的CA125水平和阳性率均明显高于良性组,且Finkler评分及阳性率也高于良性组,差异均有统计学意义(P<0.05)。CA125联合Finkler评分诊断的阳性预测值、阴性预测值、敏感度及特异度均高于单一检测,差异均有统计学意义(P<0.05)。且CA125联合Finkler评分诊断Ⅰ~Ⅱ期卵巢癌的阳性率高于单一诊断(P<0.05),但诊断Ⅲ~Ⅳ期的阳性率差异不明显(P>0.05)。结论卵巢恶性肿瘤患者血清CA125及超声Finkler评分均升高,且联合诊断敏感性及特异性均较好,尤其是对Ⅰ~Ⅱ期卵巢癌,值得临床借鉴。

Objective To study the diagnosis and differential diagnosis of ovarian benign and malignant tumors by serum CA125 combined with ultrasonic score,and to provide reference for clinical diagnosis and treatment.Methods 184 patients with malignant ovarian tumor treated in our hospital from November 2015 to November -2017 were selected as malignant group.Another 216 patients with benign ovarian tumor treated as benign group were treated at the same time.Underwent abdominal ultrasound and vaginal ultrasound examination and Finkler ultrasound score a week before the two groups of patients,while fasting venous blood serum CA125.The Finkler score and positive rate,CA125 level and positive rate of the two groups were compared,and the specificity,sensitivity,negative predictive value and positive predictive value of combined diagnosis were studied,and the positive rate of combined diagnosis of different stages of ovarian cancer was studied.Results compared with the benign group,the CA125 level and positive rate in the malignant group were significantly higher than those in the benign group,and the Finkler score and positive rate were also higher than those in the benign group ( P <0.05).The difference between the two groups was statistically significant ( P >0).The positive predictive value,negative predictive value,sensitivity and specificity of CA125 combined with Finkler score were higher than those of single detection,and the differences were statistically significant ( P <0.05).The positive rate of CA125 combined with Finkler score in diagnosis of stage I to II ovarian cancer was higher than that of single diagnosis ( P <0.05),but there was no significant difference in the positive rate of diagnosis between stage III and IV ( P >0.05).Conclusion the serum CA125 and Finkler scores of ovarian cancer patients are increased,and the sensitivity and specificity of combined diagnosis are good,especially for stage I to II ovarian cancer,which is worthy of clinical reference.