LPA、CA125与经阴道彩色多普勒超声联合诊断卵巢上皮癌的临床价值

目的:探讨血浆溶血磷脂酸(LPA)在卵巢上皮癌患者血浆中的表达水平,及其与血清CA125和经阴道彩色多普勒超声(TV-CDUS)联合应用诊断卵巢上皮癌的临床价值。方法:术前检测卵巢上皮癌48例,卵巢良性肿瘤30例的LPA、CA125,以20例健康者作为对照,卵巢肿瘤患者同时经阴道超声评分和TV-CDUS检查。结果:卵巢癌患者LPA水平明显高于卵巢良性肿瘤组和健康对照组,差异有统计学意义(P0.05),LPA水平在良性肿瘤组与健康对照组之间无显著差异(P0.05)。单独应用LPA、CA125、TV-CDUS检测诊断卵巢癌的敏感性和特异性分别为87.5%、79.16%、81.25%和80%、70%、86%,各组间敏感性和特异性比较,无显著差异(P0.05)。LPA、CA125、TV-CDUS 3项联合检测诊断卵巢癌的敏感性和特异性为95.80%和94%,与单独应用CA125检测特异性比较,差异有统计学意义(P0.05)。LPA诊断卵巢癌的敏感性和特异性与卵巢癌分期和病理类型无关(P0.05),CA125诊断卵巢癌的敏感性和特异性与卵巢癌的分期和病理类型有关(P0.05)。结论:卵巢上皮癌患者血浆LPA水平明显升高,有望成为卵巢上皮癌诊断的敏感指标,联合检测血浆LPA、血清CA125与TV-CDUS有助于术前卵巢癌的诊断。

Evaluation of plasma LPA, serum CA125 combined with transvaginal color doppler ultrasonography for diagnosis of ovarian epithelial cancer

Objective:To evaluate the clinical value of preoperative plasma lysophosphatidic acid(LPA) and serum CA125 combined with transvaginal color doppler ultrasonography(TV-CDUS) for the preoperative diagnosis of ovarian epithelial cancer and its role in discriminating benign from malignant ovarian tumors.Methods:48 malignant ovarian epithelial cancer patients,30 benign ovarian tumor patients and 20 healthy women volunteers were measured with LPA and CA125 and then all patients were examined by transvaginal ulltrasonography to quantify mass scoring and by TV-CDUS to measure RI value of peripheral blood flow of mass.All data have been used to analyse for correleation with the pathological diagnosis.Results:The preoperative plasma LPA levels of patients with ovarian epithelial cancers were higher than those of patients with ovarian benign tumor and the healthy women group(P<0.05).There was no significant difference between patients with ovarian benign tumor and the healthy women group(P>0.05).The sensitivity of plasma LPA,serum CA125 and TV-CDUS for the diagnosis of ovarian epithelial cancer were 87.5%,79.16% and 81.25%,respectively.The specificity of plasma LPA,serum CA125,TV-CDUS for it were 80%,70% and 86%,respectively.Three methods were compared with each other,no significant difference was found respectively(P>0.05).The sensitivity and specificity of combination of the three methods were 95.8% and 94%,there was significant difference between the specificity of combination of the three methods and that of serum CA125 alone(P<0.05).There were no relation between the sensitivity and specificity of plasma LPA and the stage and pathology types of the ovarian epithelial cancer(P>0.05),whereas the sensitivity and specificity of serum CA125 levels were positively correlated with stage and pathological types of the ovarian epithelial cancer(P<0.05).Conclusions:The combination of the levels of plasma LPA and serum CA125 with TV-CDUS could conduce to the diagnosis of the ovarian epithelial cancer and elevate the accuracy of differential diagnosis of benign tumor from malignant ovarian tumor.