人附睾蛋白4联合其他指标诊断卵巢癌的价值

发布时间：2018-05-19 17:36

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

【摘要】：目的:探讨新型肿瘤标记物HE4联合CA125及彩色多普勒超声诊断上皮性卵巢癌的临床价值,以及HE4在不同阳性区间的诊断意义。方法:严格按照纳入及排除标准选取在2013年1月至2016年1月在新疆医科大学第一附属医院妇科病区接受手术治疗并根据术后常规病理检查结果确诊为卵巢上皮性肿瘤的207例患者作为研究对象,其中卵巢恶性肿瘤组73例、卵巢良性肿瘤组93例、交界性肿瘤组41例,对所有病人术前检测的血清肿瘤标记物及彩色多普勒超声结果进行回顾性分析。结果:HE4、CA125及彩色多普勒超声检查结果在恶性组中的阳性率明显高于良性组,差异有统计学意义(分别为2cHE4=80.38,P0.005;2cCA125=93.02,P0.005;2c超声=31.48,P0.005);HE4、CA125及彩色多普勒超声检查单独诊断上皮性卵巢癌的灵敏度、特异度、准确度、阳性预测值、阴性预测值分别是75.34%、92.47%、84.94%、88.71%、82.69%;90.41%、84.95%、87.35%、82.50%、91.86%及73.97%、69.89%、71.67%、65.85%、77.38%。三者联合诊断上皮性卵巢癌的灵敏度、特异度、准确度、阳性预测值、阴性预测值分别是98.63%、54.84%、74.10%、63.16%、98.08%。当HE4值大于105.10 pmol/L时,卵巢恶性肿瘤组所占比例大于卵巢良性肿瘤组,差异有统计学意义(2c=7.22,P0.005)。结论:新型血清肿瘤标记物HE4联合CA125及彩色多普勒超声可显著提高术前诊断卵巢癌的正确性,减少漏误诊率,对早期筛查和诊断卵巢癌、从而及时治疗并改善预后有着重要的临床价值。
[Abstract]:Objective: to evaluate the clinical value of new tumor marker HE4 combined with CA125 and color Doppler ultrasound in the diagnosis of epithelial ovarian cancer and the diagnostic significance of HE4 in different positive regions. Methods: from January 2013 to January 2016, the patients received surgical treatment in the gynecological ward of the first affiliated Hospital of Xinjiang Medical University according to the inclusion and exclusion criteria, and were diagnosed as ovarian epithelium according to the results of postoperative routine pathological examination. A total of 207 cancer patients were included in the study. There were 73 cases of ovarian malignant tumor, 93 cases of benign ovarian tumor and 41 cases of borderline tumor. The results of serum tumor markers and color Doppler ultrasound were analyzed retrospectively. Results the positive rate in malignant group was significantly higher than that in benign group. The difference was statistically significant (2cHE4H _ 4, 80.38, P 0.005 ~ (0.005), P _ (0.005) P _ (0.005), P _ (0.005) ~ (2c), the sensitivity and specificity of color Doppler ultrasound in diagnosing epithelial ovarian cancer, respectively. The accuracy, the positive predictive value, the negative predictive value were 75.34 and 92.477.94, respectively. They were 88.71and 82.690.491.90.41 and 87.35m 82.5091.86% and 73.97765.8577.8577.38. respectively. The results showed that the accuracy, the positive predictive value and the negative predictive value were 88.71% and 84.95%, 87.35%, 82.50% and 77.38%, respectively, and 73.97%, 65.85% and 77.38%, respectively. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the three diagnostic methods were 98.63 and 54.84 respectively. When the HE4 value was more than 105.10 pmol/L, the proportion of ovarian malignant tumor group was larger than that of ovarian benign tumor group, and the difference was statistically significant (P 0.005). Conclusion: the new serum tumor marker HE4 combined with CA125 and color Doppler ultrasound can significantly improve the accuracy of preoperative diagnosis of ovarian cancer, reduce the rate of misdiagnosis, early screening and diagnosis of ovarian cancer. It has important clinical value to treat and improve prognosis in time.
【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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