Lymphoepithelial cysts and cystic lymphangiomas: Underrecognized benign cystic lesions of the pancreas

AIM: To identify their diagnostic and prognostic clinical characteristics in a large series.METHODS: Retrospective review of clinicopathologic and imaging characteristics of patients diagnosed with lymphoepithelial cysts and cystic lymphangiomas of the pancreas at Massachusetts General Hospital.RESULTS: Twelve patients were identified between 1/1/1997 and 8/1/2007. Their median age was 55.5 years(range 19-78 years), and 6 were females. The le-sion was incidentally discovered in half of the patients.Contrast enhanced computed tomography demonstrat-ed that the cysts had thin walls, without calcifications, pancreatic duct dilation or pancreatic parenchyma inva-sion. Endoscopic ultrasound with fine needle aspiration(EUS/FNA) confirmed the diagnosis of a lymphoepithe-lial cyst in 3 patients, one of whom was spared an op-eration and continues to do well after 6 years. Eleven patients had a resection: 3 pancreaticoduodenecto-mies, 7 distal pancreatectomies, and 1 enucleation. The median size of the cysts was 3 cm(range 2-20 cm). At a median follow-up of 57 mo no recurrences or other pancreas-related conditions occurred.CONCLUSION: Lymphoepithelial cysts and cystic lymphangiomas of the pancreas can be diagnosed with a combination of contrast-enhanced computed tomog-raphy scans and EUS/FNA. If the lesion is asymptom-atic, an operation might be avoided.

MRI Differentiation Diagnosis of Occupying Lesions in Cerebellopontine Angle Area

Objective： To explore the value of magnetic resonance imaging （MRI） in diagnosis of occupying lesions in cerebellopontine angle area. Methods： MRI records of 78 patients with pathologically confirmed occupied lesions in cerebellopontine angle area were analyzed. Results： Of the 78 cases, 48 （61.5%） were unilateral acoustic neuroma, 5 （6.4%） were bilateral acoustic neuroma, 12 （15.4%） were meningioma, 4 （5.1%） were trigeminal neuroma, 3 （3.8%） were lipoma, 2 （2.6%） were melanoma, and 1 （1.3%） was medulloblastoma. According to the anatomic site, tumor lesion character, and MRI signal, the majority of cerebellopontine angle area tumors were diagnosed accurately. Conclusion： MRI plays an important role in diagnosis of occupying lesions in cerebellopontine angle area.

A Drug-induced Hepatitis Patient with a Manifestation of Liver Occupying Lesions on Ultrasound B:Case Report and Literature Review

Drug-induced liver injury(DILI)is defined as injury to the liver caused by exposure to a drug or some drugs.The number of cases suffering from DILI has been increased.There are few clinical features specifically associated with DILI.The recognition and diagnosis of DILI is difficult.In this report,we have described a DILI case caused by herbal remedies.

Acute inflammation occurring in gastric aberrant pancreas followed up by endoscopic ultrasonography

We describe a case of gastric aberrant pancreas with acute pancreatitis followed up with subsequent endoscopic ultrasound. A 20-year-old woman known to have aberrant pancreas in the stomach was admitted to our hospital because of severe epigastralgia. Laboratory tests showed slight C reactive protein elevation without hyperamylasemia. Esophagogastroduodenoscopy revealed a swollen submucosal lesion (SML) to a greater degree compared with the previous findings. Subsequent endoscopic ultrasonography (EUS) revealed a swollen lesion of 35 mm in diameter. The internal echo-pattern was more hypoechoic than in the previous EUS. The border between the fourth layer (muscularis propria) and the SML was unclear. The anechoic lumen in the mass, considered as the ductal lumen, was dilated. Based on these results, we diagnosed the patient as having acute inflammation, resembling pancreatitis, in the aberrant pancreas.

Machine learning in endoscopic ultrasonography and the pancreas:The new frontier?

Pancreatic diseases have a substantial burden on society which is predicted to increase further over the next decades.Endoscopic ultrasonography(EUS)remains the best available diagnostic method to assess the pancreas,however,there remains room for improvement.Artificial intelligence(AI)approaches have been adopted to assess pancreatic diseases for over a decade,but this methodology has recently reached a new era with the innovative machine learning algorithms which can process,recognize,and label endosonographic images.Our review provides a targeted summary of AI in EUS for pancreatic diseases.Included studies cover a wide spectrum of pancreatic diseases from pancreatic cystic lesions to pancreatic masses and diagnosis of pancreatic cancer,chronic pancreatitis,and autoimmune pancreatitis.For these,AI models seemed highly successful,although the results should be evaluated carefully as the tasks,datasets and models were greatly heterogenous.In addition to use in diagnostics,AI was also tested as a procedural real-time assistant for EUS-guided biopsy as well as recognition of standard pancreatic stations and labeling anatomical landmarks during routine examination.Studies thus far have suggested that the adoption of AI in pancreatic EUS is highly promising and further opportunities should be explored in the field.

