目的 探讨超声评分系统结合血清附睾分泌蛋白4 (human epididymal secretory protein 4,HE4)、CA125检测结果,对卵巢肿瘤的诊断意义。方法 选取卵巢癌78例(卵巢癌组),卵巢良性肿瘤102例(卵巢良性肿瘤组),检测两组血清HE4及CA125水平,以80例健康人为对照组,制作受试者工作特征(ROC)曲线,以曲线下面积(AUC)反映诊断的准确性。对两组患者进行超声评分,分别计算超声评分系统与肿瘤标志物联合对卵巢癌诊断的敏感性、特异性。结果 卵巢癌组血清HE4及CA125水平明显高于卵巢良性肿瘤组和对照组,差异均有统计学意义(P＜0.05);卵巢良性肿瘤组与对照组间比较,HE4差异无统计学意义(P＞0.05),CA125差异有统计学意义(P＜0.05)。HE4诊断卵巢癌的敏感性、特异性分别为94.3%,96.1 %;CA125诊断卵巢癌的敏感性、特异性分别为87.4%,94.2%。HE4联合超声评分系统敏感度为为91.4%;CA125联合超声评分系统为85.7%;HE4、CA125、超声评分系统三项联合检测为96.1%。结论 血清HE4、CA125联合超声评分系统诊断卵巢肿瘤的敏感性最高。
Abstract
Objective To study significance of combined with ultrasound score and serum HE4, CA125 in differentiating malignant from benign ovarian tumor. Methods Senventy-eight cases of epithelial ovarian cancer (ovarian cancer group) and 102 cases of benign ovarian tumor (benign ovarian tumor group) measured the serum level of CA125, results are expressed as median (M) said. In 80 cases of normal people as control (control group). By making the receiver operating characteristic (ROC) curve, the area under the curve (AUC) to reflect the accuracy of diagnosis. At the same time, ultrasonic scoring system scores of the two groups of patients, ultrasound scoring system and different tumor markers combination were calculated on the sensitivity, specificity of diagnosis of ovarian cancer. Results The serum HE4 and CA125 in ovarian cancer is significantly higher than that in benign ovarian tumor group and normal control group, compared the differences were statistically significant (P<0.05); Compard ovarian benign tumor group and the normal control group, HE4 showed no statistically significant difference (P>0.05), CA125 show a significant difference(P<0.05). The specificity and sensitivity of HE4 were 94.3%, 96.1%; The specificity and sensitivity of CA125 were 87.4%, 94.2%. HE4 CA125, ultrasonic scoring system of combined detection of three kinds of sensitivity of 96.1%. Conclusions HE4 and CA125 in combination with ultrasonic scoring system for differential diagnosis of the highest sensitivity.
关键词
人附睾分泌蛋白 /
CA125 /
卵巢恶性肿瘤 /
超声评分系统
Key words
human epididymal secretory protein /
CA125 /
ovarian cancer /
color doppler ultrasound
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Whitehouse C, Solomon E. Current status of the molecular characterization of the ovarian cancer antigen CA125 and implications for its use in clinical screening [J]. Gynecol Onco, 2003, 88: 152-157.
[2] Cohen L S, Escobar P F, Scharm C, et al. Three dimension al power doppler ultrasound improves the diagnostic accuracy for ovarian cancer prediction [J] . Gynecol Onco, 2001, 84(2) : 352-353.
[3] Valentin L.Limited contribution of Doppler velocimetry to the differential diagnosis of extrauterine pelvic tumors[J].Obstet Gynecol,1994,83:425-433.
[4] Sasson A M,Timor I E,Antner A, et al.Transvaginal sonographic characterization of ovarian diseases: Evaluation of a new scoring system to predict malignancy[J].Obsetet Gynecol,1991,78:70-76.
[5] Finkler N I,Benacerraf B I,Lavin P, et al.Comparison of serum CA125, clinical impression and ultrasound in the preoperative evaluation of ovarian masses[J].Obstet Gynecol,1988,72:659-663.
[6] Lerner J R,Timor I E,Fedeman A, et al.Transv -aginal ultrasonographic characterization of ovarian masseswith an inproved,werghted scoring system [J].Am J Obstet Gynecol,1994,170:81-87.
[7] Weber G,Merz E,Bahlmann F, et al.A new so Nnomorphologic scoring- system (Mainz score)for the assessment of ovarian tumors using transvaginal ultrasonography[J].Ultraschall Med,1999,20(1):2-8.
[8] Juan L.A newscoring systemto differentiate benign from nalignant adnexal masses[J].Am J Obstet Gynecol,2003,34(4):685-697.
[9] Karlsen N S, Karlsen M A, Hgdall C K,et al.HE4 Tissue Expression and Serum HE4 Levels in Healthy Individuals and Patients with Benign or Malignant Tumors: A Systematic Review[J].Cancer Epidemiol Biomarkers Prev,2014,23(11):2285-2295.
[10] 陈 光,谢松元,吴 洁,等. 卵巢癌97例彩色多普勒超声与CT扫描的诊断价值比较[J]. 武警医学,2011,12(1):67-68.
[11] Shah C A, Low e K A, Paley P, et al. Influence of ovarian cancer risk status on the diagnostic performance of the serum biomarker smesothelin, HE4, and CA125[J]. Cancer Epidemiol Biomarkers Prev, 2009,18(5):1365-1372.
PDF(1797 KB)
