磁共振成像参数联合肿瘤标志物检测对卵巢肿瘤的诊断价值

Value of Magnetic Resonance Imaging Parameters Combined with Tumor Markers in the Diagnosis of Ovarian Tumors

目的探讨磁共振成像(MRI)参数联合血清肿瘤标志物检测对卵巢肿瘤诊断的价值。方法选择2021年7月至2023年5月在开封市肿瘤医院就诊的113例卵巢肿瘤患者作为研究对象,经病理确诊良性肿瘤患者70例(良性组),恶性肿瘤患者43例(恶性组)。所有研究对象均进行MRI检查,并检测血清糖类抗原125(CA125)、人附睾蛋白4(HE4)以及甲胎蛋白(AFP)等肿瘤标志物。采用灵敏度、特异度和受试者工作特征(ROC)曲线中曲线下面积(AUC)评价单一检测和联合检测的对卵巢肿瘤的诊断价值。结果恶性组患者肿瘤最大直径高于良性组,表观弥散系数(ADC)低于良性组,且边界不清晰、形态不规则、实性或囊实性成分以及强化程度的占比均高于良性组,血清CA125、HE4和AFP肿瘤标志物诊断阳性率均高于良性组,差异有统计学意义(P<0.05)。MRI和肿瘤标志物单一检测的灵敏度为62.79%~81.40%,AUC面积为0.743~0.878。MRI+CA125+HE4联合检测方式的灵敏度和AUC面积均最高,分别为97.67%和0.938。结论卵巢良、恶性肿瘤患者中MRI参数和血清CA125、HE4、AFP肿瘤标志物存在差异,其中MRI联合血清CA125、HE4检查方式对卵巢肿瘤鉴别诊断具有重要临床价值。

Objective To investigate the value of magnetic resonance imaging(MRI)parameters combined with serum tumor markers in the diagnosis of ovarian tumors.Methods A total of 113 patients with ovarian tumor who were treated in Kaifeng Cancer Hospital from July 2021 to May 2023 were selected as the study objects,70 patients with benign tumor(benign group)and 43 patients with malignant tumor(malignant group)were pathologically confirmed.All subjects underwent MRI and tumor markers such as serum carbohydrate antigen 125(CA125),human epididymis protein 4(HE4),and alpha-fetoprotein(AFP)were detected.Sensitivity,specificity and area under the curve(AUC)area of receiver operating characteristic(ROC)curve were used to evaluate the diagnostic value of single and combined tests for ovarian tumors.Results The maximum tumor diameter in the malignant group was higher than that in the benign group,the apparent diffusion coefficient(ADC)value was lower than that in the benign group,and the proportion of unclear boundary,irregular shape,solid or cystic components and enhancement degree was higher than that in the benign group,and the diagnostic positive rate of serum CA125,HE4 and AFP tumor markers was higher than that in the benign group,with statistical significance(P<0.05).The sensitivity of MRI and tumor markers was 62.79%-81.40%,and the AUC area was 0.743-0.878.The sensitivity and AUC area of MRI+CA125+HE4 were the highest,which were 97.67%and 0.938,respectively.Conclusion There are significant differences in MRI parameters and serum CA125,HE4 and AFP tumor markers between benign and malignant ovarian tumors.MRI combined with serum CA125 and HE4 has important clinical value in the differential diagnosis of ovarian tumors.