检测CA125、CA199联合多普勒超声检查对卵巢肿物鉴别诊断的意义

目的探讨检测肿瘤标志物CA125、CA199联合超声检查对卵巢良恶性肿物鉴别诊断及指导临床的实用意义。方法对本院2007年1月～2012年12月妇女健康体检和妇检初步发现有卵巢肿物的130例患者．进一步采用化学发光法检测CA125、CA199的水平，并作盆腔部超声影像检查，对照比较术后（包括腔镜术、穿刺取检术或开腹探查术）病理结果，分析CA125、CA199及超声影像学检查的阳性结果与阴性结果。分别与肿物的良性和恶性比例关系。结果130例中，CA125升高36例，CA199升高37例，多普勒超声检查初步怀疑恶性肿瘤患者32例。术后病理诊断为良性肿物100例，术后病理诊断为恶性肿瘤28例。术后病理诊断为良性肿物100例中经超声检查初步诊断为良性肿物96例，诊断符合率为96％，误诊率5％；术后病理诊断为恶性肿瘤的28例中，超声检查初步怀疑恶性肿瘤26例，符合率92．86％，误诊率7．14％；在130例中，超声影像检查初步怀疑恶性肿瘤且CA125及CA199均阳性共26例，且术后病理也确诊为恶性肿瘤的25例，符合率96．15％，假阳性率3．85％。结论对妇女健康体检和妇检初步发现有卵巢肿物的患者，进行检测肿瘤标志物CA125、CA199联合超声影像检查，对卵巢良恶性肿物鉴别诊断具有临床实用意义。

Significance of detection of CA125, CA199 combined with ultrasound ex- amination for the differential diagnosis of ovarian tumors

Objective To investigate the differential diagnosis and clinical applicability of ovarian tumor by detecting tumor markers CA125, CA199 combined with ultrasound examination. Methods A total of 130 patients with ovarian tumor initially found in the gynecological examination in our hospital from Jan.2007 to Dec. 2012 were enrolled in this study. Serum CA125 and CA199 were detected by chemoluminescence assay,and pelvic ultrasonography were also employed. By comparing the results with the pathology results after surgery （including laparoscopic surgery, Ovarian biopsy or abdominal exploratory surgery）,we managed to find their internal correlations. Results Among the 130 cas- es,36 were found CA125 increased, 37 were found CA199 increased,and 32 cases were suspected malignant tumor by doppler ultrasound. 100 cases were diagnosed as benign tumors,but 28 cases turned out to be malignant according to the postoperative pathologic diagnosis. Meanwhile,among the 100 cases diagnosed as benign according to pathology, 96 cases were initially diagnosed as benign by ultrasound examination. In other words,the accurately diagnostic rate was 96.00% ,and the misdiagnosis rate was 4.00%. In the 28 cases pathological diagnosed as malignant, 26 cases were also initially diagnosed as malignant tumor by ultrasound examination. Which means, the coincidence rate was 92.86%, and the misdiagnosis rate was 7.14%. 26 of 130 cases that ultrasound imaging preliminary suspected malig- nant tumors were CA125 and CA199 positive, and of which 25 cases were confirmed by pathology, the coincidence rate was 96.15%, and the false positive rate was 3.85%. Conclusion Detection of the tumor markers CA125, and CA199 combined with ultrasound imaging on patients first found ovarian tumor, has clinical significance for differential diagnosis of ovarian tumor.