超声联合血清HE4、D-二聚体检测对卵巢癌诊断价值

目的研究超声联合血清HE4、D-二聚体（D-D）检测在诊断卵巢癌中的价值。方法将我院2016年1月~2020年6月接收的70例经病理检查证实卵巢病变性质的卵巢占位患者及20例健康志愿者纳为研究对象，其中经病理检查证实卵巢癌44例（恶性组），卵巢良性病变26例（良性组），检测并统计恶性组、良性组及健康组血清HE4、D-D水平及超声成像特点，分析超声联合血清HE4、D-D在诊断卵巢癌中的价值。结果对照组、良性组及恶性组间血清HE4及D-D水平差异具有统计学意义（P < 0.05），其中恶性组及良性组血清HE4水平高于对照组，且恶性组血清HE4水平高于良性组（P < 0.05），恶性组血清D-D水平高于良性组与对照组，而良性组与对照组间血清D-D水平差异无统计学意义（P>0.05）；随着肿瘤分期的上升，恶性组患者血清HE4及DD水平均呈依次上升趋势，组间差异有统计学意义（P < 0.05）；当HE4及D-D分别取临界值97.12 pmol/L与0.45 mg/L时，两物质在诊断卵巢癌中的效能最高，但两者联合可有效提高各物质单独诊断效能；以病理检查结果作为“金标准”，比较发现，卵巢良性病变组超声评分低于恶性组，差异有统计学意义（P < 0.05），良、恶性卵巢病变组成分、分隔、厚度RI及PI等超声征象差异均有统计学意义（P < 0.05）；且超声联合血清HE4及D-D诊断卵巢癌的灵敏度、特异度及准确率最高，分别为92.31%、93.18%和92.86%。结论超声、血清HE4及D-D在诊断恶性卵巢肿瘤中均具有一定的价值，而三者联合能有效提高诊断效果，为临床诊断提供更可靠的参考。 

ROC curve analysis of diagnostic value of ultrasound combined with serum HE4 and Ddimer in ovarian cancer

ObjectiveTo analyze the diagnostic value of ultrasound combined with serum HE4 and D-dimer in ovarian cancer based on ROC curve.MethodsSeventy patients with ovarian lesions in the hospital from January 2016 to June 2020 were enrolled, including 44 cases of ovarian cancer (malignant group) and 26 cases of benign ovarian lesions (benign group), and 20 healthy individuals (control group). Serum HE4 and D-D levels and ultrasound imaging characteristics of three groups were compared, and the value of ultrasound combined with serum HE4 and D-D in the diagnosis of ovarian cancer was analyzed.ResultsSerum HE4 and D-D levels had significant difference among three groups (P<0.05). Serum HE4 level among three groups was the highest in malignant group, followed by benign group and control group (P<0.05). Serum D-D level among three groups was the highest in malignant group (P<0.05), while the D-D level showed no significant difference between benign group and control group (P>0.05). With the increase of tumor stage, there was an increasing trend in the levels of serum HE4 and D-D in malignant group, with statistic difference (P<0.05). When the critical values of HE4 and D-D were 97.12 pmol/L and 0.45 mg/L respectively, the two substances had the highest efficiency in the diagnosis of ovarian cancer, while the diagnostic efficacy of combined detection of HE4 and D-D was higher than that of single detection. Taking pathological examination results as "gold standard", the ultrasound score of benign group was significantly lower than that of malignant group (P<0.05). And there were significant differences in ultrasound signs such as the composition, separation, and thickness RI and PI between benign group and malignant group (P<0.05). The sensitivity, specificity and accuracy of ultrasound combined with serum HE4 and D-D in diagnosing ovarian cancer were the highest, being 92.31%, 93.18% and 92.86%, respectively.ConclusionUltrasound, serum HE4 and D-D are of certain value in diagnosis of malignant ovarian cancer, and the combined detection of the three can effectively improve the diagnosis efficacy and provide a more reliable reference for clinical diagnosis.