阴道超声联合血清HE4检测在卵巢癌早期诊断与病情监测中的意义

目的：探讨阴道超声联合血清人附睾蛋白4（HE4）检测在卵巢癌早期诊断与病情监测中的意义，为临床卵巢癌诊断治疗提供依据。方法选择100例卵巢癌患者作为研究对象，另选取同期住院的卵巢良性病变患者100例，均行阴道超声检查，ELISA法测定患者血清HE4、CA125水平，对单一检测及联合检测灵敏度及特异度进行比较分析。结果卵巢癌组血清HE4水平、CA125水平、阴道超声评分均高于卵巢良性病变组，差异有统计学意义（P﹤0.05）；随着卵巢癌组临床分期增加，血清HE4水平、CA125水平、阴道超声评分升高（P﹤0.05）；实性肿物较囊性肿物恶性率高，单侧病变最大径线﹥5 cm较最大径线≤5 cm恶性率高，可见腹腔积液患者较无腹腔积液患者恶性率高，肿瘤分期Ⅲ~Ⅳ期恶性率高于Ⅰ~Ⅱ期，差异均有统计学意义（P﹤0.05）；卵巢癌组HE4、CA125、阴道超声检测阳性率均高于卵巢良性病变组（P﹤0.05）；HE4单项检测性能优于阴道超声检测，阴道超声与HE4联合检测的灵敏度、特异度高于阴道超声、HE4单一检测，阴道超声+HE4联合检测灵敏度和特异度与阴道超声+CA125比较，差异均有统计学意义（P﹤0.05）；阴道超声+HE4联合检测灵敏度及特异度与阴道超声+CA125+HE4比较，差异无统计学意义（P﹥0.05）。结论阴道超声联合HE4检测可提高卵巢癌诊断灵敏度与特异度，有助于卵巢癌早期诊断及病情监测。

Significance of transvaginal ultrasonography combined with serum HE4 detection in early diagnosis and monitoring of ovarian cancer

Objective To investigate the clinical significance of transvaginal ultrasonography (TVU) in combination with serum HE4 detection in early diagnosis and disease monitoring for ovarian cancer, facilitating the clinical diagnosis and treatment procedures. Method A total of 100 patients with ovarian cancer were enrolled as study group, and another 100 patients with benign ovarian lesions during the same period were included as control group. All patients were admin-istered with TVU, besides the serum HE4 and CA125 levels were detected by ELISA assay. The sensitivity and specifici-ty of single or combined detection were compared. Result Serum HE4 and CA125 levels and TVU scores were signifi-cantly higher in study group than that in control group (P<0.05). In study group, with clinical stages of ovarian cancer in-creased, the serum HE4 and CA125 levels and vaginal ultrasound score were elevated (P<0.05). More malignancies were observed in solid mass than cystic mass, and in lesions with unilateral maximum diameter>5 cm than that with maxi-mum diameter≤5 cm, as well as in patients with visible ascites than those with no malignant ascites (P<0.05). The posi-tive detection rate of HE4, CA125 and TVU in study group were all higher than that in control group (P<0.05);HE4 de-tection alone had a better performance than TVU, while the combination of TVU+HE4 were superior in sensitivity and specificity than TVU or HE4 detection alone, and were significantly different with that of TVU+CA125 (all P<0.05), though comparable with TVU + HE4 + CA125 (P>0.05). Conclusion Transvaginal ultrasonography combined with HE4 detection improves the sensitivity and specificity in diagnosing ovarian cancer, which is useful in promoting early di-agnosis and disease monitoring for the disease.