磁共振成像检查联合血清HE4、TK1、CA199检测在卵巢癌诊断中的应用价值

The Application Value of MRI Combined with Serum HE4,TK1 and CA199 in the Diagnosis of Ovarian Cancer

目的:研究磁共振成像(MRI)检查联合血清人附睾蛋白4(HE4)、细胞质胸苷激酶(TK1)、糖类抗原199(CA199)检测在卵巢癌诊断中的应用价值。方法:将2017年4月~2019年12月我院收治的卵巢癌患者54例作为卵巢癌组,卵巢良性肿瘤患者49例作为卵巢良性肿瘤组,所有受试者均进行MRI检测,并采集受试者血清检测HE4、TK1、CA199水平,以受试者工作特征(ROC)曲线分析MRI检查联合血清HE4、TK1、CA199检测诊断卵巢癌的效能。结果:卵巢癌MRI特点包括以下几点:(1)囊实性肿块;(2)形态不规则;(3)呈长T2/T1等信号;(4)病灶边界模糊;(5)增强扫描结果呈病灶显著强化;(6)腹膜转移者存在显著腹腔积液以及散在分布的结节状种植病灶。卵巢良性肿瘤MRI特点包括以下几点:(1)囊壁光滑;(2)呈长T1以及长T2信;(3)病灶边界清晰;(4)增强扫描结果提示病灶无强化/稍有强化。卵巢癌组血清HE4、TK1、CA199水平分别为(87.13±15.32)pmol/L、(2.15±0.13)pmol/L、(95.39±15.25)U/m L,明显高于卵巢良性肿瘤组的(66.42±10.19)pmol/L、(0.85±0.20)pmol/L、(37.94±1.05)U/m L(均P<0.05)。经ROC曲线分析可得:MRI检查联合血清HE4、TK1、CA199检测诊断卵巢癌的灵敏度、特异度以及曲线下面积均高于上述各项单独诊断。结论:卵巢癌患者血清HE4、TK1、CA199水平较高,MRI检查联合血清HE4、TK1、CA199检测诊断卵巢癌的价值较高,具有一定的临床应用价值。

Objective:To study the application value of magnetic resonance imaging(MRI)combined with serum human epididymal protein 4(HE4),cytoplasmic thymidine kinase(TK1),and saccharide antigen 199(CA199)in the diagnosis of ovarian cancer.Methods:54 patients with ovarian cancer admitted to our hospital from April 2017 to December 2019 were selected as ovarian cancer group.49 patients with benign ovarian tumor were selected as benign ovarian tumor group.MRI was performed on all subjects,and serum levels of HE4,TK1 and CA199 of all subjects were collected.The effectiveness of MRI combined with serum HE4,TK1 and CA199 in detecting and diagnosing ovarian cancer was analyzed by receiver operating characteristic(ROC)curve.Results:MRI features of ovarian cancer include the following points:(1)cystic solid mass;(2)irregular in shape;(3)Long T2/T1 isosignal;(4)the boundary of the lesion was fuzzy;(5)enhanced scan results showed significant enhancement of lesions;(6)peritoneal metastasis patients had significant peritoneal effusion and scattered nodular implant lesions.MRI features of benign ovarian tumors include the following points:(1)smooth cyst wall;(2)long T1 and long T2 signals;(3)clear lesion boundary;(4)enhanced scan results showed no enhancement/slight enhancement in the lesion.The levels of serum HE4,TK1 and CA199 of ovarian cancer group were(87.13±15.32)pmol/L,(2.15±0.13)pmol/L and(95.39±15.25)U/m L respectively,which were significantly higher than(66.42±10.19)pmol/L,(0.85±0.20)pmol/L and(37.94±1.05)U/m L of benign ovarian tumor group(all P<0.05).According to ROC curve analysis,the sensitivity,specificity and area under the curve of MRI combined with serum HE4,TK1 and CA199 in diagnosing ovarian cancer were all higher than the above single diagnoses.Conclusion:The levels of serum HE4,TK1 and CA199 in ovarian cancer patients are relatively high.MRI examination combined with serum HE4,TK1 and CA199 is of high diagnostic value for ovarian cancer,and which has certain clinical application value.