经阴道三维超声联合血清恶性肿瘤特异性生长因子鉴别卵巢占位性病变性质的价值

Value of transvaginal three-dimensional ultrasound combined with serum malignant tumor specific growth factor in differentiation of ovarian space occupying lesion

目的分析经阴道三维超声联合血清恶性肿瘤特异性生长因子(TSGF)鉴别卵巢占位性病变性质的价值。方法选取2017年4月—2020年1月于桐乡市妇幼保健院和余姚市人民医院因卵巢占位性疾病行手术治疗的80例患者为研究对象,根据术后病理结果,将患者分为卵巢癌组(37例卵巢癌患者)和良性肿瘤组(43例良性肿瘤患者)。采用PUZS-300全自动生化分析仪检测血清TSGF表达水平,患者术前均行经阴道三维超声检查,获得阻力指数(RI)、搏动指数(PI)。比较两组RI、PI及血清TSGF水平;分析良性肿瘤和卵巢癌患者经阴道三维超声参数和血清TSGF水平的相关性;分析经阴道三维超声参数和血清TSGF水平对卵巢癌的诊断价值;分析卵巢癌发生的影响因素。结果卵巢癌组RI、PI及血清TSGF水平分别为(0.45±0.14)、(0.75±0.26)及(132.59±46.37)U/ml;良性肿瘤组RI、PI及血清TSGF水平分别为(0.82±0.29)、(1.35±0.41)及(79.54±24.36)U/ml。卵巢癌组RI、PI均显著小于良性肿瘤组,血清TSGF水平显著高于良性肿瘤组,差异均有统计学意义(t=6.314、7.158及6.532,均P<0.05)。Pearson法分析结果显示:卵巢癌患者经阴道三维超声参数RI、PI和血清TSGF水平均呈负相关(r=-0.599,P=0.000;r=-0.675,P=0.000)。二元Logistic回归分析结果显示:RI<0.581、PI<1.153及TSGF≥119.022 U/ml是卵巢癌发生的危险因素(P<0.05)。结论经阴道三维超声参数RI、PI与血清TSGF对卵巢占位性病变的性质均有一定诊断价值,三者联合对于早期预测卵巢癌的发生有重要的参考价值。

Objective To analyze the value of transvaginal three-dimensional ultrasound combined with serum malignant tumor specific growth factor(TSGF)in differentiation of ovarian space occupying lesion.Methods From April 2017 to January 2020,80 patients undergoing surgery due to ovarian space occupying lesion in Tongxiang Municipal Maternal and Child Health Care Hospital and Yuyao People’s Hospital were selected,according to postoperative pathological results,the patients were divided into ovarian cancer group(37 patients with ovarian cancer)and benign tumor group(43 patients with benign tumor),PUZS-300 fully automatic biochemical analyzer was used to detect serum TSGF levels,transvaginal three-dimensional ultrasonography was performed before surgery to obtain resistance index(RI)and pulsatility index(PI).The levels of RI,PI,and serum TSGF in the two groups were compared;the correlations between transvaginal three-dimensional ultrasound indexes and serum TSGF level in benign tumor patients and ovarian cancer patients were analyzed.The diagnostic value of transvaginal three-dimensional ultrasound indexes and serum TSGF level for ovarian cancer was analyzed.The influencing factors of ovarian cancer were analyzed.Results The levels of RI,PI,and serum TSGF in ovarian cancer group were(0.45±0.14),(0.75±0.26),and(132.59±46.37)U/ml,respectively;the levels of RI,PI,and serum TSGF in benign tumor group were(0.82±0.29),(1.35±0.41),(79.54±24.36)U/ml,respectively.RI and PI in ovarian cancer group were significantly lower than those in benign tumor group,serum TSGF in ovarian cancer group was significantly higher than that in benign tumor group(t=6.314,7.158,6.532,P<0.05).Pearson analysis showed that transvaginal three-dimensional ultrasound indexes(RI and PI)were negatively correlated with serum TSGF level(r=-0.599,P=0.000;r=-0.675,P=0.000).Binary Logistic regression analysis showed that RI<0.581,PI<1.153,and TSGF≥119.022 U/ml were risk factors of ovarian cancer(P<0.05).Conclusion Transvaginal three-dimensional ultrasound indexes(RI and PI)and serum TSGF have a certain value for diagnosis of ovarian space occupying lesion,joint detection has important reference value for early prediction of ovarian cancer.