超声与血清HE4和CA125联合检测对早期卵巢癌的鉴别诊断

发布时间：2018-03-07 12:13

  本文选题：卵巢癌　切入点：HE4　出处：《山西医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的研究血清人附睾分泌蛋白4(HE4)和糖类抗原125(CA125)的生物学特性及其在卵巢癌诊断中的临床意义,同时联合经腹部及经阴道超声检查,探索一种灵敏、准确且特异性高检测方法,探讨肿瘤标志物血清检测及超声影像两种检查方法的相关性及联合检查敏感度,旨在为提高卵巢癌的期诊断提供科学的依据。 方法收集2008年1月至2012年6月在山西省肿瘤医院妇科因卵巢占位就诊有完整临床资料并均有组织病理学确诊的卵巢占位患者161例,其中良性肿瘤75例,恶性肿瘤患者86例,健康对照组150例,采用电化学发光法和酶联免疫吸附法检测良性病变患者、恶性病变患者及健康对照组血清HE4、CA125水平,同时收集超声声像图,按照声像图特点进行评分。SPSS13.0软件进行统计学处理 结果86例卵巢癌患者血清CA125阳性率为91.9%,HE4阳性率为59.3%,明显高于75例卵巢良性病变患者的46.7%和4.0%,在卵巢恶性组CA125在各个分期中的水平比较,各分期之间无明显差异(P0.05)；HE4在各个分期中水平比较,对于Ⅰ期、Ⅱ期和Ⅲ期、Ⅳ期两者之间有显著差异(P0.05)。本研究结果提示,血清HE4联合CA125检测对于早期卵巢癌的诊断较在初诊卵巢疾病患者中可提供重要的信息。腹部超声及TRUS检查卵巢癌患者评分值为4.89±1.64,敏感度为69.7%,均明显高于卵巢良性病变组及健康对照组,经统计学处理,差异具有显著性(P0.05)。HE4、CA125、超声评分及三者联合敏感度分别为75.2%、96.2%、67.9%和98.8%,特异度分别为85.1%、66.7%、61.3%和96.1%,血清CA125、HE4及超声联合检测的敏感性及特异性均明显高于单项检测,差异有统计学意义(P0.05) 结论血清HE4、CA125联合检测对卵巢占位诊断的敏感性和特异性明显高于各个单项检测。血清HE4水平在卵巢癌分期中有显著差异,可联合CA125对于卵巢癌患者的分期诊断提供重要提示。超声联合血清HE4、CA125检查对卵巢癌诊断的特异性和敏感性明显高于超声单项检查。血清HE4、CA125和超声联合检查不仅明显的提高卵巢癌检出的阳性率和敏感性,为早期诊断卵巢癌提供有效的临床依据
[Abstract]:Objective to study the biological characteristics of human epididymal secretory protein (Hepididymis) and carbohydrate antigen 125 (CA125) and its clinical significance in the diagnosis of ovarian cancer, and to explore a sensitive, accurate and specific method for diagnosis of ovarian cancer by transabdominal and transvaginal ultrasound. To explore the correlation and sensitivity of serum detection of tumor markers and ultrasound imaging in order to provide scientific basis for improving the stage diagnosis of ovarian cancer. Methods from January 2008 to June 2012, 161 cases of ovarian occupying were collected from gynecology department of Shanxi Cancer Hospital, including 75 cases of benign tumor and 86 cases of malignant tumor, which had complete clinical data and confirmed by histopathology. Serum levels of HE4CA-125 were detected by electrochemiluminescence and enzyme-linked immunosorbent assay (Elisa) in 150 healthy controls, and ultrasound images were collected at the same time. According to the characteristics of sonogram, the software SPSS 13.0 is used for statistical processing. Results the positive rate of serum CA125 in 86 patients with ovarian cancer was 91.9 and 59.3, which was significantly higher than that in 75 patients with benign ovarian disease (46.7% and 4.0). There was no significant difference among stages (P 0.05) and there was significant difference between stage 鈪，

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