超声联合肿瘤标志物CA125对卵巢原发恶性肿瘤的诊断价值分析

发布时间：2018-10-25 14:17

【摘要】：目的探讨超声联合肿瘤标志物CA125对卵巢原发性恶性肿瘤的诊断效果。方法将2010年1月至2012年12月于唐山市妇幼保健院就诊，临床怀疑有卵巢包块的女性患者245例作为研究对象。术前均进行肿瘤二维超声、彩色多普勒超声及三维超声检查及肿瘤标志物CA125检测，以术后肿物病理诊断为金标准，分析单纯超声、CA125及其联合试验诊断卵巢恶性肿瘤的真实性、可靠性及其与病理结果的一致性，评价超声与CA125联合试验的诊断效果。结果245例肿物进行病理诊断后，共诊断出良性肿瘤160例，恶性肿瘤85例，良、恶性肿瘤在二维超声中的形态、包膜、内部结构及实性回声图像不同，超声检查对卵巢原发性肿瘤的检查其灵敏度为89.41%、特异度为85.00%、准确度为86.53%、阳性预测值76%、阴性预测值93.79%、阳性似然比5.96、阴性似然比0.12，kappa值=0.72；肿瘤标志物CA125对卵巢原发性肿瘤的检查其灵敏度为88.24%、特异度为73.75%、准确度为78.78%、阳性预测值64.10%、阴性预测值92.19%、阳性似然比3.36、阴性似然比0.16，kappa值=0.59；超声结合肿瘤标志物CA125其对卵巢原发性肿瘤的检查灵敏度为95.29%、特异度为84.38%、准确度为88.16%、阳性预测值76.42%、阴性预测值97.12%、阳性似然比6.10、阴性似然比0.06，kappa值=0.77。结论单纯的超声检查或肿瘤标志物CA125检查对卵巢原发性恶性肿瘤具有一定的诊断价值，，但灵敏度相对偏低，两者联合试验可以较大幅度提高诊断的灵敏度及一致性，提高临床诊断效果。
[Abstract]:Objective to investigate the effect of ultrasound combined with tumor marker CA125 in diagnosis of primary ovarian malignant tumor. Methods from January 2010 to December 2012, 245 female patients with suspected ovarian mass were enrolled in the study. Two dimensional ultrasound, color Doppler ultrasound, three dimensional ultrasound and CA125 were performed before operation. The accuracy of simple ultrasound, CA125 and their combined tests in the diagnosis of ovarian malignant tumor was analyzed by using the pathological diagnosis of tumor as the gold standard. The reliability and consistency with pathological results were evaluated. The diagnostic effect of combined ultrasound and CA125 test was evaluated. Results after pathological diagnosis of 245 cases of tumor, 160 cases of benign tumor, 85 cases of malignant tumor, benign and malignant tumor were diagnosed. The morphology, capsule, internal structure and solid echo images of benign and malignant tumors were different in two-dimensional ultrasound. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio and negative likelihood ratio were 89.41, 85.00, 86.53, 76, 93.79, 5.96 and 0.12 kappa, respectively. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio and negative likelihood ratio of CA125 for primary ovarian tumors were 88.24, 73.75, 78.78, 64.10, 92.19, 3.36 and 0.59, respectively. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio and negative likelihood ratio of ultrasound combined with tumor marker CA125 for primary ovarian tumors were 95.29, 84.38, 88.16, 76.42, 97.12, 6.10 and 0.77, respectively. Conclusion simple ultrasound examination or tumor marker CA125 examination has certain diagnostic value for primary ovarian malignant tumor, but the sensitivity is relatively low. The combined test can greatly improve the sensitivity and consistency of diagnosis. To improve the clinical diagnosis effect.
【学位授予单位】：河北联合大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.1;R737.31

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