2019 年第 11 期 第 14 卷

超声和CT及磁共振成像联合血清糖类抗原125诊断卵巢肿瘤的临床价值

Clinical value of combined ultrasound, CT, magnetic resonance imaging and serum carbohydrate antigen 125 detection in diagnosis of ovarian neoplasms

作者：焦桢王琳路兰兰赵兰

英文作者：

单位：830001乌鲁木齐，新疆维吾尔自治区人民医院妇科

英文单位：

关键词：卵巢肿瘤；超声；CT；磁共振成像；糖类抗原125

英文关键词：

• 摘要：

• 【摘要】目的    探究超声、CT、磁共振成像(MRI)及血清糖类抗原125（CA125）联合检查对于鉴别诊断良恶性卵巢肿瘤的价值。方法    回顾性分析2015年12月至2017年12月新疆维吾尔自治区人民医院收治的400例卵巢肿瘤患者的病历资料，其中184例卵巢恶性肿瘤患者为恶性组，216例卵巢良性肿瘤患者为良性组。2组患者术前均进行超声、CT、MRI及血清CA125检测。以病理结果为标准，对比2组超声、CT、MRI诊断阳性率，血清CA125水平及诊断阳性率，联合诊断的敏感度、特异度、阳性预测值及阴性预测值，并分析联合诊断不同分期卵巢癌的阳性率。结果    恶性组患者的超声、CT、MRI诊断阳性率均明显高于良性组［67.9%（125/184）比9.7%（21/216）、82.6%（152/184）比12.0%（24/216）、91.3%（168/184）比15.2%（33/216）］，且血清CA125水平和诊断阳性率均明显高于良性组［（637±110）kU/L比（29±6）kU/L、88.0%（162/184）比13.0%（28/216）］，差异均有统计学意义(均P＜0.001)。超声、CT、MRI及血清CA125联合诊断的阴性预测值、阳性预测值、敏感度、特异度（96.2%、95.8%、94.5%、97.0%）均明显高于单项诊断，差异均有统计学意义(均P＜0.05)。超声、CT、MRI联合血清CA125诊断Ⅰ～Ⅱ期卵巢癌（116例）及Ⅲ～Ⅳ期卵巢癌（68例）的阳性率（95.7%、95.6%）均明显高于单项诊断，差异均有统计学意义(均P＜0.05)。结论    超声、CT、MRI联合血清CA125诊断卵巢癌具有较高的敏感度及特异度，能有效预判卵巢癌分期。

• 【Abstract】Objective    To analyze the value of combined ultrasound, CT, magnetic resonance imaging(MRI) and serum carbohydrate antigen 125(CA125) detection in differential diagnosis of benign and malignant ovarian tumors. Methods    Clinical data of 400 patients with ovarian tumor admitted to People′s Hospital of Xinjiang Uygur Autonomous Region from December 2015 to December 2017 were retrospectively analyzed, including 184 cases of malignant tumor and 216 cases of benign tumor diagnosed by surgical pathological results. All patients had ultrasound, CT, MRI and serum CA125 detection before surgery. Positive diagnostic rates of ultrasound, CT and MRI, serum level and positive diagnostic rate of CA125 were analyzed. Sensitivity, specificity, positive predictive value and negative predictive value of combined diagnosis for begine and malignant tumors, and the positive diagnostic rate of combined diagnosis for ovarian cancer at different stages were analyzed. Results    Positive diagnostic rates of ultrasound, CT and MRI for malignant tumor were significantly higher than those for benign tumor［67.9%（125/184） vs 9.7%（21/216）, 82.6%（152/184） vs 12.0%（24/216）, 91.3%（168/184） vs 15.2%（33/216）］; serum CA125 level and the positive diagnostic rate of CA125 in patients with malignant tumor were significantly higher than those in patients with benign tumor［（637±110）kU/L vs （29±6）kU/L 88.0%（162/184） vs 13.0%（28/216）］(all P＜0.001). Negative predictive value, positive predictive value, sensitivity and specificity of combined ultrasound, CT, MRI and serum CA125（96.2%, 95.8%, 94.5%, 97.0%） were higher than those of separate diagnosis(all P<0.05). Diagnostic positive rates of combined detection for stage Ⅰ-Ⅱ and Ⅲ-Ⅳ ovarian cancer（95.7%, 95.6%） were higher than those of separate diagnosis(all P<0.05). Conclusion    Combined detection of ultrasound, CT, MRI and serum CA125 shows high positive rate, sensitivity and specificity in the diagnosis of ovarian cancer.