血清CA125、经阴道B超检查及CT检查在子宫内膜癌术前评估方面的价值

目的 研究血清CA125、经阴道B超检查及CT检查在子宫内膜癌（EC）术前评估方面的价值。方法 选取2017年2月~2018年2月在我院确诊的46例EC行分期手术患者为研究对象，术前分别进行阴道B超、CT检查以及血清CA125检测，对比术前与术后检测结果，并根据术后病理结果分析术前各种检测方法特异性、敏感性等。结果 术前血清CA125水平、阳性率在I期（40.0±23.20）U/ml、26.92%，低于Ⅱ~Ⅳ期（131.7±85.10）U/ml、75.00%，差异有统计学意义（P＜0.05）；肿瘤深肌层浸润诊断中血清CA125联合CT与血清CA125联合阴道B超、血清CA125联合CT与阴道B超特异性、敏感性、准确性对比，差异无统计学意义（P＞0.05）；在诊断累及宫颈中血清CA125联合CT与CA125联合阴道B超、CA125联合CT与阴道B超特异性、敏感性、准确性对比，差异无统计学意义（P＞0.05）；在诊断盆腔淋巴转移方面，CA125联合CT检查与CA125单纯检查对比，特异性、敏感性、准确性升高，敏感性升高，差异无统计学意义（P＞0.05），特异性、准确性升高，差异有统计学意义（P＜0.05）。结论 血清CA125、经阴道B超检查在EC术前分期、病理分级、诊断肿瘤深肌层浸润、宫颈受累方面具有较大的价值，但在盆腔淋巴癌转移方面CT检查更具有优势。

The Value of Serum CA125,Transvaginal B-ultrasound and CT Examination in Preoperative Evaluation of Endometrial Cancer

Abstract:Objective To study the value of serum CA125,transvaginal B-ultrasound and CT examination in preoperative evaluation of endometrial carcinoma(EC).Methods 46 patients with EC staging surgery diagnosed in our hospital from February 2017 to February 2018 were enrolled in the study.Preoperative vaginal B-ultrasound,CT examination and serum CA125 were performed to compare preoperative and postoperative results.And analyze the postoperative pathological results and the specificity and sensitivity of various test methods before surgery.Results Preoperative serum CA125 level and positive rate were in I phase(40.0 23.20)U/ml,26.92%,lower than phase II to IV(131.7 85.10)U/ml,75.00%,and the difference was statistically significant(P<0.05).In the diagnosis of deep myometrium infiltration of tumor,serum CA125 combined with CT,serum CA125 combined with vaginal B-ultrasound,serum CA125 combined with CT and vaginal ultrasound specificity,sensitivity and accuracy,the difference was not statistically significant(P>0.05).There was no significant difference in the specificity,sensitivity and accuracy of CA125 combined with CT and CA125 combined with CA125,CA125 combined with CT and vaginal B-ultrasound in diagnosis of cervical cancer(P>0.05).In the diagnosis of pelvic lymphatic metastasis,CA125 combined with CT examination and CA125 simple examination,the specificity,sensitivity,accuracy and sensitivity increased,the difference was not statistically significant(P>0.05),the specificity and accuracy increased,the difference was statistically significant(P<0.05).Conclusion Serum CA125 and transvaginal B-ultrasound have great value in preoperative EC staging, pathological grade,diagnosis of deep myometrial invasion and cervical involvement,but CT examination is more advantageous in pelvic lymphoma metastasis.