MSCT联合血清CA125、HE4诊断卵巢癌的价值

The value of MSCT combined with serum CA125 and HE4 in the diagnosis of ovarian cancer

目的探究多层螺旋CT(multislice spiral CT,MSCT)联合人血清癌抗原125(cancer antigen 125,CA125)合人附睾蛋白4(human epididymis protein 4,HE4)对卵巢癌的诊断价值。方法选择卵巢癌患者90例作为研究对象,其中合并腹膜转移的患者48例不合并腹膜转移的患者42例。选择同期卵巢良性病变患者40例作为对照组。所有患者接受MSCT检查。通过酶联免疫吸附法和电化学发光分别检测血清中CA125和HE4水平。分析MSCT、CA125和HE4单项和联合检测对卵巢癌以及卵巢癌腹膜转移的诊断效能。结果卵巢癌患者血清中CA125和HE4的水平分别为(67.24±13.07 U/mL)和(237.92±50.12 pmol/L),显著高于对照组(P<0.05)。MSCT、CA125和HE4对卵巢癌的诊断准确度分别为73.08%(95/130)、76.15%(99/130)和70.77%(92/130)(P>0.05)。平行联合检测的准确度和敏感度分别为87.69%(114/130)和95.56%(86/90),显著高于单项检测和系列联合检测(P<0.05)。系列联合检测的特异度为97.50%(39/40),显著高于单项检测和平行联合检测(P<0.05)。合并腹膜转移的卵巢癌患者血清CA125水平为(72.73±16.04 U/mL),HE4水平为(245.81±57.82 pmol/L),显著高于无腹膜转移的卵巢癌患者(P<0.05)。MSCT、CA125和HE4对卵巢癌腹膜转移的诊断准确度分别为73.33%(67/90)、66.67%(63/90)和78.89%(67/90)(P>0.05)。平行联合检测的准确度和敏感度分别为90.00%(81/90)和95.83%(46/48),显著高于单项检测和系列联合检测(P<0.05)。系列联合检测的特异度为95.24%(40/42),显著高于单项检测和平行联合检测(P<0.05)。结论卵巢癌患者血清CA125和HE4水平显著升高,并且在合并腹膜转移的胃肠道卵巢转移癌患者中CA125和HE4水平升高更显著。MSCT联合血清HE4和CA125可提高对卵巢癌的诊断效果,并且对于卵巢癌腹膜转移的诊断具有较好的效果。

Objective To explore the diagnostic value of multislice spiral CT(MSCT)combined with human serum cancer antigen 125(CA125)and human epididymis protein 4(HE4)for ovarian cancer.Methods Ninety patients with ovarian cancer were selected as research objects.Forty-eight patients with peritoneal metastasis and 42 patients without peritoneal metastasis.Forty patients with benign ovarian lesions were selected as the control group.All patients underwent MSCT.Serum CA125 and HE4 levels were detected by enzyme-linked immunosorbent assay and electrochemical luminescence,respectively.Analysis of single and combined detection of MSCT,CA125 and HE4 in the diagnosis of ovarian cancer and peritoneal metastasis of ovarian cancer.Results The serum levels of CA125 and HE4 in patients with ovarian cancer were(67.24±13.07 U/mL)and(237.92±50.12 pmol/L),which were significantly higher than those in the control group(P<0.05).The diagnostic accuracy of MSCT,CA125 and HE4 for ovarian cancer were 73.08%(95/130),76.15%(99/130)and 70.77%(92/130)(P>0.05).The accuracy and sensitivity of parallel joint detection were 87.69%(114/130)and 95.56%(86/90),which were significantly higher than those if the single test and the series of joint tests(P<0.05).The specificity of the series of joint tests was 97.50%(39/40),which was significantly higher than that of the single test and parallel joint tests(P<0.05).The serum CA125 level of ovarian cancer patients with peritoneal metastasis was(72.73±16.04 U/mL)and the HE4 level was(245.81±57.82 pmol/L),which were significantly higher than those of ovarian cancer patients without peritoneal metastasis(P<0.05).The diagnostic accuracy of MSCT,CA125 and HE4 for peritoneal metastasis of ovarian cancer were 73.33%(67/90),66.67%(63/90)and 78.89%(67/90)(P>0.05).The accuracy and sensitivity of the parallel joint detection were 90.00%(81/90)and 95.83%(46/48),which were significantly higher than those of the single test and the series of joint tests(P<0.05).The specificity of the series of joint tests was 95.24%(40/42),which was significantly higher than those of the single test and parallel joint tests(P<0.05).Conclusion Serum CA125 and HE4 levels were significantly increased in patients with ovarian cancer,and CA125 and HE4 levels were more significant in patients with gastrointestinal ovarian metastases with peritoneal metastasis.MSCT combined with serum HE4 and CA125 can improve the diagnosis of ovarian cancer,and has a better effect on the diagnosis of ovarian cancer peritoneal metastasis.