超声GI-RADS分类联合HE4及CA125水平检测对卵巢单房囊实混合性肿瘤的诊断价值

Analysis of GI-RADS Classification combined with HE4 and CA125 Level Detection in the Gynecological Diagnosis of Ovarian Unilocular Cystic and Solid Tumors

目的分析妇科卵巢单房性肿瘤超声GI-RADS分类法结合HE4与CA125水平检测的诊断效能。方法随机选取卵巢单房性肿瘤患者98例,均接受妇科彩色多普勒超声检查、超声引导下穿刺活检或手术后行病理检查,分析98例患者GI-RADS分类法结合HE4与CA125水平检测结果、GI-RADS分类法、HE4与CA125水平检测诊断卵巢单房囊实性肿瘤的效能,统计分析GI-RADS分类法、HE4与CA125水平检测诊断卵巢单房囊实性肿瘤的效能。结果98例患者中,病理诊断显示74例良性,24例恶性;GI-RADS分类法76例良性,22例恶性;伴HE4/CA125水平提升19例,结合HE4/CA125水平后GI-RADS分类法72例良性,26例恶性。GI-RADS分类法诊断卵巢单房囊实性肿瘤的灵敏度为79.2%(19/24),特异度为95.9%(71/74),准确度为91.8%(90/98),阳性预测值为86.4%(19/22),阴性预测值为93.4%(71/76)。HE4与CA125水平诊断卵巢单房囊实性肿瘤的灵敏度为95.8%(23/24),特异度为95.9%(71/74),准确度为95.9%(94/98),阳性预测值为88.5%(23/26),阴性预测值为98.6%(71/72)。GI-RADS分类法诊断卵巢单房囊实性肿瘤的灵敏度、准确度、阴性预测值均显著高于HE4与CA125水平检测(P<0.05),但二者的特异度、阳性预测值之间的差异均不显著(P>0.05)。结论妇科卵巢单房囊实性肿瘤GI-RADS分类法结合HE4与CA125水平检测的诊断效能高,值得在临床推广应用。

Objective To analyze the effect of GI-RADS classification combined with HE4 and CA125 level detection in the gynecological diagnosis of ovarian unilocular cystic and solid tumors.Methods 98 patients with ovarian unilocular cystic and solid tumors were randomly selected,who were examined by color doppler ultrasound,ultrasound guided percutaneous biopsy,or surgical pathology,the efficacy of GI-RADS classification combined with the detection results of HE4 and CA125 levels,GI-RADS classification and the detection of HE4 and CA125 levels in the diagnosis of single-locular cystic ovarian tumors in 98 patients was analyzed,the effect of GI-RADS classification,HE4 and CA125 level detection in the diagnosis of ovarian unilocular cystic and solid tumors were analyzed.Results Of 98 patients,74 were benign and 24 were malignant by pathological diagnosis;76 were benign and 22 were malignant by GI-RADS classification;19 were with elevation of HE4/CA125 level,72 were benign and 26 were malignant by GI-RADS classification combined with elevation of HE4/CA125 level.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of GI-RADS were 79.2%(19/24),95.9%(71/74),91.8%(90/98),86.4%(19/22)and 93.4%(71/76),respectively.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of HE4 and CA125 were 95.8%(23/24),95.9%(71/74),95.9%(94/98),88.5%(23/26)and 98.6%(71/72)respectively.The sensitivity,accuracy and negative predictive value of GI-RADS classification in the diagnosis of ovarian single-locular cystic solid tumors were significantly higher than those of HE4 and CA125(P<0.05),but the difference between the specificity and positive predictive value was not significant(P>0.05).Conclusion The effect of GI-RADS classification combined with HE4 and CA125 level detection in the gynecological diagnosis of ovarian unilocular cystic and solid tumors is high,which is worthy of clinical application.