彩色多普勒血流成像联合血清CA125、CA724检测对卵巢良恶性肿瘤的鉴别诊断效能
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摘要
目的分析彩色多普勒血流成像(CDFI)联合血清糖类抗原(CA)125、CA724水平检测对卵巢癌诊断效能的影响。方法选取2016年3月至2018年4月收治的99例初步诊断为卵巢肿物患者,均行CDFI、CA125、CA724检查,统计CDFI、CA125、CA724、CDFI+CA125、CDFI+CA724、CDFI+CA125+CA724检出卵巢癌及良性病变情况,并以手术病理结果为准,分析各组联合检查诊断卵巢癌的灵敏度、准确度、特异度、误诊率,比较术前、术后1周良性组、恶性组血清CA125、CA724水平、搏动指数(PI)、阻力指数(RI)。结果手术病理证实48例卵巢癌,51例良性肿物;CDFI检出55例卵巢癌,CA125检出50例卵巢癌,CA724检出51例卵巢癌,CDFI+CA125检出48例卵巢癌,CDFI+CA724检出48例卵巢癌,CDFI+CA125+CA724检出34例卵巢癌;CDFI、CA125、CA724、CDFI+CA125、CDFI+CA724、CDFI+CA125+CA724检查对卵巢癌的诊断灵敏度、准确度比较无统计学差异(P>0.05);CDFI+CA125+CA724检查对卵巢癌的诊断特异度高于其他检查项目,误诊率低于其他检查项目(P<0.05);术前恶性组CA125、CA724水平高于良性组,RI、PI低于良性组(P<0.05);术后1周恶性组CA125、CA724水平低于术前,但高于良性组(P<0.05);术后1周良性、恶性组RI、PI比较无统计差异(P>0.05)。结论 CDFI联合血清CA125、CA724水平检测对卵巢癌的诊断能实现疾病定性与定位,有助于提高诊断特异度,降低误诊率,且CA125、CA724可应用于卵巢癌疗效评估,可为临床后续治疗方案制定提供有价值参考。
Objective To investigate the effect of color Doppler flow imaging(CDFI) combined with serum carbohydrate antigen 125(CA125) and CA724 levels on the diagnosis of ovarian cancer(OC).Methods A total of 99 patients with ovarian mass diagnosed from March 2016 to April 2018 were enrolled.All patients received CDFI examination and serum CA125 and CA724 detection.The OC and benign lesions were detected respectively by CDFI,CA125,CA724,CDFI+CA125,CDFI+CA724,CDFI+CA125+CA724 methods.The sensitivity,accuracy,specificity and misdiagnosis rate of each combination examination were analyzed,and the levels of serum CA125,CA724,pulsation index(PI) and resistance index(RI) were compared before and 1 week after operation between benign group and malignant groups.Results Surgical pathology confirmed 48 cases of OC,51 cases of benign tumors.There were 55 cases of OC detected by CDFI,50 cases by CA125,51 cases by CA724,48 cases by CDFI+CA125,48 cases by CDFI+CA724 and 34 cases by CDFI+CA125+CA724.There were no significant differences in sensitivity and accuracy among detection methods(P>0.05).Compared with other detections,the specificity of CDFI + CA125 + CA724 increased,and the misdiagnosis rate decreased significantly(P<0.05).Before operation,the levels of CA125 and CA724 in malignant group were higher than those in benign group,and RI and PI were lower than those in benign group(P<0.05).At 1 week after operation,the levels of CA125 and CA724 in malignant group were lower than those before surgery,but higher than those in benign group(P<0.05);there were no significant differences in RI and PI between benign group and malignant group(P>0.05).Conclusion CDFI combined with serum CA125 and CA724 levels can achieve disease identification and localization,which can improve the diagnostic specificity and reduce the rate of misdiagnosis.CA125 and CA724 can be applied to the evaluation of the therapeutic efficacy of OC,providing valuable reference for the formulation of clinical follow-up treatment programs.
