子宫内膜血流参数联合血清人附睾分泌蛋白4水平检测对子宫内膜癌的诊断价值

Diagnostic value of endometrial blood flow parameters combined with serum human epididymis protein 4 for endometrial carcinoma

目的探究子宫内膜血流参数联合血清人附睾分泌蛋白4(human epididymis protein 4,HE4)水平检测对子宫内膜癌的诊断价值。方法回顾性分析2013年2月至2017年12月在石家庄市第一医院因绝经后异常阴道出血进行相关检查的106例患者的临床资料。根据病理检查结果将入选患者分为良性病变组(55例)和子宫内膜癌组(51例)。所有患者均进行子宫内膜血流参数检查和血清HE4水平检测,比较两种方法单一检查和联合检查对子宫内膜癌的诊断效能。结果子宫内膜癌组患者血管指数、血流指数和阻力指数均显著高于良性病变组(均P<0.05),血清HE4水平显著高于良性病变组(P<0.05)。子宫内膜血流参数联合血清HE4水平检测诊断子宫内膜癌的灵敏度为98.04%,特异度为94.55%,阳性预测值为95.61%,阴性预测值为92.44%,约登指数为0.926,联合检查的诊断价值高于单一检查(均P<0.05)。结论子宫内膜血流参数联合血清HE4水平检测对子宫内膜癌的诊断准确率、灵敏度和特异度均较高,值得临床进一步推广应用。

Objective To explore the diagnostic value of endometrial blood flow parameters combined with serum human epididymis protein 4(HE4)in endometrial carcinoma.Method The clinical data of 106 patients with abnormal vaginal bleeding after menopause in the First Hospital of Shijiazhuang from February 2013 to December 2017 were retrospectively analyzed.According to the results of pathological examination,the patients were divided into benign group(n=55)and endometrial carcinoma group(n=51).All patients underwent endometrial blood flow parameter examination and serum HE4 level examination to compare the diagnostic efficacy of the two methods:single test and combined test for endometrial cancer.Result The vascular index,blood flow index and resistance index of endometrial carcinoma group were significantly higher than those of benign group(all P<0.05),and the serum HE4 level was significantly higher than that of benign group(P<0.05).The sensitivity,specificity,positive predictive value,negative predictive value and the Youden index of combined detection of endometrial blood flow parameters and serum HE4 level were 98.04%,94.55%,95.61%and 0.926 respectively.The diagnostic value of combined detection was higher than that of single examination(P<0.05).Conclusion Endometrial blood flow parameters combined with serum HE4 level has higher accuracy,sensitivity and specificity in the diagnosis of endometrial carcinoma,and is worthy of further clinical application.