肾母细胞瘤基因联合二维超声在卵巢癌患者中的辅助诊断效果及预后指导价值研究

Study on the Assistant Diagnostic Effect and Prognosis Guiding Value of WT1 Gene Combined with Two-Dimensional Ultrasound in Patients with Ovarian Cancer

目的:探讨肾母细胞瘤基因(WT1)联合二维超声在卵巢癌患者中的辅助诊断效果及预后指导价值。方法:回顾性收集2017年4月~2020年12月术前疑似卵巢癌患者87例,收集患者已有二维超声的阻力指数(RI)和搏动指数(PI),边界、包膜、内部回声、盆腔积液及彩色血流情况。收集标本库血液标本行PCR检测WT1表达情况,以病理组织检查结果作为“金标准”,分析WT1联合二维超声在卵巢癌中的辅助诊断效果;并完成24个月门诊随访,绘制生存曲线,分析WT1不同表达下患者生存期差异。结果:87例患者经“金标准”检查确诊52例,确诊率为59.77%;二维超声检查阳性41例,血液WT1检查44例阳性,二者联合检查50例阳性;WT1联合二维超声在卵巢癌患者中检查准确度、灵敏度、特异度、阳性与阴性预测值均高于二维超声和WT1(P<0.05);WT1联合二维超声检查阳性患者生存期为(23.29±4.67)月短于WT1基因联合二维超声检查阴性患者(P<0.05)。结论:肾母细胞瘤基因(WT1)和二维超声用于卵巢癌患者中具有较高检出率,且二者联合检查能提高诊断效能,可为临床诊疗提供指导依据。

Objective:To investigate the auxiliary diagnostic effect and prognosis guiding value of WT1 gene combined with two-dimensional ultrasound in patients with ovarian cancer.Methods:87 patients suspected of ovarian cancer from April 2017 to December 2020 were retrospectively collected as the subjects.The resistance index(RI)and pulsatility index(PI),boundary,envelope,internal echo,the pelvic cavity accumulates liquid and color blood flow of the patients with two-dimensional ultrasound were collected.Collect blood samples from the specimen bank and detect the expression of WT1 by PCR.The results of pathological tissue examination were used as the"gold standard"to analyze the auxiliary diagnostic effect of WT1 gene combined with two-dimensional ultrasound in ovarian cancer.According to the above diagnosis results,followed up for 24 months,drew the survival curve,and analyzed the difference of survival period of patients with different expressions of WT1 genes.Results:52 of 87 patients were diagnosed by"gold standard"examination,with a diagnosis rate of 59.77%;41 cases were positive by two-dimensional ultrasound,44 cases were positive by gene detection of WT1,and 50 cases were positive by combined detection of the two;The accuracy,sensitivity,specificity,positive and negative predictive values of WT1 gene combined with two-dimensional ultrasound in ovarian cancer patients were higher than those of two-dimensional ultrasound and WT1 gene(P<0.05);The survival time of patients with positive WT1 gene combined with two-dimensional ultrasound was(23.29±4.67)months shorter than that of patients with negative WT1 gene combined with twodimensional ultrasound(P<0.05).Conclusion:The detection rate of WT1 gene and two-dimensional ultrasound in patients with ovarian cancer is high,and the combined examination of the two can improve the diagnostic efficacy,which can provide guidance for clinical diagnosis and treatment.