Assessment of optic nerve and optic tract alterations in patients with orbital space-occupying lesions using probabilistic diffusion tractography

AIM: To investigate the diffusion changes in both the optic nerve and optic tract in orbital space-occupying lesion patients with decreased visual acuity, and its clinical significance using probabilistic diffusion tractography(PDT). METHODS: Twenty patients with orbital space-occupying lesions and 25 age-and gender-matched healthy persons were included. All patients and controls underwent routine orbital magnetic resonance imaging and diffusion tensor imaging(DTI), using a 3.0 T magnetic resonance scanner(Trio Tim Siemens). After the image data were preprocessed, each DTI parameters of the optic nerve and optic tract was obtained by PDT, including fractional anisotropy(FA), mean diffusivity(MD), axial diffusivity(AD) and radial diffusivity(RD). The asymmetry index(AI) of each parameter was calculated. Compared the parameters of the affected side optic nerve and ipsilateral optic tract with the contralateral side by paired sample t-test;compared AI of parameters of optic nerve and optic tract between the patient group and the control group by independent sample t-test. Patients were divided into threesubgroups according to the low vision grade standard of WHO, compared the FA and AI of FA between the three subgroups by single factor variance analysis. RESULTS: The affected side optic nerve presented significantly decreased FA, increased MD, AD, and RD values compared to the unaffected side(P<0.05). The AI of FA, MD, AD, and RD of optic nerve in the patients was significantly higher than that of the controls(P<0.05). The comparison results of the optic tract showed that there was no significant difference between the patient group and control group in terms of the bilateral optic tracts in patients(P>0.05). The AIs of the FA value of the optic nerve in the eyesight <0.1 subgroup was significantly higher than that in the other groups(P<0.05). CONCLUSION: FA, MD, AD, and RD of the affected side optic nerve of the orbital space-occupying lesions have significantly changed, the FA value is the most sensitive. The PDT could be a useful tool to provide valid quantitative markers of optic nerve injuries and evaluate the severity of orbital diseases, which other examinations cannot be acquired.

Recurrent orbital space-occupying lesions:a clinicopathologic study of 253 cases

Objective：To analyze the clinical features,histopathologic classification and frequencies of various types of recurrent orbital space-occupying lesions.Methods：A retrospective study was carried out in 253 consecutive patients with recurrent orbital spaceoccupying lesions treated by surgical excision in the Institute of Orbital Diseases,the General Hospital of the Armed Police Force from January 2009 to December 2010.Results：The patients included 123 males and 130 females aged 2 to 78 years（mean,36.2 years）,and the last recurrence interval after operation ranged from 1 month to 40 years（median,4.75 years）.Of all the cases,159（62.8%）,65（25.7%）,20（7.9%）,8（3.2%） and 1（0.4%） had previously experienced once,twice,three,four and six times of surgeries,respectively.Among them,29（11.5%） cases had recurred 3 times or over,and 37（14.6%） cases got recurrence in 10 or more years postoperatively.Most of the patients with local recurrence presented with various clinical manifestations,while 31（12.3%） cases were symptom-free.Two hundred and thirty-one（91.3%） cases underwent surgical removal of the recurrent orbital lesions,and another 22（8.7%） cases had to receive the exenteration of orbit.Categories of these recurrent orbital lesions after operation were as follows：lacrimal gland tumors,65（25.7%） cases;vasogenic diseases,54（21.3%） cases;neurogenic tumors,42（16.6%） cases;secondary tumors,24（9.5%） cases;orbital inflammation,21（8.3%） cases;myogenic tumors,14（5.5%） cases;fibrous and adipose tumors,12（4.7%） cases;lympho-hematopoietic tumors,7（2.8%） cases;bone or cartilage tumors,7（2.8%） cases;orbital cysts,6（2.4%） cases;and indefinitely differentiated tumor,1（0.4%） case.The 10 top histopathologic diagnoses were lacrimal gland pleomorphic adenoma,hemangiolymphangioma,lacrimal gland adenoid cystic carcinoma,meningioma,inflammatory pseudotumor,neurofibroma,sebaceous gland carcinoma,vascular malformation,rhabdomyosarcoma and hemangioma.Conclusions：The variety of recurrent orbital lesions after operation includes mainly of tumors except for vascular malformation and orbital inflammatory lesions.The lacrimal gland epithelial tumor is most prone to relapse after resection,and early and longer-term postoperative follow-up is needed.

