常用肿瘤标记物在卵巢良恶性肿瘤鉴别诊断中的临床价值探讨

发布时间：2018-05-11 14:57

本文选题：肿瘤标记物 + 上皮性卵巢癌　；参考：《新疆医科大学》2017年硕士论文

【摘要】：目的:研究常用肿瘤标记物CA125、CA199、HE4和LDH单项及联合检测在卵巢良恶性肿瘤鉴别诊断中的临床价值。方法:用化学发光微粒子免疫检测法和酶速率法检测新疆医科大学附属肿瘤医院在2013年1月~2015年12月期间收治的220例上皮性卵巢癌、78例卵巢上皮性交界性肿瘤、120例卵巢成熟性畸胎瘤和162例卵巢子宫内膜异位囊肿患者术前血清中肿瘤标记物浓度。结果:(1)上皮性卵巢癌组的CA125、CA199、HE4和LDH平均浓度水平显著高于其它三组(P0.05)。(2)HE4诊断上皮性卵巢癌的灵敏度为73.18%,特异度为98.89%,Youden指数为72.07%,ROC曲线下面积为0.952,综合其他评价指标可得出HE4诊断能力最好。(3)CA125、CA199、HE4、LDH四项联合检测诊断上皮性卵巢癌的灵敏度为97.73%,特异度为25.00%,ROC曲线下面积为0.973,其诊断价值最高。(4)CA125、HE4诊断卵巢浆液性腺癌和卵巢子宫内膜样癌的灵敏度较高,CA199诊断卵巢黏液性腺癌和卵巢透明细胞癌的灵敏度较高,而LDH诊断各病理类型的上皮性卵巢癌的灵敏度均不高。(5)CA125、CA199和HE4诊断早期上皮性卵巢癌的灵敏度较高,而LDH的灵敏度较低。(6)CA125、CA199诊断卵巢上皮性交界性肿瘤和卵巢子宫内膜异位囊肿的灵敏度和特异度较高,CA199诊断卵巢成熟性畸胎瘤的灵敏度和特异度高于CA125。(7)CA125、CA199联合检测提高了诊断卵巢上皮性交界性肿瘤、卵巢成熟性畸胎瘤和卵巢子宫内膜异位囊肿的灵敏度。结论:(1)CA125、CA199、HE4、LDH四项联合检测是诊断上皮性卵巢癌比较理想的肿瘤标记物组合。(2)CA125、CA199联合检测能提高对卵巢上皮性交界性肿瘤、卵巢成熟性畸胎瘤和卵巢子宫内膜异位囊肿的诊断能力。
[Abstract]:Objective: To study the clinical value of the common tumor markers CA125, CA199, HE4 and LDH in the differential diagnosis of ovarian benign and malignant tumors. Methods: 220 cases of epithelial ovary in the Affiliated Cancer Hospital of Xinjiang Medical University were detected by the chemiluminescent particle immunoassay and enzyme rate method in the December ~2015 January 2013. Cancer, 78 cases of ovarian epithelial borderline tumors, 120 cases of ovarian mature teratoma and 162 cases of ovarian endometriosis cysts before operation, the concentration of tumor markers in serum. Results: (1) the level of CA125, CA199, HE4 and LDH in the epithelial ovarian cancer group was significantly higher than that of its three groups (P0.05). (2) the sensitivity of HE4 to the diagnosis of epithelial ovarian cancer. The specificity was 73.18%, the specificity was 98.89%, the Youden index was 72.07%, the area under the ROC curve was 0.952. The best diagnostic ability of the HE4 was best. (3) CA125, CA199, HE4, LDH four combined detection for the diagnosis of epithelial ovarian cancer was 97.73%, the specificity was 25%, the area under the ROC curve was 0.973, and the diagnostic value was the highest. (4) CA125, HE4 The sensitivity of the diagnosis of ovarian serous adenocarcinoma and ovarian endometrioid carcinoma is high. The sensitivity of CA199 in the diagnosis of ovarian mucinous and ovarian clear cell carcinoma is high, while the sensitivity of LDH in the diagnosis of epithelial ovarian cancer is not high. (5) CA125, CA199 and HE4 are sensitive to the early diagnosis of epithelial ovarian cancer, and the spirit of LDH is very high. The sensitivity and specificity of CA199 in the diagnosis of ovarian epithelial borderline tumors and ovarian endometriosis cysts were higher (6) (6). The sensitivity and specificity of CA199 for the diagnosis of ovarian mature teratoma were higher than that of CA125. (7) CA125. The combined detection of CA199 enhanced the diagnosis of ovarian epithelial borderline tumors, ovarian mature teratoma, and the diagnosis of ovarian mature teratoma. The sensitivity of ovarian endometriosis cysts. Conclusion: (1) the combined detection of CA125, CA199, HE4, and LDH is an ideal combination of tumor markers for the diagnosis of epithelial ovarian cancer. (2) the combined detection of CA125 and CA199 can improve the diagnostic ability of ovarian epithelial borderline tumors, ovarian mature teratoma and ovarian endometriosis cysts.

【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.31

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