超声造影联合血清CEA、CA72-4对卵巢良恶性肿瘤鉴别诊断的价值

目的:探讨超声造影联合血清癌胚抗原（CEA）、糖类抗原72-4（CA72-4）对卵巢良恶性肿瘤鉴别诊断的价值。方法:选取2017年1月至2018年6月本院肿瘤科收治的128例卵巢肿瘤患者进行研究，进行超声造影和血清CEA、CA72-4水平检测，观察超声造影、CEA、CA72-4及联合检测对卵巢良恶性肿瘤鉴别诊断的价值。结果:在良性肿瘤组中超声造影符合率为72.92%，恶性肿瘤组中超声造影符合率为75.00%，两组比较差异无统计学意义（P>0.05）；恶性肿瘤组患者血清CEA、CA72-4水平高于良性肿瘤组，两组比较差异有统计学意义（P<0.05）；恶性肿瘤组超声造影、CA72-4检测阳性率均高于良性肿瘤组（P<0.05），两组血清CEA检测阳性率比较差异无统计学意义（P>0.05），三者联合检测阳性率高于单项指标检测（P<0.05）；通过ROC曲线分析显示，CEA的AUC为0.644，诊断灵敏度为31.25%，特异性为82.29%，CA72-4的AUC为0.702，诊断灵敏度为40.63%，特异性为79.17%，二者联合检测的AUC为0.785，诊断敏感性为56.25%，特异性为73.96%；三项指标单独检测，超声造影检测的灵敏度、阳性预测率、阴性预测率、诊断准确度及误诊率最高，CEA检测的特异性、漏诊率最高，三者联合检测的灵敏度、特异性、阳性预测率、阴性预测率、诊断准确度最高，漏诊率、误诊率最低。结论:超声造影联合血清CEA、CA72-4检测较单独检测诊断效能高，对卵巢良恶性肿瘤鉴别诊断有较高参考价值。

Value of contrast-enhanced ultrasound combined with serum CEA and CA72-4 in differential diagnosis of benign and malignant ovarian tumors

Objective:To explore the value of contrast-enhanced ultrasound combined with serum carcino-embryonic antigen (CEA) and carbohydrate antigen 72-4 (CA72-4) in differential diagnosis of benign and malignant ovarian tumors.Methods:128 patients with ovarian tumors admitted to the oncology department of our hospital from January 2017 to June 2018 were selected for the study and contrast-enhanced ultrasonography was performed.Serum CEA and CA72-4 levels were also detected.The value of contrast-enhanced ultrasound，CEA，CA72-4 and combined detection in differential diagnosis of benign and malignant ovarian tumors was observed.Results:The coincidence rate of contrast-enhanced ultrasound was 72.92% in benign tumors and 75.00% in malignant tumors.There was no significant difference between the two groups (P>0.05).The levels of serum CEA and CA72-4 in malignant tumors were higher than those in benign tumors (P<0.05).The positive rate of contrast-enhanced ultrasound and CA72-4 in malignant tumors group was higher than that in benign tumors group (P<0.05).There was no significant difference in the positive rate of CEA in serum between the two groups (P>0.05).The positive rate of combined detection of the three groups was higher than that of single index detection (P<0.05).ROC curve analysis showed that AUC of CEA was 0.644.Diagnostic sensitivity was 31.25%.Specificity was 82.29%.AUC of CA72-4 was 0.702.Diagnostic sensitivity was 40.63%.Specificity was 79.17%.AUC of combined detection of CEA and CA72-4 was 0.785.Diagnostic sensitivity was 56.25%.Specificity was 73.96%.The sensitivity，positive predictive rate，negative predictive rate，diagnostic accuracy and misdiagnosis rate of contrast-enhanced ultrasound were the highest.The specificity and missed diagnosis rate were the highest.The sensitivity，specificity，positive predictive rate，negative predictive rate and diagnostic accuracy of combined detection of CEA were the highest，and the missed diagnosis rate and misdiagnosis rate were the lowest.Conclusion:Contrast-enhanced ultrasound combined with serum CEA and CA72-4 detection has higher diagnostic efficiency than single detection，and has a higher reference value for differential diagnosis of benign and malignant ovarian tumors.