基于磁共振多模态成像定量参数鉴别诊断乳腺良恶性病变及与临床病理特征的关系探究

目的 分析磁共振多模态成像定量参数鉴别诊断乳腺良恶性病变的价值,并探究乳腺病变性质与临床病理特征的关系。方法 纳入2015年1月-2022年12月医院120例乳腺占位性病变患者,所有患者入院时均接受磁共振多模态成像检查,包括弥散加权(DWI)、磁共振波谱成像(MRS)与磁共振动态增强(DCE-MRI),以病理检查结果为“金标准”,分析该检查方式鉴别诊断乳腺良恶性病变的价值。依据乳腺占位性病变性质将患者分为恶性组与良性组,对比两组临床病理特征,分析乳腺病变性质与临床病理特征的关系。结果 120例乳腺占位性病变患者经病理检查结果显示,乳腺癌98例(81.67%),乳腺良性病变22例(18.33%);以病理检查结果为“金标准”,DCE-MRI及联合诊断乳腺病变性质的灵敏度、准确度高于DWI(P<0.05);乳腺癌组表观扩散系数(ADC)、rADC值低于乳腺良性病变组,Ⅰ型TIC曲线占比低于乳腺良性病变组,Ⅲ型TIC曲线占比高于乳腺良性病变组(P<0.05);绘制ROC曲线,结果显示,ADC、rADC及TIC曲线类型诊断乳腺病变性质具有一定价值(AUC=0.815、0.850、0.911);乳腺癌组肿瘤形态不规则、边缘毛刺/不规则、强化不均匀占比高于乳腺良性病变组(P<0.05);经Logistic回归分析,结果显示,肿瘤临床病理特征与乳腺占位性病变密切相关,形态不规则、边缘毛刺/不规则、强化不均匀是乳腺癌的危险因素(OR>1,P<0.05)。结论磁共振多模态成像定量参数对乳腺良恶性病变具有一定鉴别诊断价值,乳腺癌的发生与肿瘤形态不规则、边缘毛刺/不规则、强化不均匀等临床病理特征密切相关。

直肠双平面超声引导下经会阴穿刺活检诊断女性盆腔占位性病变

目的观察直肠双平面超声引导下经会阴穿刺活检诊断女性盆腔占位性病变的安全性及可行性。方法回顾性分析14例接受直肠双平面超声引导下经会阴穿刺活检的女性盆腔占位患者,记录盆腔占位分布位置、无法经腹及经阴道穿刺活检原因、穿刺操作时长、并发症及活检病理诊断。结果14例盆腔占位中,4例位于直肠、3例位于单侧或双侧卵巢、5例位于宫颈或子宫下段、1例位于阴道侧壁、1例位于膀胱后方;因阴道严重出血、真菌感染,阴道畸形、水肿或阴道切除术后,以及病变位置深在、损伤肠管风险高等原因而未能实施经腹或经阴道穿刺活检。14例直肠双平面超声引导下经会阴穿刺活检操作时长(29.50±6.05)min;操作过程中1例发生针道出血、1例出现迷走神经反射症状,之后随访6个月,未见其他相关并发症。穿刺活检病理诊断鳞状细胞癌5例、高级别浆液性癌2例,恶性黑色素瘤、低级别浆液性癌、腺癌及梭形细胞肿瘤各1例,以及慢性炎症3例,均与术后病理或随访结果相符。结论直肠双平面超声引导下经会阴穿刺活检诊断女性盆腔占位性病变安全、可行。

自身免疫性胰腺炎患者少见的影像表现

自身免疫性胰腺炎(autoimmune pancreatitis,AIP)是一种特殊类型的胰腺炎症,其常见的影像学特征已被影像科医师熟知,成为诊断AIP的影像学依据。然而在临床工作中我们也发现,除了常见的影像表现,AIP还可出现主胰管扩张、胰腺囊性病变、胰腺周围血管受累、胰腺钙化与胰管结石、类固醇治疗后短期内显著胰腺萎缩、合并恶性肿瘤等少见的影像表现。为进一步提高对AIP影像表现的认识,本文介绍这些AIP少见的CT和MRI表现。

