MRI、HE4在卵巢交界性肿瘤与Ⅰ期卵巢癌鉴别诊断中的价值

发布时间：2018-05-27 01:34

  本文选题：卵巢肿瘤 + 磁共振成像　； 参考：《兰州大学》2014年硕士论文

【摘要】：目的：探讨MRI、血清人附睾分泌蛋白4在卵巢交界性肿瘤与Ⅰ期上皮性卵巢癌鉴别诊断中的价值。 方法：收集经手术病理证实的卵巢交界性肿瘤32例,Ⅰ期卵巢癌24例,观察肿瘤的MRI表现,内容包括肿瘤位置、大小、分隔数和分隔厚度、结节或乳头状突起(实性成分)的最大径、有无腹膜种植及腹水,并检测所有患者术前血清HE4含量。计量资料采用独立样本t检验；计数资料采用X2检验,当有理论频数1或所得概率接近检验水平时,采用Fisher确切概率法检验。实性成分最大径、分隔厚度、实性成分和厚分隔对应的血清HE4鉴别两组肿瘤的最佳临界值及其敏感度、特异度采用ROC曲线分析；实性成分、厚分隔和血清HE4诊断卵巢交界性肿瘤和Ⅰ期卵巢癌的总确诊率采用Logistic回归分析。 结果：(1)两组肿瘤位置、大小、分隔数差异无统计学意义,实性成分、厚分隔率的差异有统计学意义(P0.05),实性成分的最大径、分隔厚度差异有统计学意义(P0.05)。(2)双侧分布、大小、分隔数分别对应的两组肿瘤血清HE4含量差异无统计学意义；出现实性成分、厚分隔的Ⅰ期卵巢癌组血清HE4含量明显高于卵巢交界性肿瘤组(P0.05)；ROC曲线分析得出实性成分和厚分隔对应的血清HE4鉴别两组肿瘤的最佳临界值及其敏感度、特异度分别为108.95pmol/L、58%、87%,105.42pmol/L、55%、84%。Logistic回归分析得出实性成分、厚分隔、HE4含量诊断两组肿瘤的总确诊率为78.6%(卵巢交界性肿瘤组为75.0%,Ⅰ期卵巢癌组为83.3%)。 结论：MRI能为卵巢交界性肿瘤与Ⅰ期卵巢癌鉴别诊断提供一定的信息,Ⅰ期卵巢癌出现实性成分和厚分隔的概率高于卵巢交界性肿瘤,Ⅰ期卵巢癌实性成分的最大径、分隔厚度大于卵巢交界性肿瘤。Ⅰ期卵巢癌实性成分、厚分隔对应的血清HE4含量高于卵巢交界性肿瘤,MRI表现结合血清HE4含量有助于卵巢交界性肿瘤与Ⅰ期卵巢癌的术前鉴别诊断。
[Abstract]:Objective: to investigate the value of MRI and human epididymal secretory protein 4 in differential diagnosis of ovarian borderline tumor and stage I epithelial ovarian carcinoma. Methods: 32 cases of borderline ovarian tumors and 24 cases of stage I ovarian cancer were collected. The MRI findings of the tumors, including tumor location, size, number of separations and thickness of septum, were observed. The largest diameter of nodules or papillary processes (solid components), with or without peritoneal implants and ascites, and serum HE4 levels were measured in all patients before operation. The measurement data are tested by independent sample t test, and the counting data by X2 test. When the theoretical frequency is 1 or the probability is close to the test level, the exact probability method of Fisher is used. The maximum diameter, septal thickness, solid component and thick-spaced serum HE4 were used to identify the optimal critical value and sensitivity of the two groups of tumors. The specificity was analyzed by ROC curve. The total diagnostic rate of ovarian borderline tumor and stage I ovarian cancer with thick septum and serum HE4 was analyzed by Logistic regression analysis. Results (1) there was no significant difference in tumor location, size and septal number between the two groups. There were significant differences in solid component and thick septal rate between the two groups (P 0.05). The maximum diameter of solid component and the difference in thickness between the two groups were statistically significant. There was no significant difference in serum HE4 content between the two groups. The level of serum HE4 in stage I ovarian cancer with thick separation was significantly higher than that in borderline ovarian tumor group (P 0.05). The optimal critical value and sensitivity of solid component and serum HE4 corresponding to thick separation were obtained. The specificity was 108.95 pmol / L ~ (58) and 105.42 pmol / L ~ 5555 ~ (55) ~ (84). Logistic regression analysis showed that the total diagnosis rate of the two groups was 78.6% (75.0% in ovarian borderline tumor group, 83.3% in stage I ovarian cancer group). Conclusion the differential diagnosis of ovarian borderline tumor and stage I ovarian cancer can be provided by Mr imaging. The probability of realistic components and thick separation in stage I ovarian cancer is higher than that in borderline ovarian tumor, and the maximum diameter of solid component in stage 鈪，

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