Objective To investigate the effect of color Doppler flow imaging(CDFI) combined with serum carbohydrate antigen 125(CA125) and CA724 levels on the diagnosis of ovarian cancer(OC).Methods A total of 99 patients with ovarian mass diagnosed from March 2016 to April 2018 were enrolled.All patients received CDFI examination and serum CA125 and CA724 detection.The OC and benign lesions were detected respectively by CDFI,CA125,CA724,CDFI+CA125,CDFI+CA724,CDFI+CA125+CA724 methods.The sensitivity,accuracy,specificity and misdiagnosis rate of each combination examination were analyzed,and the levels of serum CA125,CA724,pulsation index(PI) and resistance index(RI) were compared before and 1 week after operation between benign group and malignant groups.Results Surgical pathology confirmed 48 cases of OC,51 cases of benign tumors.There were 55 cases of OC detected by CDFI,50 cases by CA125,51 cases by CA724,48 cases by CDFI+CA125,48 cases by CDFI+CA724 and 34 cases by CDFI+CA125+CA724.There were no significant differences in sensitivity and accuracy among detection methods(P>0.05).Compared with other detections,the specificity of CDFI + CA125 + CA724 increased,and the misdiagnosis rate decreased significantly(P<0.05).Before operation,the levels of CA125 and CA724 in malignant group were higher than those in benign group,and RI and PI were lower than those in benign group(P<0.05).At 1 week after operation,the levels of CA125 and CA724 in malignant group were lower than those before surgery,but higher than those in benign group(P<0.05);there were no significant differences in RI and PI between benign group and malignant group(P>0.05).Conclusion CDFI combined with serum CA125 and CA724 levels can achieve disease identification and localization,which can improve the diagnostic specificity and reduce the rate of misdiagnosis.CA125 and CA724 can be applied to the evaluation of the therapeutic efficacy of OC,providing valuable reference for the formulation of clinical follow-up treatment programs.
引文
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[10] 张亮,孟杰.超声联合血清肿瘤标记物CA125、B7同源体4(B7-H4)对卵巢癌的诊断价值[J].实用癌症杂志,2017,32(8):1364-1366.
[11] 李静,彭曦,江静,等.卵巢癌患者不同方案化疗前后HE4和CA125变化情况分析[J].中国医院药学杂志,2017,37(12):1171-1173,1178.
[12] 张靖,白惠娟.卵巢癌腹腔热灌注化疗临床效果及血清CA125水平变化[J].安徽医学,2017,38(9):1169-1171.
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[15] 杨士军,陆卫平,郑云会,等.血清CA125、HE4联合ROMA指数对卵巢癌诊断的研究分析[J].检验医学与临床,2016,13(14):1931-1933.
[16] Karadag B,Kocak M,Kayikcioglu F,et al.Risk for malignant and borderline ovarian neoplasms following basic preoperative evaluation by ultrasonography,Ca125 level and age[J].Asian Pac J Cancer Prev,2014,15(19):8489-8493.
[17] Karlsen MA,Sandhu N,H?gdall C,et al.Evaluation of HE4,CA125,risk of ovarian malignancy algorithm (ROMA) and risk of malignancy index (RMI) as diagnostic tools of epithelial ovarian cancer in patients with a pelvic mass[J].Gynecol Oncol,2012,127(2):379-383.
[18] 李载红,景香香,陈银,等.彩超联合血清CA125、CA724对卵巢良恶性肿瘤鉴别诊断的意义[J].中国临床医学影像杂志,2016,27(6):416-418.
[19] 贾明利,王莹,史丽玲.CA199、CA242及CA724在消化系恶性肿瘤患者血清中的表达及意义[J].中国实用医药,2017,12(32):14-16.
[20] 吕晓梅,陈涛,张小强,等.血清HE4、CA125、CA199、CA724联合检测对卵巢癌早期诊断的临床价值探讨[J].国际检验医学杂志,2016,37(9):1274-1276.
[21] 邵海玲,肖庆,卢琳.彩色多普勒超声联合肿瘤标志物CA125、CA724对卵巢良恶性肿瘤的鉴别诊断价值[J].现代肿瘤医学,2017,25(14):2314-2317.
[22] 姜楠,周忠春,郭顺林.糖类抗原724和影像学新技术在胃癌中的研究进展[J].中国老年学杂志,2015,35(19):5672-5675.
[23] DoraSK,DandapatAB,PandeB,etal.A prospective study to evaluate the risk malignancy index and its diagnostic implication in patients with suspected ovarian mass[J].J Ovarian Res,2017,10(1):55.
[24] 张红.人附睾蛋白4联合CA199、CA724检测诊断卵巢癌的价值[J].中国妇幼保健,2017,32(15):3482-3485.
[25] Lahlou N,Brun JL.Ovarian tumor markers of presumed benign ovarian tumors[J].J Gynecol Obstet Biol Reprod (Paris),2013,42(8):752-759.
[2] 王乐华,黄旴宁,刘艳婷,等.经阴道彩超联合血清CA125、CEA检测对卵巢癌诊断灵敏度及准确率[J].中国地方病防治杂志,2017,32(7):793,795.
[3] Park SY,Oh YT,Jung DC.Differentiation between borderline and benign ovarian tumors:combined analysis of MRI with tumor markers for large cystic masses (≥5 cm)[J].Acta Radiol,2016,57(5):633-639.