Gastric subepithelial lesion complicated with abscess: Case report and literature review

Gastric abscess is a localized pyogenic inflammation of the gastric wall, which is a rare form of suppurative gastritis. The rarity of gastric abscess may be associated with the difficulty of early diagnosis and high mortality as a result. In general, subepithelial lesions (SELs) of the stomach are incidentally detected during the course of upper endoscopy without specific clinical symptoms and signs. However, some gastric SELs present rarely as a form of hemorrhage, obstruction, perforation, and abscess. Here we report a 45-year-old man with gastric SEL presenting as a gastric abscess, which was diagnosed as an ectopic pancreas of the stomach, along with a review of the literature. Although gastric SEL presenting as an abscess is known as a serious and life-threatening lesion, the patient made a complete recovery through surgical resection as well as medical treatment.

多层螺旋CT与磁共振LAVA增强扫描诊断肝内占位性病变性质效能分析

目的分析多层螺旋CT与高场强磁共振肝脏三维容积快速扫描(LAVA)诊断肝内占位性病变性质的效能。方法2020年5月~2023年4月我院诊治的160例肝内占位性病变患者,均行多层螺旋CT和LAVA增强扫描,以组织病理学诊断为金标准,计算两种方法的诊断效能。结果在本组160例肝内占位性病变患者中,组织病理学诊断恶性病灶87例,包括肝细胞癌(HCC)79例和肝内胆管细胞癌(ICC)8例,和良性病变73例,包括肝硬化结节46例、肝结节状再生性增生(NRHL)20例和肝脏局灶性结节性增生(FNH)7例;CT扫描诊断恶性病灶77例和良性病灶83例,其中将5例良性肿瘤诊断为恶性肿瘤,将15例恶性肿瘤诊断为良性肿瘤,LAVA增强扫描诊断恶性病灶86例和良性病变74例,其中将3例良性肿瘤诊断为恶性肿瘤,将4例恶性肿瘤诊断为良性肿瘤;CT诊断肝内占位性病变的准确率为87.5%、灵敏度为82.8%,特异度为93.2%,阳性预测值为93.5%和阴性预测值为81.9%,而LAVA增强扫描诊断则分别为95.6%、95.4%、95.9%、96.5%和94.6%,显著优于CT诊断(P<0.05)。结论相较于多层螺旋CT扫描,磁共振LAVA增强可更为准确地判断肝内占位性病变的性质,值得临床深入研究。

胰腺导管内乳头状黏液性肿瘤的病理诊断进展

胰腺导管内乳头状黏液性肿瘤(intraductal papillary mucinous neoplasm, IPMN)是胰腺导管腺癌重要的癌前病变。IPMN诊疗决策的制定首先基于对IPMN相关病理学的深刻理解。本文围绕IPMN宏观检查、微观检查、分子检测及鉴别诊断四个方面进行系统的文献综述。本综述详细阐述了IPMN大体类型分类、组织学分级与分化亚型、IPMN伴浸润性癌的组成模式和组织学类型、IPMN分子研究的新进展以及重要的鉴别诊断等。该分析肯定IPMN特殊的异质性和异时性的特点,为寻找新的方法帮助临床医师制定适宜的诊疗方案奠定基础。

心脏超声造影鉴别右心占位病变的临床应用价值

目的:探讨心脏超声造影鉴别右心占位病变的临床应用价值。方法:回顾性分析延边大学附属医院2019年1月至2023年1月期间39例经手术病理及临床治疗证实的右心占位病变患者的影像资料和临床资料。总结右心占位病变的心脏超声造影特征,并比较心脏超声造影与心脏磁共振成像(CMR)对右心占位病变的诊断效能。结果:39例患者的右心占位病变中,12例(30.8%)为血栓、赘生物,6例(15.4%)为良性肿瘤,21例(53.8%)为恶性肿瘤,其中血栓、赘生物、良性肿瘤、恶性肿瘤位于右心房的患者分别有8、4、4、17例。心脏超声造影诊断血栓、赘生物12例(30.8%),良性肿瘤5例(12.8%),恶性肿瘤22例(56.4%);CMR诊断血栓、赘生物18例(46.2%),良性肿瘤5例(12.8%),恶性肿瘤16例(41.0%)。心脏超声造影诊断与临床诊断的Kappa系数为0.956(P<0.001),CMR与临床诊断的Kappa系数为0.754(P<0.001)。结论:心脏超声造影可实时动态观察病变组织内血管化程度,能有效鉴别右心占位病变性质。

