超声联合CA125检测在卵巢上皮性癌的早期诊断价值

发布时间：2018-11-22 18:52

【摘要】：目的:探讨超声联合CA125检测在卵巢上皮性癌早期诊断中的临床应用价值。方法:回顾2010年1月~2014年6月在贵州省人民医院住院手术治疗、经术后病理证实为卵巢上皮性癌的病例124例,从超声检查、CA125检测结果、病理标本组织学分型、临床分期方面进行统计学处理。结果:根据卵巢恶性肿瘤手术病理分期(FIGO,2014年),卵巢上皮性癌I期46例、II期14例、III期54例、IV期10例,各期血清CA125统计水平明显升高(35U/ml),阳性率分别为52.17%、64.29%、90.74%、100.00%。其中晚期(III-IV)明显高于早期(I-II)(p0.05)。血清CA125检测阳性92例,总阳性率为74.19%。卵巢粘液性腺癌和透明细胞癌血清CA125水平也升高,但相对不明显。在早期,血清CA125检测阳性率相对低,说明单一CA125检测筛查卵巢上皮性癌具有一定的局限性。通过超声检查提示卵巢癌81例,阳性率为65.32%,仅通过超声诊断卵巢癌的阳性率并不高,结合超声检查及CA125检测结果计算,阳性率达91.94%,说明两者联合可以显著提高卵巢上皮性癌诊断的阳性率(p0.05)。病例中有7例术前超声显示为囊性或混合型包块,未见明显卵巢癌征象,提示为良性肿瘤或炎性病变,但CA125检测异常(35U/ml),术后病理证实为浆液性癌3例,粘液性癌4例,分期均为早期。结论:1、卵巢上皮性癌患者血清CA125水平升高,且随分期递增。卵巢粘液性腺癌和透明细胞癌血清CA125水平也升高,但相对不明显。2、超声联合血清CA125检测,可提高卵巢上皮性癌的早期诊断率。
[Abstract]:Objective: to evaluate the clinical value of ultrasound combined with CA125 in the early diagnosis of ovarian epithelial carcinoma. Methods: from January 2010 to June 2014, 124 cases of ovarian epithelial carcinoma were treated in Guizhou Provincial people's Hospital from January 2010 to June 2014. The results of ultrasonic examination, CA125 examination and histological classification of pathological specimens were reviewed. The clinical stage was treated statistically. Results: according to FIGO, 2014, 46 cases of ovarian epithelial carcinoma, 14 cases of II, 54 cases of III, 10 cases of IV, the level of serum CA125 was significantly increased (35U/ml). The positive rates were 52.17 and 64.29, respectively. The late stage (III-IV) was significantly higher than the early stage (I-II) (p0. 05). The positive rate of serum CA125 was 74.19 in 92 cases. Serum CA125 levels in mucinous adenocarcinoma and clear cell carcinoma of the ovary were also elevated, but relatively insignificant. In the early stage, the positive rate of serum CA125 was relatively low, which indicated that single CA125 was limited in the screening of ovarian epithelial carcinoma. 81 cases of ovarian cancer were diagnosed by ultrasound, the positive rate was 65.322.The positive rate of ovarian cancer diagnosed by ultrasound only was not high. Combined with the results of ultrasound and CA125, the positive rate was 91.94. The results showed that the combination of the two can significantly improve the positive rate of diagnosis of epithelial ovarian carcinoma (p0.05). Among them, 7 cases were diagnosed as cystic or mixed mass by ultrasonography before operation. No obvious signs of ovarian cancer were found, indicating benign tumor or inflammatory lesion, but abnormal CA125 detection (35U/ml), and 3 cases of serous carcinoma confirmed by postoperative pathology. Mucinous carcinoma was found in 4 cases with early stage. Conclusion: 1. The serum CA125 level in patients with epithelial ovarian carcinoma increased with the stage. The level of serum CA125 in mucinous adenocarcinoma and clear cell carcinoma of ovary was also increased, but it was not obvious. 2Ultrasound combined with serum CA125 could improve the early diagnosis rate of epithelial ovarian carcinoma.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R737.31

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