超声评分系统、螺旋CT及术前血清检查鉴别诊断青春期卵巢肿瘤的价值

Value of Ultrasound Scoring System,Spiral CT,and Preoperative Serum Examination in the Differential Diagnosis of Ovarian Tumors in Adolescent

目的研究超声评分系统、螺旋CT及血清学指标在鉴别青春期卵巢肿瘤中的价值。方法将医院2016年1月至2018年1月间,96例经手术病理确诊为青春期卵巢肿瘤患者纳为研究对象,以手术病理结果为“金标准”,研究超声评分系统、螺旋CT及血清学指标在诊断青春期良恶性卵巢肿瘤中的价值。结果96例患者全部行手术治疗,术中冰冻检查提示良性61例,恶性35例,青春期卵巢恶性肿瘤以生殖细胞肿瘤为主的有45.71%(16/35);共91例患者术前行彩色多普勒超声检查,Alaczar评分系统在鉴别青春期卵巢肿瘤良恶性中的灵敏度、特异度及准确度分别为91.23%、91.18%和91.21%;共20例患者术前行螺旋CT检查,螺旋CT在鉴别青春期卵巢肿瘤中的灵敏度、特异度及准确度分别为75.00%、93.75%和90.00%;所有患者术前均行血清学检查,检查结果提示血清癌胚抗原125(CA125)水平异常者66例(44~569.45U/mL),术后病理检查提示良性病变51例,恶性病变15例;血清糖链抗原199(CA199)水平异常者26例(46~151U/mL),其中良性病变7例,恶性病变19例;血清甲胎蛋白(AFP)水平异常者16例(215.15~3751.21ng/mL),病理检查提示恶性病变者9例,良性病变者7例。结论青春期卵巢肿瘤发病隐匿,临床表现缺乏特异性,需医者仔细检查,结合各种信息加以判断,而超声评分系统、螺旋CT及血清肿瘤标志物在辅助鉴别青春期卵巢肿瘤良恶性中均具有一定效能。

Objective To investigate the value of ultrasound scoring system,spiral CT and preoperative serum examination in differential diagnosis of ovarian tumors in adolescent.Methods 96 adolescents with pathologically confirmed ovarian tumors in our hospital from January 2016 to January 2018 were enrolled.Taking the surgical pathological results as the"gold standard",the diagnostic value of ultrasound scoring system,spiral CT,and serological indexes in the diagnosis of benign and malignant ovarian tumors in adolescence was studied.Results All 96 patients were treated by operation.The intraoperative frozen-section examination showed that 61 cases were benign and 35 cases were malignant.The majority of ovarian malignant tumors in adolescence were germ cell tumors(45.71%,16/35).A total of 91 patients underwent color doppler ultrasonography before operation.The sensitivity,specificity and accuracy of the Alaczar scoring system in differentiating benign and malignant ovarian tumors in adolescence were 91.23%,91.18%,and 91.21%,respectively.A total of 20 patients underwent preoperative spiral CT examination.The sensitivity,specificity and accuracy of spiral CT in differentiating benign and malignant ovarian tumors were 75.00%,93.75%,and 90.00%,respectively.All patients underwent serological examination before surgery,and the results indicated that 66 patients with abnormal serum oncoembryonic antigen 125 levels(CA125:44~569.45U/mL),including 51 patients with benign lesions and 15 patients with malignant lesions.There were 26 cases with abnormal serum glucose chain antigen level(CA199:46~151U/mL),including 7 cases of benign lesions and 19 cases of malignant lesions.There were 16 cases with abnormal serum alpha-fetoprotein(AFP:215.15~3751.21ng/mL)levels,including 9 cases with malignant lesions and 7 cases with benign lesions.Conclusion The onset of adolescent ovarian tumors is occult,and the clinical manifestations are lack of specificity.Careful examination combined with various information is used in clinical judgment,and the ultrasound scoring system,spiral CT,and serum tumor markers have certain efficacy in helping to differentiate the benign and malignant ovarian tumors in adolescence.