宫腔组织切除系统治疗宫腔良性占位病变的临床分析

目的:探讨宫腔组织切除系统(MyoSure)治疗宫腔良性占位病变的安全性和有效性。方法:回顾性分析2013年8月-2023年3月于湖北省妇幼保健院行MyoSure治疗的宫腔良性占位病变患者152例临床资料,其中子宫粘膜下肌瘤108例、子宫内膜息肉29例、宫内妊娠物残留15例。分析术中各项指标,术后疗效满意率及随访情况,采用子宫肌瘤症状及健康相关生活质量量表(UFS-QOL)进行症状严重性评分(SSS)与生存质量评分(HRQL)评估。结果:152例手术均成功,无严重并发症发生。手术操作时间4.71±4.60min,术中出血量9±19ml,膨宫液用量603±187ml,疗效满意率达94.7%,SSS评分和HRQL评分术后3个月(14.78±4.3分、78.82±6.31分)、6个月(14.27±3.9分、80.37±5.48分)与术前(30.26±5.7分、65.73±5.26分)比较,均有改善(均P<0.01),术后妊娠率为57.8%,复发率为2.6%。结论:MyoSure治疗宫内良性占位病变安全、有效,结局较理想。

Features associated with progression of small pancreatic cystic lesions: A retrospective study

AIM: To investigate the progression rate of small pancreatic cystic lesions and identify characteristics associated with their progression.METHODS: Patients with pancreatic cystic lesions with at least 1-year of follow-up were evaluated retrospectively. We excluded patients with cysts larger than 3 cm or with features that were a concern for malignancy. In total, 135 patients were evaluated. The interval progression of the cysts was examined. Characteristics were compared between patients with and without progression.RESULTS: The pancreatic cysts ranged from 3 to 29 mm. The mean follow-up period was 4.5 ± 2.3 years and the mean progression rate was 1.0 ± 1.3 mm/year. Ninety patients showed interval progression and were divided into two groups; the minimal-change group(n = 41), who had cyst progression at less than 1 mm/year, and the progression group(n = 49), who had a progression rate of more than 1 mm/year. Compared with the cysts without progression, the lesions of the progression group were more frequently associated with tubular cyst, septation or a prominent pancreatic duct(P < 0.05). The odds ratio for progression was 5.318 for septation and 4.582 for tubular cysts.CONCLUSION: Small pancreatic cysts progress slowly. Lesions with tubular shape, septa, or prominent pancreatic duct were more likely to progress, and required further diagnostic intervention or shorter surveillance interval.

Pancreatic transection from blunt trauma associated with vascular and biliary lesions: A case report

Major injuries of the pancreas may result in considerable morbidity and mortality when associated with vascular and visceral injuries. In such cases, a right diagnosis and a prompt surgical intervention are necessary to give a chance to the patient. We herein describe a case of blunt abdominal trauma in a 29-year- old man whose pancreatic rupture was associated with hepatic artery, splenic vein and extrahepatic bile duct damage. Immediate surgery was performed after computer tomograghy (CT), the haemorrhagic lesions dictat the emergency transfer to the operating room. Spleno-pancreatic resection was done with reconstruction of the hepatic artery, ligation of the splenic vein and a Roux-en-Y bilio-jejunal diversion. The early post-operative course was complicated by stenosis of the arterial reconstruction, which was treated by endovascular angioplasty followed by percutaneous drainage of symptomatic pseudocyst, rest and antibiotics. Finally, the patient was discharged and was alive without clinical problems at the time when we wrote this case report. The present case underlines the clinical relevance of vascular and visceral injuries associated with pancreatic trauma and the problems arising in the diagnostic evaluation and the surgical strategy of complex multiple visceral and vascular lesions in blunt abdominal trauma.

