超声联合血清CK、CXCL10检测诊断葡萄胎及预测恶变价值分析

Value of ultrasound combined with serum creatine kinase and CXCL10 levels for diagnosing hydatidiform mole and for predicting the malignant transformation of hydatidiform mole

目的:探讨超声联合血清肌酸激酶(CK)、趋势因子白介素-10(CXCL10)检测诊断葡萄胎及预测恶变价值。方法:前瞻性选择2018年2月—2021年7月在本院确诊并治疗的妊娠滋养细胞疾病患者88例为病例组,其中恶变组40例、非恶变组48例,同期健康体检志愿者88例为对照组,检测各组超声指标及血清CK、CXCL10水平并分析诊断葡萄胎及恶变效能。结果:病例组血清CK(109.76±1.17μg/ml)、CXCL10(76.55±1.77 ng/ml)水平高于对照组(29.98±1.01μg/ml、40.26±1.74 ng/ml),且恶变组(171.89μg/ml±8.24、92.59±5.97 ng/ml)高于非恶变组(57.99±9.19μg/ml、63.18±5.00 ng/ml);病例组超声阻力指数(RI)、搏动指数(PI)、峰值流速(PSV)均低于对照组,舒张末期流速(EDV)高于对照组,且恶变组RI、PI、PSV均低于非恶变组,EDV高于非恶变组(均P<0.05)。经受试者工作特征曲线分析,超声联合血清CK、CXCL10检测对葡萄胎以及恶变的曲线下面积(0.909、0.998),特异度(56.3%、41.9%)均高于单独指标检测。结论:超声联合血清CK、CXCL10检测诊断葡萄胎及恶变的预测效能较好,临床可参考。

Objective:To study the diagnostic efficacy of ultrasound combined with serum creatine kinase(CK)and CXCL10 for hydatidiform mole,and to explore their predictive value for malignant transformation of hydatidiform mole.Methods:88 patients with gestational trophoblastic disease were selected prospectively in study group from February 2018 to July 2021,which included 40 patients with malignant transformation of gestational trophoblastic disease in malignant group and 48 patients without malignant transformation in non-malignant group.In addition,88 volunteers who underwent physical examination during the same period were selected in control group.The ultrasonic indexes of all these patients were examined,and their levels of serum CK and CXCL10 were detected,and the efficiencies of which for diagnosing hydatidiform mole and the malignant transformation of gestational trophoblastic disease were analyzed.Results:The levels of serum CK(109.76±1.17μg/ml)and CXCL10(76.55±1.77 ng/ml)of the patients in the study group were significantly higher than those(29.98±1.01μg/ml and 40.26±1.74 ng/ml)of the patients in the control group,and which of the patients in malignant group(171.89μg/ml±8.24,and 92.59±5.97 ng/ml)were significantly higher than those(57.99±9.19μg/ml and 63.18±5.00 ng/ml)of the patients in the non-malignant group.In the case group the ultrasonic RI,PI and PSV were lower than those in the control group,the EDV was higher than those in the control group,and the RI,PI and PSV in the malignant group were lower than those in the non-malignant group,and the EDV was higher than those in the non-malignant group(all P<0.05).Receiver operating characteristic curve analysis showed that the areas under the curve and the specificity of ultrasound combined with serum CK and CXCL10 levels for diagnosing hydatidiform mole and the malignant transformation were 0.909 and 0.998,and 56.3%and 41.9%,which were all significantly higher than those diagnosed by ultrasound or serum CK and CXCL10 levels alone.Conclusion:Ultrasound combined with serum creatine kinase and CXCL10 levels for diagnosing hydatidiform mole and its malignant transformation has better efficacy,which can be as references in clinic.