CT影像表现及血清CA125、CA199对诊断卵巢上皮样肿瘤的价值

Analysis of CT imaging manifestations and serum CA125 and CA199 in diagnosis of ovarian epithelioid tumors

目的通过分析卵巢囊腺瘤、卵巢交界性肿瘤及卵巢囊腺癌I期患者的CT影像学资料、血清CA125、CA199浓度,旨在为卵巢上皮性肿瘤的鉴别诊断提供一定帮助。方法选取115例(123个病灶),包括卵巢囊腺瘤患者56例(59个病灶)、交界性卵巢肿瘤患者28例(31个病灶)、卵巢囊腺癌1期(FIGO 2009卵巢癌分期标准)患者31例(34个病灶);患者术前血清CA125、CA199资料完整、术前CT增强图像资料完整,并有较完整的术后组织病理资料。结果1)影像学表现:单房或多房囊性病灶提示卵巢囊腺瘤,囊实混杂肿瘤多提示交界性或卵巢癌1期,单纯实性病灶仅出现在恶性肿瘤组;菜花样壁结节、全身和局部肿大淋巴结、病灶不规则分隔对于恶性肿瘤提示作用较大;2)血清指标:血清CA125>300 U/ml和(或)CA199>200 U/ml提示交界性或早期恶性肿瘤;血清CA125<35 U/ml多数为良性肿瘤。结论通过观察得出了对于卵巢良性、交界性及早期恶性肿瘤有提示作用的影像学表现、分析血清CA125、CA199浓度,总结出有助于肿瘤性质鉴别的临界数值及相应CT表现,提高了术前对卵巢上皮样肿瘤的诊断能力。

Objective To analyze the CT imaging data and concentrations of CA125,CA199 in serum,so as to provide some help for the differential diagnosis in ovarian epithelial tumors between benign,borderline and early stage malignant tumors.Methods A total of 115 patients(123 lesions)were enrolled,including 56 patients with ovarian cystadenoma(59 lesions),28 patients with borderline ovarian tumors(31 lesions),31 patients with cystadenocarcinoma stageⅠtumors(FIGO 2009 Ovarian Cancer staging)(34 lesions);there were complete data in preoperative serum CA125,CA199 concentrations,enhanced preoperative CT image and postoperative pathological materials.A retrospective study has been made in 2 aspects:1)To observe,record and summary the most valuable imaging findings in benign,borderline and malignant tumors;2)To analyze the concentrations of CA125,CA199 in serum,finding the values of the two indicators in differential diagnosis between ovarian epithelial tumors.Results 1)CT Imaging:swollen lymph nodes,and mural nodules so can suggest of the early malignant tumors;cystic lesions without mural nodules and local thick-walled were valuable imaging in benign tumors;2)The nature of the tumor had the same tendency along with concentrations CA125 in serum;the serum CA125>300 U/ml and(or)CA199>200 U/ml prompted borderline or the early stage of malignant tumors;most benign tumors had a concentration of CA125<35 U/ml.Conclusion We summarized the most valued CT imaging findings between ovarian benign,borderline and the early stage malignant tumors,then through analysis of serum CA125,CA199 concentration,identified the critical value in different natures of tumors,thereby improving the preoperative diagnosis among ovarian benign,borderline and the early stage of malignant tumors.