miR-125b、miR-140联合超声造影在肝脏占位性病变良恶性诊断中的应用

目的:研究miR-125b、miR-140联合超声造影技术在肝占位性病变良恶性诊断中的效能及价值。方法:连续纳入并回顾分析2022年6月至2023年6月本院收治的肝脏占位性病变患者共125例,根据病理活检结果,将患者分为良性组(n=65)及恶性组(n=60),并选取同期的健康体检者作为对照组(n=56),通过qRT-PCR实验检测血清miR-125b,miR-140的相对表达水平,受试者进行超声造影检查。收集并分析受试者临床基本资料,绘制受试者工作特征(ROC)曲线分析血清miR-125b,miR-140联合超声造影技术对肝脏占位性病变患者的诊断价值。结果:与对照组相比,肝占位性病变组患者的血清miR-125b、miR-140水平显著降低(P<0.05),且与良性组相比,恶性组患者的血清miR-125b、miR-140水平也显著降低(P<0.05)。超声造影结果诊断发现良性病变患者68例,恶性病变患者57例,进一步分析超声造影特征发现,恶性病变组患者早增强、高增强和快消退比例显著高于良性病变组(P<0.05)。临床基本资料分析发现:恶性组患者的丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)均显著高于良性组(P<0.05),并且两组患者的肿瘤直径及病理类型具有显著统计学差异(P<0.05),两组患者的年龄、性别无统计学差异(P>0.05)。绘制ROC曲线发现血清miR-125b、miR-140以及两者联合诊断的AUC分别为0.768、0.841、0.903,且血清miR-125b、miR-140与超声造影联合诊断的特异性及预测准确率均高于miR-125b、miR-140、超声造影单独检测。结论:血清miR-125b、miR-140联合超声造影在肝占位性病变良恶性诊断中具有较高的临床价值,可为临床应用提供参考。

超声造影对肝细胞癌高危患者肝占位性病变的鉴别诊断价值

目的探讨超声造影对肝细胞癌高危患者肝占位性病变的鉴别诊断价值。方法回顾性分析2018年9月—2022年6月来院就诊的160例肝细胞癌高危患者肝占位性病变(204个病灶)的影像学资料,所有患者均行超声造影检查,以病理检查为金标准,分析超声造影检查与病理检查的一致性,比较良性肝脏占位性病变与恶性肝脏占位性病变造影检查时开始增强时间、达峰时间和开始消退时间。结果160例肝细胞癌高危患者共有204个肝占位性病变病灶,经手术或穿刺病理检查,共有158个恶性病变,包括93个肝细胞肝癌病灶、56个转移性肝癌病灶和9个胆管细胞型肝癌病灶;46个良性病变,包括34个肝血管瘤、7个肝硬化结节病灶和5个肝脏局灶性结节增生病灶;恶性肝脏占位性病变超声造影检查开始增强时间、达峰时间和开始消退时间均短于良性肝脏占位性病变(P<0.05);204个肝占位性病变病灶中,超声造影检查诊断检出151个恶性病灶与病理诊断一致,37个良性病灶与病理诊断一致,经Kappa一致性检验,Kappa=0.772,P<0.05,2种诊断方法的一致性较好;ROC分析显示,超声造影检查诊断肝细胞癌高危患者肝占位性病变恶性病灶的灵敏度、特异度和约登指数分别为95.57%(151/158),80.43%(37/46),0.760。结论超声造影用于肝细胞癌高危患者肝占位性病变鉴别诊断具有重要价值。

经阴道超声联合CEA、CA125、CA153鉴别诊断子宫腔占位性病变良恶性

目的:探讨经阴道超声联合CEA、CA125、CA153鉴别子宫腔占位性病变良恶性的价值.方法:收集2021年2月-2023年5月本院疑似子宫腔占位性病变患者117例临床资料,根据刮宫或术后病理检查结果分为恶性组及良性组,其中恶性组56例,为子宫内膜癌;良性组61例,为子宫内膜良性息肉.比较两组经阴道超声及血清指标差异,受试者工作特征曲线(ROC)分析各指标鉴别诊断子宫腔占位性病变良恶性效能.结果:超声检查收缩期峰值血流速度两组无差异(P>0.05),恶性组阻力指数小于良性组、内膜厚度大于良性组;恶性组血清癌胚抗原(CEA)、糖类抗原125、CA153水平均高于良性组(均P<0.05).ROC曲线结果显示,经阴道超声、血清CEA、CA125、CA153各指标单独或联合应用鉴别诊断子宫腔占位性病良恶性的AUC分别为0.822、0.713、0.728、0.797及0.915,均有价值,但联合诊断价值最高.结论:经阴道超声、血清CEA、CA125、CA153联合应用对宫腔占位性病变良恶性鉴别诊断效能较高,有较好的临床应用价值.