多普勒超声联合DKK-4、YKL-40检测对上皮性卵巢癌早期诊断价值

Value of Doppler ultrasound examination combined with the detections of DKK-4 and YKL-40 for early diagnosing epithelial ovarian cancer

目的:分析多普勒超声联合血清DKK-4、人软骨糖蛋白-39(YKL-40)检测对上皮性卵巢癌的早期诊断价值。方法:选取2017年1月-2020年1月本院确诊的上皮性卵巢癌患者92例为观察组,同期健康体检女性96例为对照组,均行阴道彩色多普勒超声检查,计算血流参数指标血流阻力指数(RI)和搏动指数(PI);采用酶联免疫吸附检测血清DKK-4、YKL-40水平;ROC曲线分析多普勒超声联合血清DKK-4、YKL-40对上皮性卵巢癌的诊断价值;logistic回归分析影响上皮性卵巢癌的危险因素。结果:与对照组比较,观察组超声血流参数RI、PI值降低,血清DKK-4、YKL-40水平均升高(均P<0.05);ROC曲线结果显示,RI、PI、DKK-4、YKL-40分别诊断上皮性卵巢癌的曲线下面积(AUC)为0.770~0.790,敏感度为74.0%~77.1%,特异性为69.6%~78.3%,RI、PI联合血清DKK-4、YKL-40诊断AUC为0.953,敏感度为90.6%,特异性为88.0%;回归分析表明血清DKK-4、YKL-40水平异常升高是发生上皮性卵巢癌的危险因素。结论:多普勒超声联合血清DKK-4、YKL-40检测对上皮性卵巢癌的早期诊断有较好临床意义,同时提醒临床对患者血清DKK-4、YKL-40水平异常升高应加以重视。

Objective: To analyze the value of Doppler ultrasound examination combined with the detections serum DKK-4 and YKL-40 for early diagnosing epithelial ovarian cancer. Methods: 92 women with epithelial ovarian cancer were selected in research group, and 96 healthy women were selected in control group from January 2017 to January 2020. Transvaginal color Doppler ultrasound was conducted in the women in the two groups. The blood flow parameters, such as resistance index(RI) and pulsatility index(PI), of the women in the two groups were calculated. The expression levels of serum DKK-4 and YKL-40 of the women in the two groups were detected by enzyme-linked immunosorbent assay(ELISA). ROC curve was used to analyze the diagnostic value of Doppler ultrasound examination combined with serum DKK-4 and YKL-40 detections for epithelial ovarian cancer. Logistic regression analysis was used to analyze the risk factors of epithelial ovarian cancer. Results: The values of blood flow parameters by ultrasound, such as RI and PI of the women in the research group were significantly lower than those of the women in the control group, but the serum DKK-4 and YKL-40 levels of the women in the research group were significantly higher(all P<0.05). ROC curve showed that the area under curve(AUC), the sensitivity, and the specificity of the RI value, the PI value, the DKK-4 level, and the YKL-40 level for diagnosing epithelial ovarian cancer ranged from 0.770 to 0.790, from 74.0% to 77.1%, and from 69.6% to 78.3%, respectively. The AUC, the sensitivity, and the specificity of the values of RI and PI combined with the serum DKK-4 and YKL-40 levels for diagnosing epithelial ovarian cancer were 0.953, 90.6%, and 88.0%, respectively. Regression analysis showed that abnormal increases of serum DKK-4 and YKL-40 levels were the risk factors of epithelial ovarian cancer.Conclusion:Doppler ultrasound examination combined with the detections serum DKK-4 and YKL-40 for early diagnosing epithelial ovarian cancer has better clinical significance,and the abnormal increases of serum DKK-4 and YKL-40 levels of the women with epithelial ovarian cancer should be paid more attention to in clinic.