HE4、CA125、超声在卵巢癌诊断及鉴别诊断中的意义

发布时间：2018-04-24 06:10

本文选题：HE4CA125 + 超声　；参考：《大连医科大学》2014年硕士论文

【摘要】：目的：探讨HE4、CA125、超声在卵巢癌诊断及与卵巢子宫内膜异位囊肿（巧囊）鉴别诊断中的临床应用价值方法：回顾性分析本院卵巢癌患者40例（简称卵巢癌组）、巧囊患者70例（简称巧囊组）及卵巢良性肿瘤患者62例（简称良性肿瘤组）的术前血清HE4、CA125水平及超声结果，与术后病理诊断的关系，通过比较其敏感性、特异性探讨个指标的临床价值。结果：1.血清CA125水平的中位数在卵巢癌组、巧囊组、良性肿瘤组分别：334.1u/ml、56.0u/ml、13.5u/ml,两两组的相比较，差异均有显著意义（P0.01）。 2.血清HE4水平的中位数卵巢癌组、巧囊组、良性肿瘤组分别223.7pmol/l、46.1pmol/l、45.2pmol/l，卵巢癌组高于巧囊组、良性肿瘤组的指标（P0.01），巧囊组与良性肿瘤组的水平比较，差异无统计学意义（P0.05） 3.超声在卵巢癌组、巧囊组、良性肿瘤组的符合率为67.5%、95.9%、77.4%，巧囊组的符合率高于卵巢癌与良性肿瘤组的符合率（P0.01）,卵巢癌组与良性肿瘤组相比较，差异无统计学意义（P0.05）。 4.Ⅰ期卵巢癌患者的HE4、CA125及超声的阳性率分别为63.6%、81.8%、63.6%，两两比较差异统计学意义（P0.05），Ⅱ期卵巢癌患者的HE4、CA125及超声的阳性率均为66.7%,两两比较差异统计学意义(P0.05),Ⅲ-Ⅳ期卵巢癌患者的HE4、CA125及超声的阳性率分别为92.3%、92.3%、69.2%，两两比较差异无统计学意义（P0.05）。 5.诊断卵巢癌方面，CA125单项检测的灵敏度上均高于HE4和超声，HE4单检测的特异度、准确率上均高于超声及CA125；诊断巧囊方面上，超声单项检测的灵敏度和准确率上高于HE4和CA125，三者联合检测的灵敏度、特异度及准确率均高于三项中任意一项单检的指标。结论：1.HE4在卵巢癌诊断及鉴别诊断的特异度和准确度高于超声和CA125，在诊断巧囊上，，超声诊断的准确性比HE4和CA125均高。 2.三者联合检测较单项检测时，可进一ki提高卵巢癌诊断和鉴别诊断的准确率。
[Abstract]:Objective: To investigate the clinical value of HE4, CA125 and ultrasonography in the differential diagnosis of ovarian cancer and ovarian endometriosis cyst.
Methods: 40 cases of ovarian cancer, 70 cases of ovarian cancer, 62 cases of ovarian benign tumors and 62 cases of benign ovarian tumors (benign tumor group) were analyzed retrospectively. The relationship between the preoperative serum levels and the results of CA125 and ultrasound and the postoperative pathological diagnosis were compared. By comparing their sensitivity and specificity, the clinical price of the index was discussed. Value.
Results: 1. the median of serum CA125 levels in the ovarian cancer group, the ingenious capsule group and the benign tumor group: 334.1u/ml, 56.0u/ml, 13.5u/ml, and the 22 groups were significantly different (P0.01).
2. the serum HE4 level in the median ovarian cancer group, the cyst group, the benign tumor group 223.7pmol/l, the 46.1pmol/l, the 45.2pmol/l, the ovarian cancer group is higher than the clever capsule group, the benign tumor group index (P0.01), the comparison between the skillful capsule group and the benign tumor group, the difference is not statistically significant (P0.05).
The coincidence rate of 3. ultrasound in ovarian cancer group, ingenious capsule group and benign tumor group was 67.5%, 95.9%, 77.4%. The coincidence rate of ovarian cancer group was higher than that of ovarian cancer and benign tumor group (P0.01). There was no statistical difference between ovarian cancer group and benign tumor group (P0.05).
The positive rates of HE4, CA125 and ultrasound in 4. stage ovarian cancer patients were 63.6%, 81.8%, 63.6% and 22, respectively (P0.05). The positive rates of HE4, CA125 and ultrasound in stage II ovarian cancer patients were 66.7%, 22 were statistically significant (P0.05). The positive rates of HE4, CA125 and ultrasound in stage III - IV ovarian cancer patients were 9, respectively. The difference between 2.3%, 92.3%, 69.2% and 22 was not statistically significant (P0.05).
5. in the diagnosis of ovarian cancer, the sensitivity of single detection of CA125 was higher than that of HE4 and ultrasound. The specificity and accuracy of HE4 single detection were higher than that of ultrasound and CA125; the sensitivity and accuracy of single detection were higher than HE4 and CA125, and the sensitivity, specificity and accuracy of the combined detection were higher than those of three. An indicator of a single check.
Conclusion: the specificity and accuracy of 1.HE4 in the diagnosis and differential diagnosis of ovarian cancer are higher than that of ultrasound and CA125, and the accuracy of ultrasonic diagnosis is higher than that of HE4 and CA125 in the diagnosis of skillful sacs.
2. the combined detection of three can increase the accuracy of diagnosis and differential diagnosis of ovarian cancer by one ki.

【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.31

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