腹部彩超结合肿瘤标记物检测鉴别诊断子宫腺肌病与子宫肌瘤的临床价值

Clinical Value of Abdominal Color Ultrasound Combined with Tumor Marker Detection in Differential Diagnosis of Adenomyosis and Uterine Fibroids

目的:探讨在子宫腺肌病和子宫肌瘤患者鉴别诊断中,腹部彩超联合肿瘤标记物[糖类抗原125(CA125)、糖类抗原199(CA199)]检测的诊断价值。方法:将2021年1月-2022年4月鄂州市中医医院收治65例子宫肌瘤患者纳入子宫肌瘤组,另将同期65例子宫腺肌病患者纳入子宫腺肌病组。所有患者均给予腹部彩超、肿瘤标记物(CA199、CA125)检查,分析检查结果。结果:子宫腺肌病组患者的血清CA199、CA125水平均高于子宫肌瘤组,差异均有统计学意义(P<0.05)。腹部彩超检查与病理诊断结果一致性一般(Kappa=0.415,P=0.000);CA199检测与病理诊断结果一致性一般(Kappa=0.585,P=0.000);CA125检测与病理诊断结果一致性一般(Kappa=0.492,P=0.000);联合检查与病理诊断结果一致良好(Kappa=0.846,P=0.000)。联合检查诊断子宫腺肌病的敏感度、特异度、准确度均高于任一单项检测(P<0.05)。结论:子宫腺肌病与子宫肌瘤鉴别中采用腹部彩超与血清CA199、CA125联合诊断,可提升诊断准确率,值得推广。

Objective:To explore the diagnostic value of abdominal color ultrasound combined with tumor markers[carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA199)]detection in the differential diagnosis of adenomyosis and uterine fibroids.Method:A total of 65 patients with uterine fibroids admitted to Ezhou Hospital of Traditional Chinese Medicine from January 2021 to April 2022 were included in the uterine fibroids group,and another 65 patients with adenomyosis during the same period were included in the adenomyosis group.All patients were given abdominal color ultrasound and tumor markers(CA199 and CA125)examination,and the results were analyzed.Result:Serum CA199 and CA125 levels in adenomyosis group were higher than those in uterine fibroids group,the differences were statistically significant(P<0.05).The results of abdominal color ultrasound were generally consistent with those of pathological diagnosis(Kappa=0.415,P=0.000);CA199 was generally consistent with pathological diagnosis(Kappa=0.585,P=0.000);CA125 was generally consistent with pathological diagnosis(Kappa=0.492,P=0.000);Combined examination and pathological diagnosis were in good agreement(kappa=0.846,P=0.000).The sensitivity,specificity and accuracy of combined examination in the diagnosis of adenomyosis were higher than those of any single test(P<0.05).Conclusion:The combination of abdominal color ultrasound with serum CA199 and CA125 in the identification of adenomyosis and uterine fibroids can improve the diagnostic accuracy and is worth popularizing.