超声形态积分联合CA125和CA199检测诊断卵巢癌术后复发价值ROC曲线分析

发布时间：2018-03-09 05:36

本文选题：超声形态积分　切入点：卵巢癌　出处：《中华肿瘤防治杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的超声形态积分(sonographic morphologic score,SMS)在卵巢癌术前诊断中具有重要价值,报道较多;而SMS在卵巢癌术后的应用报道较少,作用不明。本研究运用接受器工作特性曲线(receiver operating characteristic curve,ROC)分析比较SMS和CA125及CA199诊断卵巢癌术后复发的价值。方法收集2013-01-01-2015-06-30南通市肿瘤医院经手术病理确诊为卵巢癌64例患者的术后临床资料。所有患者行超声检查,计算SMS,检测血清CA125和CA199;SMS范围0~10,由肿瘤体积积分和结构积分组成。复发诊断标准以临床检查、MRI及盆腔肿块穿刺获取的病理诊断等综合判断。绘制ROC曲线,确定最佳截断值。结果 64例患者中,临床诊断29例肿瘤复发,SMS平均(5.0±0.3)分。未见复发35例,其中21例盆腔未见占位,SMS均为0分;1例炎症肿块,SMS 3分;13例淋巴囊肿,SMS平均(2.0±0.4)分。SMS和CA125诊断卵巢癌复发的曲线下面积分别为0.848和0.883,差异无统计学意义,Z=0.24,P=0.66;SMS和CA199的曲线下面积分别为0.872和0.813,差异无统计学意义,Z=0.48,P=0.26。以5为截断值,SMS诊断肿瘤复发的敏感度、特异度、阳性预期值和阴性预期值分别为75.86%、91.43%、88.00%和82.05%。SMS与卵巢癌复发诊断存在相关性,χ~2=30.168 3,P0.001。结论 SMS与CA125和CA199诊断卵巢癌术后复发的ROC曲线下面积差异无统计学意义,SMS在卵巢癌复发诊断中具有重要价值。
[Abstract]:Objective to evaluate the value of sonographic morphologic scoreography (SMSs) in the preoperative diagnosis of ovarian cancer, and to report more reports on the application of SMS after ovarian cancer surgery. The purpose of this study was to compare the diagnostic value of SMS, CA125 and CA199 for postoperative recurrence of ovarian cancer by receiver operating characteristic curveroc. Methods 64 cases of ovarian cancer diagnosed by operation and pathology in Nantong Cancer Hospital, 2013-01-01-2015-06-30, were collected. Clinical data of patients after operation. All patients were examined by ultrasound. SMSs were calculated, serum CA125 and CA199SMs were measured in the range of 0 ~ 10, which consisted of tumor volume integral and structural integral. Recurrence diagnosis criteria were judged by clinical examination and pathological diagnosis of pelvic mass puncture. ROC curves were plotted. Results among 64 patients, 29 patients with tumor recurrence had an average score of 5.0 卤0.3, and no recurrence was found in 35 patients. Among them, 21 cases of pelvic space occupying tumor were all 0, 1 case of inflammatory mass SMS3 and 13 cases of lymphoid cyst had an average of 2.0 卤0.4). The area under the curve of SMS and CA125 for the diagnosis of ovarian cancer recurrence were 0.848 and 0.883, respectively. There was no significant difference between the two groups. The area under line was 0.872 and 0.813, respectively. There was no significant difference between them. The sensitivity of SMS in diagnosis of tumor recurrence was determined by using 5 as truncation value. Specificity, The positive and negative predictive values were 75.86% and 82.05%, respectively. The positive and negative predictive values were correlated with the recurrence diagnosis of ovarian cancer. Conclusion there is no significant difference in the area under the ROC curve between SMS and CA125 and CA199 in the diagnosis of ovarian cancer recurrence after operation. It has important value in diagnosis.
【作者单位】：南通市肿瘤医院影像科;
【分类号】：R445;R737.31

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