论文部分内容阅读
目的探讨超声、癌胚抗原125(CA125)、人附睾分泌蛋白4(HE4)在卵巢癌和卵巢子宫内膜异位囊肿鉴别诊断中的价值。方法选择70例卵巢癌患者作为卵巢癌组,70例卵巢子宫内膜异位囊肿患者为子宫内膜异位囊肿组,70例健康体检女性为对照组。对所有对象进行超声、血清CA125和血清HE4水平测定。结果子宫内膜异位囊肿组和卵巢癌组患者血清CA125水平高于对照组(P<0.05),卵巢癌组患者血清CA125水平高于子宫内膜异位囊肿组(P<0.05),卵巢癌组患者血清HE4水平高于子宫内膜异位囊肿组和对照组(P<0.05),子宫内膜异位囊肿组血清HE4水平和对照组比较,差异无统计学意义(P>0.05)。子宫内膜异位囊肿组和卵巢癌组患者血清CA125阳性率高于对照组(P<0.05),卵巢癌组患者血清CA125阳性率高于子宫内膜异位囊肿组(P<0.05),卵巢癌组患者血清HE4阳性率高于子宫内膜异位囊肿组和对照组(P<0.05),子宫内膜异位囊肿组血清HE4阳性率和对照组比较,差异无统计学意义(P>0.05)。子宫内膜异位囊肿组超声结果和病理结果的一致率高于卵巢癌组(P<0.05)。超声鉴别卵巢癌和子宫内膜异位囊肿的特异度、阳性预测值较高,均在90%以上;CA125鉴别卵巢癌和子宫内膜异位囊肿的灵敏度高,但特异度、阳性预测值、阴性预测值和准确率都较低;HE4鉴别卵巢癌和子宫内膜异位囊肿的灵敏度较低,特异度、阳性预测值、阴性预测值和准确率均较高;超声+CA125+HE4鉴别卵巢癌和子宫内膜异位囊肿的灵敏度、特异度、阳性预测值、阴性预测值和准确率均高,分别为95.7%、98.4%、98.1%、97.6%、97.8%。结论超声+CA125+HE4联合检测是鉴别诊断卵巢癌和卵巢子宫内膜异位囊肿的良好指标。
Objective To investigate the value of ultrasound, carcinoembryonic antigen 125 (CA125), human epididymis secretory protein 4 (HE4) in the differential diagnosis of ovarian cancer and ovarian endometriosis. Methods Seventy patients with ovarian cancer were selected as ovarian cancer group, 70 patients with ovarian endometriosis as endometriosis cyst group and 70 healthy women as control group. All subjects were sonicated, serum CA125 and serum HE4 levels were determined. Results Serum CA125 levels in patients with endometriosis and ovarian cancer were significantly higher than those in controls (P <0.05). Serum CA125 levels in patients with ovarian cancer were significantly higher than those in patients with endometriosis (P <0.05), ovarian cancer The level of serum HE4 in patients with endometriosis was higher than that in patients with endometriosis and control (P <0.05). There was no significant difference in HE4 level between endometriosis and control groups (P> 0.05). The positive rate of serum CA125 in endometriosis group and ovarian cancer group was higher than that in control group (P <0.05). The positive rate of serum CA125 in ovarian cancer group was higher than that in endometriosis group (P <0.05) The positive rate of HE4 in the cancer group was higher than that in the endometriosis group and the control group (P <0.05). The positive rate of HE4 in the endometriosis group was not significantly different from that in the control group (P> 0.05 ). The consistency of ultrasound results and pathological findings in endometriotic cyst group was higher than that in ovarian cancer group (P <0.05). Ultrasound to identify ovarian cancer and endometrial cyst specificity, the positive predictive value higher, were more than 90%; CA125 differential diagnosis of ovarian cancer and endometrial cyst high sensitivity, specificity, positive predictive value, Negative predictive value and accuracy were lower; HE4 identification of ovarian cancer and endometriotic cyst lower sensitivity, specificity, positive predictive value, negative predictive value and accuracy were higher; ultrasound + CA125 + HE4 differential ovarian The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the cancerous and endometriotic cysts were 95.7%, 98.4%, 98.1%, 97.6% and 97.8%, respectively. Conclusion Combined ultrasound + CA125 + HE4 is a good marker for differential diagnosis of ovarian cancer and ovarian endometriosis.