MRI联合糖类抗原125及人附睾蛋白4鉴别诊断Ⅰ型与Ⅱ型上皮性卵巢癌

MRI combined with serum carbohydrate antigen 125 and human epididymis protein 4 for differential diagnosis of typeⅠandⅡepithelial ovarian cancers

目的观察MRI联合血清糖类抗原125(CA125)及人附睾蛋白4(HE4)鉴别诊断Ⅰ型与Ⅱ型上皮性卵巢癌(EOC)的价值。方法回顾性收集87例EOC患者,根据病理结果将35例Ⅰ型及52例Ⅱ型EOC分别归入Ⅰ型组及Ⅱ型组;比较组间常规MRI表现、表观弥散系数(ADC)值、CA125及HE4,分析其单一及联合鉴别诊断Ⅰ、Ⅱ型EOC的效能。结果组间常规MRI表现,包括病灶成分、附壁结节、腹膜扩散、淋巴结转移,ADC值,以及患者CA125和HE4差异均有统计学意义(P均<0.05)。根据常规MRI表现、ADC值,以及患者CA125及HE4鉴别Ⅰ、Ⅱ型EOC的曲线下面积(AUC)分别为0.694、0.730、0.670及0.708;四者联合的AUC为0.865,高于任意单一项(Z=3.008、2.138、3.005、2.746,P均<0.05)。结论MRI联合CA125及HE4有助于鉴别诊断Ⅰ、Ⅱ型EOC。

Objective To observe the value of MRI combined with serum carbohydrate antigen 125(CA125)and human epididymis protein 4(HE4)for differential diagnosis of typeⅠandⅡepithelial ovarian cancers(EOC).Methods Totally 87 EOC patients were retrospectively enrolled.According to pathology,35 cases of typeⅠEOC were taken as typeⅠgroup,while 52 cases of typeⅡEOC were taken as typeⅡgroup.Conventional MRI manifestations and apparent diffusion coefficient(ADC)value of lesions,as well as CA125 and HE4 were compared between groups,and their efficacy for differential diagnosis of typeⅠandⅡEOC were analyzed.Results Significant differences of conventional MRI manifestations of lesions,including composition,mural nodules,peritoneal diffusion and lymph node metastasis,of ADC value of lesions,also of patients’CA125 and HE4 were found between groups(all P<0.05).The area under the curve(AUC)of conventional MRI manifestations and ADC value of lesions,patients’CA125 and HE4 for distinguishing typeⅠand typeⅡEOC was 0.694,0.730,0.670 and 0.708,respectively,while of the combination of the above four was 0.865,higher than that of each one alone(Z=3.008,2.138,3.005,2.746,all P<0.05).Conclusion MRI combined with CA125 and HE4 was helpful for differential diagnosis of typeⅠandⅡEOC.