MSCT、MRI及血清肿瘤标志物在卵巢卵黄囊瘤诊断中的应用价值

The Value of MSCT,MRI and Serum Tumor Markers in the Diagnosis of Ovarian Yolk Sac Tumor

目的探讨多层螺旋计算机断层扫描(MSCT)、核磁共振成像(MRI)及血清肿瘤标志物在卵巢卵黄囊瘤诊断中的应用价值,并尝试建立量化规则,把MSCT、MRI征象描述转化为可进行比较分析的数值资料。方法收集2019年1月-2022年3月在达州市中西医结合医院经手术病理证实的卵巢卵黄囊瘤的患者93例作为研究对象(研究组),另选取同时期内年龄范围相同且经病理证实为其他类型卵巢肿瘤的患者88例作为对照组进行比较。所有患者均完善CT、MRI及血清肿瘤标志物检查。观察卵巢卵黄囊瘤MSCT、MRI表现,绘制接收者工作特征(ROC)曲线分析MSCT、MRI及血清肿瘤标志物对卵黄囊瘤单独和联合诊断的应用价值,计算准确度、灵敏度和特异度,分析其诊断价值。结果研究组患者血清甲胎蛋白(AFP)水平明显高于对照组,差异有统计学意义(P<0.05)。研究组患者血清糖类抗原125(CA125)水平明显低于对照组,差异有统计学意义(P<0.05)。ROC分析显示:MSCT、MRI征象及血清AFP、CA125联合应用时的灵敏度、特异度、准确度分别为0.903、0.852、0.878,均高于单独应用的诊断结果,MSCT、MRI及血清肿瘤标志物联合应用对卵黄囊瘤具有较高的诊断价值,曲线下面积(AUC)为0.878。结论MSCT、MRI及血清肿瘤标志物(AFP、CA125)联合应用对卵巢卵黄囊瘤具有较高的诊断价值,且具有重复性好、临床应用范围广泛等优势。

Objective To explore the value of multislice spiral computed tomography(MSCT),magnetic resonance imaging(MRI)and serum tumor markers in the diagnosis of ovarian yolk sac tumor,and try to establish quantitative rules to transform MSCT and MRI signs into numerical data that can be compared and analyzed.Methods 93 cases of ovarian yolk sac tumor confirmed by surgery and pathology in Dazhou Integrated Traditional Chinese and Western Medicine Hospital from January 2019 March 2022 were collected as research objects(research group).Another 88 patients of the same age range and pathologically confirmed as other types of ovarian tumors in the same period were selected as the control group for comparison.CT,MRI and serum tumor markers were completed in all patients.To observe the MSCT and MRI manifestations of ovarian yolk sac tumor,draw receiver operating characteristic(ROC)curve,analyze the application value of MSCT,MRI and serum tumor markers in the single and combined diagnosis of ovarian yolk sac tumor,calculate the accuracy,sensitivity and specificity,and analyze its diagnostic value.Results The level of serum alpha fetoprotein(AFP)in the study group was significantly higher than that in the control group(P<0.05).The level of serum carbohydrate antigen 125(CA125)in the study group was significantly lower than that in the control group,with a statistically significant difference(P<0.05).ROC analysis showed that the sensitivity,specificity and accuracy of MSCT,MRI signs and serum AFP,CA125 combined were 0.903,0.852 and 0.878 respectively,which were higher than those of single application.The combined application of MSCT,MRI and serum tumor markers had high diagnostic value for yolk sac tumor,and the area under the curve(AU C)was 0.878.Conclusion The combination of MSCT,MRI and serum tumor markers(AFP,CA125)has high diagnostic value for ovarian yolk sac tumor,and has the advantages of good repeatability and wide clinical application.