[4] 周燕,陈列,黄平,等.超声检查诊断卵巢良恶性肿瘤的临床价值分析[J].中国肿瘤临床与康复,2017,24(7):848-850.
[5] Fujiwara H,Suzuki M,Takeshima N,et al.Evaluation of human epididymis protein 4 (HE4) and Risk of Ovarian Malignancy Algorithm (ROMA) as diagnostic tools of type I and type II epithelial ovarian cancer in Japanese women[J].Tumour Biol,2015,36(2):1045-1053.
[6] 董素民,李文澎,张秀玲,等.血清CA125、CA199、VEGF-C联合检测对卵巢癌淋巴结转移的诊断价值[J].山东医药,2016,56(10):86-87.
[7] 王丽华,陈福美,仲艳密,等.超声联合血清CA125对卵巢癌的诊断价值分析[J].中国临床医学影像杂志,2018,29(2):144-145.
[8] 许强.血清CA125、CA199与CEA联合检测对卵巢癌病情诊断及疗效监测的有效性研究[J].河北医药,2015,37(15):2263-2265.
[9] 张婧,金海艳,金丽仙.彩超诊断与血清CA125检测联用对卵巢癌的诊疗价值探究[J].中国妇幼保健,2015,30(32):5684-5686.
[10] 张亮,孟杰.超声联合血清肿瘤标记物CA125、B7同源体4(B7-H4)对卵巢癌的诊断价值[J].实用癌症杂志,2017,32(8):1364-1366.
[11] 李静,彭曦,江静,等.卵巢癌患者不同方案化疗前后HE4和CA125变化情况分析[J].中国医院药学杂志,2017,37(12):1171-1173,1178.
[12] 张靖,白惠娟.卵巢癌腹腔热灌注化疗临床效果及血清CA125水平变化[J].安徽医学,2017,38(9):1169-1171.
[13] 赵文斌,范睿睿,马天宇.血清CA125和HE4联合uPA及其受体在卵巢肿瘤中的表达和意义[J].中国慢性病预防与控制,2017,25(11):847-849.
[14] 陈丹.超声结合血清CA125对绝经后卵巢肿瘤的诊断价值[J].中华全科医学,2015,13(6):966-968.
[15] 杨士军,陆卫平,郑云会,等.血清CA125、HE4联合ROMA指数对卵巢癌诊断的研究分析[J].检验医学与临床,2016,13(14):1931-1933.
[16] Karadag B,Kocak M,Kayikcioglu F,et al.Risk for malignant and borderline ovarian neoplasms following basic preoperative evaluation by ultrasonography,Ca125 level and age[J].Asian Pac J Cancer Prev,2014,15(19):8489-8493.
[17] Karlsen MA,Sandhu N,H?gdall C,et al.Evaluation of HE4,CA125,risk of ovarian malignancy algorithm (ROMA) and risk of malignancy index (RMI) as diagnostic tools of epithelial ovarian cancer in patients with a pelvic mass[J].Gynecol Oncol,2012,127(2):379-383.
[18] 李载红,景香香,陈银,等.彩超联合血清CA125、CA724对卵巢良恶性肿瘤鉴别诊断的意义[J].中国临床医学影像杂志,2016,27(6):416-418.
[19] 贾明利,王莹,史丽玲.CA199、CA242及CA724在消化系恶性肿瘤患者血清中的表达及意义[J].中国实用医药,2017,12(32):14-16.
[20] 吕晓梅,陈涛,张小强,等.血清HE4、CA125、CA199、CA724联合检测对卵巢癌早期诊断的临床价值探讨[J].国际检验医学杂志,2016,37(9):1274-1276.
[21] 邵海玲,肖庆,卢琳.彩色多普勒超声联合肿瘤标志物CA125、CA724对卵巢良恶性肿瘤的鉴别诊断价值[J].现代肿瘤医学,2017,25(14):2314-2317.
[22] 姜楠,周忠春,郭顺林.糖类抗原724和影像学新技术在胃癌中的研究进展[J].中国老年学杂志,2015,35(19):5672-5675.
[23] DoraSK,DandapatAB,PandeB,etal.A prospective study to evaluate the risk malignancy index and its diagnostic implication in patients with suspected ovarian mass[J].J Ovarian Res,2017,10(1):55.
[24] 张红.人附睾蛋白4联合CA199、CA724检测诊断卵巢癌的价值[J].中国妇幼保健,2017,32(15):3482-3485.
[25] Lahlou N,Brun JL.Ovarian tumor markers of presumed benign ovarian tumors[J].J Gynecol Obstet Biol Reprod (Paris),2013,42(8):752-759.