三维能量多普勒超声联合血清标志物对子宫内膜癌肌层浸润的临床诊断价值

目的探讨三维能量多普勒超声联合血清标志物评估子宫内膜癌(EC)肌层浸润深度的临床价值。方法选取2021年1月至2023年5月在本院接受手术治疗的118例子宫内膜癌患者作为研究对象。根据术后病理结果将患者分为两组:肌层浸润≥1/2组和肌层浸润<1/2组;通过三维能量多普勒超声检查评估子宫内膜癌肌层浸润深度的诊断价值,包括灵敏度、特异度、准确度、阳性预测值、阴性预测值,并分析HE4、CEA、CA125、CA19-9、CA72-4及AFP在子宫内膜癌不同浸润深度患者血清中的阳性表达率,根据血清标志物阳性及阴性对患者进行亚组分析。结果三维能量多普勒超声检查诊断EC肌层浸润≥1/2时,灵敏度、特异度、准确度、阳性预测值及阴性预测值分别为64.3%、88.9%、83.1%、64.3%、88.9%,在肌层浸润≥1/2组中,HE4、CA125和CA19-9的阳性表达率明显高于浸润<1/2组,而CEA、CA72-4和AFP阳性表达率在肌层浸润≥1/2组和<1/2组间差异无统计学意义(P>0.05)。血清标志物阳性组患者三维能量多普勒超声检查诊断EC肌层浸润≥1/2灵敏度、特异度、准确度、阳性预测值及阴性预测值分别为83.3%、90.0%、86.7%、80.0%、90.0%,其中准确度和阳性预测值明显高于血清标志物阴性组。结论三维能量多普勒超声联合血清标志物检查可以提高EC肌层浸润诊断的准确性和一致性,为术前评估提供参考。

Objective To explore the clinical value of three-dimensional energy Doppler ultrasound combined with serum markers in assessing the depth of myometrial invasion in endometrial cancer(EC).Methods A total of 118 patients with EC who underwent surgical treatment at Lishui Central Hospital in Zhejiang Province from January 2021 to May 2023 were selected as the subjects.Patients were divided into two groups based on postoperative pathological results:the group with myometrial invasion≥1/2 and the group with myometrial invasion<1/2.The diagnostic value of three-dimensional energy Doppler ultrasound in assessing the depth of myometrial invasion in endometrial cancer was evaluated,including sensitivity,specificity,accuracy,posi tive predictive value,and negative predictive value.The positive expression rates of HE4,CEA,CA125,CA19-9,CA72-4,and AFP in the serum of patients with different depths of myometrial invasion were analyzed,and subgroup analysis was performed based on the positivity and negativity of serum markers.Results The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of three-dimensional energy Doppler ultrasound in diagnosing EC myometrial invasion≥1/2 were 64.3%,88.9%,83.1%,64.3%,and 88.9%,respectively.In the group with myometrial invasion≥1/2,the positive expression rates of HE4,CA125,and CA19-9 were significantly higher than in the group with myometrial invasion<1/2,while the positive expression rates of CEA,CA72-4,and AFP showed no statistically significant differences between the two groups(P>0.05).In the group with positive serum markers,the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of three-dimensional energy Doppler ultrasound in diagnosing EC myometrial invasion≥1/2 were 83.3%,90.0%,86.7%,80.0%,and 90.0%,respectively,with significantly higher accuracy and positive predictive value compared to the group with negative serum markers.Conclusion The combined use of three-dimensional energy Doppler ultrasound and serum markers can improve the accuracy and consistency of diagnosing the depth of myometrial invasion in endometrial cancer,providing a reference for clinical preoperative assessment.