彩超联合不同种类肿瘤标志物检测在卵巢癌早期诊断中的临床应用

摘要

目的 分析彩色多普勒超声联合CA125、HE4和AFP在卵巢癌早期诊断中的临床应用价值.方法 采取回顾性研究的方式,选取2013年1月到2015年1月妇科病理学诊断确诊卵巢肿瘤307例,其中卵巢恶性肿瘤63例,卵巢良性肿瘤244例.收集研究对象彩色多普勒超声结果与血清CA125、HE4和AFP检测结果,分析比较彩超与不同种类肿瘤标志物单独、联合检测在卵巢癌早期诊断中的应用价值.结果 卵巢良、恶性肿瘤患者彩超影像学与血流比较显示,形态、位置、质地、血流以及乳头和腹水情况,差异有统计学意义(P<0.05).肿瘤标志物单独检测中,卵巢良、恶性肿瘤患者血清CA125和HE4差异有统计学意义(P<0.05).CA125与HE4水平随肿瘤恶性程度的提高而升高,差异有统计学意义(P<0.05).联合检测中,彩超+CA125+HE4+AFP以较强的灵敏度(95.24%)与特异度(90.98%),成为最佳联合检测方式.结论 彩色超声多普勒联合肿瘤标志物早期检测卵巢癌,具有较高灵敏度、特异度以及检验符合率;弥补了单一彩超检测中,主观与客观原因造成的偏倚;医生可根据患者年龄、身体素质、经济情况以及彩超影像学特征,灵活运用联合检测手段,以提高卵巢癌的早期检测水平.%Objective To investiigate the clinical value of color Doppler ultrasound combined with CA125,HE4 and AFP detection in early diagnosis of ovarian cancer. Methods A total of 307 patients with ovarian neoplasms who were diagnosed definitely in our hospital from January 2013 to January 2015,including 63 cases of ovarian malignant tumors and 244 cases of ovarian benign tumors.were enrolled in the study. The results of ultrasound and detection of serum levels of CA125, HE4 and AFP were analyzed,and the diagnostic value of color Doppler ultrasound and detection of different kinds of tumor markers in early diagnosis of ovarian cancer was compared. Results The color Doppler ultrasound showed there were significant differences in shape,location,texture,blood flow,nipple and ascites between benign ovarian tumors and malignant ovarian tumors(P<0.05). There were significant differences in the serum levels of CA125 and HE4 between benign ovarian tumors and malignant ovarian tumors (P<0.05).The serum levels of CA125 and HE4 were significantly increased with the increase of malignant degree(P<0.05).In the combined detection,color Doppler ultrasonography + CA125 + HE4 + AFP was the optimized combination detection method,with higher sensitivity(95.24%) and specificity(90.98%).Conclusion The color Doppler ultrasound combined with different kinds of tumor markers dtection in early diagnosis of ovarian cancer have has higher sensitivity,specificity and test coincidence rate, which can make up the bias caused by subjective and objective causes to improve the early diagnosis levels for ovarian cancer.