MRI检查联合血清CA19-9检测对卵巢癌的诊断价值

Diagnostic value of MRI combined with serum CA19-9 in ovarian cancer

目的探讨磁共振成像(MRI)检查联合血清糖类抗原19-9(CA19-9)检测对卵巢癌的诊断价值。方法选择42例卵巢癌患者(恶性组)、35例卵巢良性肿瘤患者(良性组)及50例女性健康体检者(对照组),所有研究对象均接受血清CA19-9检测,恶性组及良性组患者接受MRI检查。比较3组研究对象的血清CA19-9水平,分析恶性组和良性组患者的MRI特征,以及MRI、CA19-9及MRI联合CA19-9对卵巢良恶性肿瘤的鉴别诊断价值。结果卵巢癌的MRI表现为形态不规则囊实性肿块,与周围交界模糊,增强扫描显示病灶明显强化;卵巢良性肿瘤的MRI表现为病灶边界清楚,囊壁光滑,囊内呈长T1、长T2信号,增强后无强化或呈轻度强化。恶性组的血清CA19-9水平为(150.1±75.2)U/ml,高于良性组的(52.7±16.1)U/ml和对照组的(33.4±11.2)U/ml,差异均有统计学意义(P﹤0.05);良性组和对照组的血清CA19-9水平比较,差异无统计学意义(P﹥0.05)。MRI联合CA19-9诊断卵巢癌的灵敏度、特异度、阳性预测值、阴性预测值、约登指数分别为90.48%、94.29%、95.00%、89.19%、0.848,均高于MRI或CA19-9单独诊断的结果。结论MRI检查联合血清CA19-9检测对卵巢良恶性肿瘤具有较高的鉴别诊断价值。

Objective To explore the diagnostic value of combined examination with magnetic resonance imaging(MRI)and serum carbohydrate antigen 19-9(CA19-9)in patients with ovarian cancer.Method The clinical data of 42 cases of ovarian cancer(malignant group),35 cases of benign ovarian tumor(benign group)and 50 healthy women(control group)were included in the retrospective analysis.All subjects had received serum CA19-9 test,and the malignant group and benign group were administered with MRI examination.The levels of serum CA19-9 in each group were measured and compared,besides,the MRI findings of malignant group and benign group were characterized,and finally,the value of MRI,CA19-9 alone or combined examination of MRI and CA19-9 in the differential diagnosis of benign and malignant ovarian tumor was analyzed.Result The MRI findings of ovarian cancer were characterized as irregular cystic solid mass,blurred border with the surrounding area,and lesion enhancement were noted in enhanced scan.Benign ovarian tumors were observed with clear boundary,smooth cyst wall,long signals on T1 and T2 weighted scan within the cyst,and no or slight enhancement in enhanced scan.The serum CA19-9 level in malignant group was(150.1±75.2)U/ml,and was higher than that in benign group at(52.7±16.1)U/ml,and also higher compared to control group at(33.4+11.2)U/ml,the difference was statistically significant(P<0.05).The serum CA19-9 level were similar in benign group and control group(P>0.05).The sensitivity,specificity,positive predictive value,negative predictive value and Youden’s index of combined examination using MRI and serum CA19-9 in the diagnosis of ovarian cancer was 90.48%,94.29%,95.00%,89.19%and 0.848,and were higher as compared with MRI or CA19-9 utilized alone.Conclusion MRI combined with CA19-9 is diagnostically effective for the differential diagnosis of ovarian cancer.