彩色多普勒超声联合糖类抗原125检测对卵巢占位的鉴别诊断价值

目的 探讨超声血流阻力指数(RI)联合血清糖类抗原125(CA125)对卵巢肿瘤良恶性的鉴别诊断价值.方法 选取卵巢良性和恶性肿瘤患者各45例,观察并比较卵巢良性和恶性肿瘤患者的超声形态学特征、超声血流RI及血清CA125表达水平,计算超声血流RI、血清CA125单独和联合检测对卵巢肿瘤良恶性的鉴别诊断效能.结果 卵巢恶性肿瘤内部回声不均质,与邻近组织界限不清,超声显示肿瘤实性部分及壁结节内血流丰富.卵巢良性肿瘤内部回声均匀,与邻近组织分界清晰,其中37例囊实性病灶的囊壁光滑,均无壁结节,超声显示肿瘤实性部分存在点状血流.与卵巢良性肿瘤患者相比,卵巢恶性肿瘤患者的超声血流RI更低,血清CA125水平更高,差异均有统计学意义(P﹤0.01).超声血流RI、血清CA125单独检测及两者联合检测对卵巢肿瘤良恶性鉴别诊断的ROC曲线下面积分别为0.792、0.794和0.887.以RI≤0.50且CA125≥453 U/ml为界值,超声血流RI与血清CA125联合检测对卵巢肿瘤良恶性鉴别诊断的灵敏度和特异度分别为95.6％和86.7％,均高于超声血流RI、血清CA125单独检测.结论 在卵巢肿瘤良恶性的鉴别诊断中,超声血流RI与血清CA125联合检测较其单独检测能够提高诊断的灵敏度及特异度.

Value of color Doppler ultrasonography combined with carbohydrate antigen 125 in the differential diagnosis of ovarian masses

Objective To investigate the value of ultrasound blood flow resistance index (RI) combined with serumcarbohydrate antigen 125 (CA125) in the differential diagnosis of benign and malignant ovarian tumors. Method 45 casesof benign ovarian tumors and 45 cases of malignant ovarian tumors were included in the study, of which the ultrasoundmorphological features, blood flow RI and serum CA125 levels were observed and compared to evaluate the diagnosticefficacy of ultrasound blood flow RI, serum CA125 alone and their combination in detecting benign and malignant ovariantumors. Result The internal echo of malignant ovarian tumor was inhomogeneous, with unclear boundary observed,and ultrasound showed abundant blood flow in the solid part of the tumor and in the parietal nodules. For benign tumors,the internal echo was homogeneous, with clear boundary, 37 cases of them were cystic and solid masses, smooth cystwall, and no parietal nodules, while in ultrasound images, spotted blood flow in the solid part was presented. Comparedwith benign ovarian tumors, the RI of ovarian malignant tumors was lower, but CA125 level was higher, the differenceswere statistically significant (P<0.01). The AUC of ROC for detecting benign and malignant ovarian tumors by ultrasoundRI, serum CA125 alone and combined detection was 0.792, 0.794 and 0.887, respectively. With RI≤0.50 andCA125≥453 U/ml as cut- off value, the sensitivity and specificity of combined ultrasound blood flow RI and serumCA125 was 95.6％ and 86.7％, respectively, which were higher than ultrasound blood flow RI or serum CA125 alone.Conclusion In the differential diagnosis of benign and malignant ovarian tumors, the combination of ultrasound RI andserum CA125 can improve the sensitivity and specificity of diagnosis.