超声联合血清CA125、AMH、HE4在卵巢子宫内膜异位症囊肿和卵巢癌中的鉴别价值

The diagnostic value of ultrasound combined with serum CA125,AMH and HE4 in ovarian endometriotic cyst and ovarian cancer

目的探讨超声联合血清糖类抗原125(CA125)、抗缪勒管激素(AMH)、人附睾蛋白4(HE4)在卵巢子宫内膜异位症囊肿(OEC)及卵巢癌中的鉴别价值。方法选取卵巢子宫内膜异位症囊肿患者(OEC组)60例、卵巢癌患者(卵巢癌组)30例,另选择同期60例健康体检者(健康组),均行超声检查,并测定所有研究对象血清CA125、AMH、HE4水平,比较其单独检测及联合检测对OEC和卵巢癌的鉴别价值。结果超声显示,OEC存在多个囊腔和分隔,卵巢癌以含实性组织及肿块血流较为多见,其中含实性组织15例,肿块血流13例,包块直径多大于100 mm。OEC组血清CA125、HE4显著高于健康组,AMH显著低于健康组(P<0.05)。超声、血清CA125、AMH、HE4在OEC和卵巢癌的鉴别中具有一定价值,但各项联合鉴别OEC和卵巢癌效果更佳。ROC曲线结果显示,超声及CA125、AMH、HE4联合检测诊断OEC和卵巢癌的AUC均高于单一检测。结论超声、血清CA125、AMH、HE4均为OEC和卵巢癌鉴别诊断的有效指标,联合检测具有更高的灵敏度、特异度和准确度。

Aim To investigate the diagnostic value of ultrasound combined with serum carbohydrate antigen 125(CA125),anti-Mullerian hormone(AMH),and human epididymal protein 4(HE4)in ovarian endometriotic cysts(OEC)and ovarian cancer.Methods 60 patients with OEC(OEC group)and 30 patients with ovarian cancer(Ovarian cancer group),and 60 healthy pepoles during the same period healthy control group were selected.Ultrasonography was performed and the serum of all subjects was measured.The level of CA125,AMH,HE4,and compare the differential value of individual detection and combined detection in OEC and ovarian cancer.Results Ultrasound showed that OEC had multiple cysts and compartments.Ovarian cancer was more common with solid tissue and mass blood flow.Among them,15 cases contained solid tissue,13 cases had mass blood flow,and the mass diameter was more than 100 mm.Serum CA125 and HE4 of the OEC group were significantly higher than those of the healthy control group,and AMH was significantly lower than that of the healthy control group(P<0.05).Ultrasound,serum CA125,AMH,and HE4 have certain value in the identification of OEC and ovarian cancer,but the combination of each of them is more effective in identifying OEC and ovarian cancer.ROC curve results show that the combined detection of ultrasound,CA125,AMH,and HE4 for diagnosis of OEC and ovarian cancer has higher AUC than single detection.Conclusions Ultrasound,combined serum CA125,AMH,and HE4 are effective indicators for the differential diagnosis of OEC and ovarian cancer.The combined detection has higher sensitivity,specificity and accuracy.