多普勒超声联合糖链抗原125、糖链抗原19-9、附睾蛋白4检测对上皮性卵巢癌的诊断价值研究

The significance of doppler ultrasound combined with tumor markers CA125,CA19-9 and HE4 in the diagnosis of epithelial ovarian cancer

目的研究多普勒超声联合糖链抗原125(CA125)、糖链抗原19-9(CA19-9)及附睾蛋白4(HE4)检测在上皮性卵巢癌中的临床价值。方法收集2018年12月至2020年12月我院收治的卵巢肿瘤患者92例,其中良性44例(良性组),上皮性卵巢癌48例(恶性组,病理分期Ⅰ期19例,Ⅱ期9例,Ⅲ期11例,Ⅳ期9例)。分析其超声特征,对比两组及恶性组不同病理分期患者CA125、CA19-9、HE4水平及超声评分;绘制ROC曲线评估多普勒超声联合上述因子对上皮性卵巢癌的诊断结果。结果恶性组CA125、CA19-9、HE4水平及超声评分均显著高于良性组(P<0.05);Ⅰ~Ⅱ期患者CA125、CA19-9、HE4水平及超声评分均显著低于Ⅲ~Ⅳ期患者(P<0.05);超声图像多表现为囊性或囊实性肿块,囊壁可见增厚,部分可见多房结构,房腔大小不等,伴有腹水无回声区。ROC结果示超声、CA125、CA19-9及HE4单项及联合检测中,以联合检测曲线下面积更大。结论CA125、CA19-9及HE4在上皮性卵巢癌中呈高表达,推测可能与肿瘤发生、发展有关;上述因子联合超声检查可提高疾病诊断效能,为临床诊治提供可靠指导意见。

Objective To explore the clinical significance of Doppler ultrasound combined with carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA19-9)and epididymal protein 4(HE4)in the detection of epithelial ovarian cancer.Methods The clinical data of 92 patients with ovarian tumor admitted to our hospital from December 2018 to December 2020 were collected.Of these patients,44 cases had benign tumors(benign group),48 cases had malignant tumors(malignant group).In the malignant group,there were 19 cases in stage I,9 cases in stage II,11 cases in stage III and 9 cases in stage IV.The ultrasound characteristics were analyzed,and the levels of CA125,CA19-9,HE4 and ultrasound scores in the malignant groups among patients with different pathological stages were compared.ROC curve was drawn to evaluate the significance of Doppler ultrasound combined with the above factors in diagnosing epithelial ovarian cancer.Results The levels of CA125,CA19-9,HE4 and ultrasound scores in the malignant group were significantly higher than those in the benign group(P<0.05).The levels of CA125,CA19-9,HE4 and ultrasound scores of patients at stageⅠ~Ⅱwere significantly lower than those of patients at stageⅢ~Ⅳ(P<0.05).Ultrasound images mostly showed cystic or cystic solid masses with thickening of the cyst wall.Part of the image showed plurilocular structure and cavity of different sizes,accompanied by ascites area without echo.ROC analysis results showed that the area under the combined detection curve was larger than that under the single indicator of ultrasound,CA125,CA19-9 and HE4.Conclusion CA125,CA19-9 and HE4 are highly expressed in epithelial ovarian cancer,which may be related to the occurrence and development of tumors.The combination of the three factors and ultrasound examination can improve the diagnostic efficiency and provide reliable guidance for clinical diagnosis and treatment.