彩色多普勒超声联合肿瘤标志物CA125、CA724对卵巢良恶性肿瘤的鉴别诊断价值

目的:探讨彩色多普勒超声检查联合肿瘤标志物血清CA125、CA724对卵巢良恶性肿瘤的鉴别诊断价值.方法:收集绵阳市第三人民医院2014年1月至2016年3月手术治疗的卵巢肿瘤患者212例,分析患者的彩色多普勒超声各项指标及血清CA125、CA724水平.以病理诊断作为金标准,计算超声诊断及三项指标联合诊断的准确率、灵敏度及特异度等.结果:超声诊断结果显示,在卵巢恶性肿瘤组中,超声诊断与病理诊断符合率为56.5%(26/46),卵巢良性肿瘤组诊断符合率为88.0%(146/166),良性卵巢肿瘤组超声病理诊断符合率高于恶性肿瘤组,差别有统计学意义(P<0.001).卵巢恶性肿瘤组患者的血清CA125和CA724水平均高于良性肿瘤组,差别有统计学意义(P<0.05).卵巢恶性肿瘤组三项指标联合检测诊断阳性率明显高于良性组(78.3% vs 37.3%,P<0.001).三个单项检测指标中,CA125的灵敏度最高,CA724的特异度最高,超声检查的准确度、阳性预测值、阴性预测价值最高.联合检测中,彩色多普勒超声检查联合CA125诊断卵巢癌的准确度、灵敏度、特异性、阳性预测值、阴性预测价值高于三项指标的联合诊断,亦高于两项肿瘤标志物的联合诊断.结论:超声联合血清肿瘤标志物一定程度上可以提高卵巢良恶性肿瘤的鉴别诊断率.

The value of color ultrasonography combined with serum CA125 and CA724 in the differential diagnosis of benign and malignant ovarian tumors

Objective:To explore the diagnostic value of color ultrasonography combined with serum CA125,CA724 in benign and malignant of ovarian tumors.Methods:All 212 patients with ovarian tumors treated with operation were detected with color ultrasound and serum CA125 and CA724 levels.The diagnostic accuracy,sensitivity,specificity and other index were analyzed by using pathological diagnosis as the gold standard,the diagnostic accuracy,sensitivity and specificity were calculated.Results:In ovarian malignant tumor group,the ultrasound diagnosis and pathologic diagnosis the rate was 56.5%(26/46),benign ovarian tumor diagnosis coincidence rate was 88.0%(146/166),pathological diagnosis of benign ovarian tumor ultrasound was higher in malignant tumor group,the difference isstatistically significant(P<0.001).The serum levels of CA125 and CA724 in patients with malignant ovarian tumor were higher than those in benign tumor group(P<0.05).The positive rate of combined detection of three indexes in the ovarian malignant tumor group was significantly higher than that in the benign group(78.3% vs 37.3%,P<0.001).The sensitivity of CA125 was the highest,the specificity of CA724 was highest in the three single detection indexes,the accuracy,positive predictive value and negative predictive value of ultrasonography were the highest.Joint detection and color doppler ultrasound combined with CA125 in diagnosis of ovarian cancer,the accuracy,sensitivity,specificity,positive predictive value and negative predictive value were higher than the combined detection of three indexes,also higher than the two tumor markers combined diagnosis.Conclusion:Color ultrasonography detection with serum tumor markers can improve the differential diagnosis of ovarian benign and malignant tumors.