不同分期卵巢癌患者血清肿瘤标志物水平及多层螺旋CT表现分析

Analysis on Levels of Serum Tumor Markers and Findings of Multi-slice Spiral CT in Ovarian Cancer Patients at Different Stages

目的分析不同分期卵巢癌患者血清肿瘤标志物水平及多层螺旋CT(MSCT)表现。方法选取2017年5月至2019年7月我院确诊的卵巢癌患者96例、卵巢良性肿瘤者52例、健康体检女性40例为研究对象,采用C-12固体肿瘤蛋白芯片检测其血清肿瘤标志物[罗马指数(ROMA)、糖链抗原125(CA125)、CA199、人附睾蛋白4(HE4)]水平,对比不同分期卵巢癌患者上述肿瘤标志物水平及MSCT表现,分析MSCT对卵巢癌分期的诊断价值。结果卵巢癌患者血清ROMA、CA125、CA199、HE4明显高于卵巢良性肿瘤者、健康体检者,卵巢良性肿瘤者、健康体检者的血清ROMA、CA125、HE4表达水平差异也有统计学意义(P<0.05);卵巢癌晚期(Ⅲ期+Ⅳ期)患者血清ROMA、CA125、CA199、HE4高于早期(Ⅰ期+Ⅱ期)患者(P<0.05);卵巢癌晚期患者腹水、强化、子宫输卵管侵犯、其他盆腔组织器官侵犯、腹膜转移率高于早期患者(P<0.05);MSCT诊断卵巢癌早期的灵敏度、特异度、准确度、约登指数分别为86.96%、84.00%、85.42%、0.708。结论卵巢癌患者血清肿瘤标志物表达水平有升高趋势,且与分期有密切关系,MSCT对卵巢癌分期也有一定诊断价值,有望将两者联合提高对卵巢癌的早期诊断水平。

Objective To analyze levels of serum tumor markers and findings of multi-slice spiral CT(MSCT)in ovarian cancer patients at different stages.Methods During May 2017 to July 2019,96 patients confirmed with ovarian cancer in the hospital,52 patients with benign ovarian tumors,and 40 healthy women undergoing physical examination were enrolled.The levels of serum tumor markers[risk ovarian malignancy algorithm(ROMA)index,carbohydrate antigen 125(CA125),CA199,human epididymis protein 4(HE4)]were detected by the C-12 solid tumor protein chip.The tumor marker and MSCT findings were compared among ovarian cancer patients in different stages.The diagnostic value of MSCT for ovarian cancer staging was analyzed.Results The levels of serum ROMA,CA125,CA199,and HE4 in ovarian cancer patients were significantly higher than those in ovarian benign tumors patients and healthy controls.There were significant differences in expression levels of serum ROMA,CA125,and HE4 between ovarian benign tumors patients and healthy controls(P<0.05).The levels of serum ROMA,CA125,CA199,and HE4 in ovarian cancer patients in advanced stage(stage Ⅲ+Ⅳ)were higher than those in early-stage(stage Ⅰ+Ⅱ)(P<0.05).The ascites,enhancement,uterine fallopian tube invasion,other pelvic tissue,organ invasion,and peritoneal metastasis rates in ovarian cancer patients in the advanced stage were higher than those in the early stage(P<0.05).The sensitivity,specificity,accuracy,and Yoden index of MSCT for early ovarian cancer diagnosis were 86.96%,84.00%,85.42%,and 0.708,respectively.Conclusion The expression levels of serum tumor markers in ovarian cancer patients show an increasing trend closely related to the staging.MSCT is of certain diagnostic value for ovarian cancer staging.It is expected that the combination of the two will improve the diagnosis level of early ovarian cancer.