Diagnostic Research of CT Combined with Serum CA125 and HE4 in Ovarian Epithelial Malignant Tumor
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摘要: 目的：探讨CT联合血清CA125及HE4对卵巢上皮恶性肿瘤的诊断价值。方法：以156例卵巢上皮肿瘤（良性72例，恶性84例）为研究对象，术前均行CT和血清肿瘤标志物CA125及HE4检测，将诊断结果与病理学对照，比较CT、CA125、HE4及联合应用对卵巢上皮恶性肿瘤的诊断价值。结果：恶性肿瘤组血清CA125及HE4阳性率均高于良性肿瘤组；CA125诊断恶性肿瘤的灵敏度高于HE4，特异度低于HE4；CA125联合HE4诊断恶性肿瘤的准确率高于CT；CT联合血清CA125及HE4诊断的灵敏度、特异度和诊断准确率分别为95.2％、88.9％ 和92.3％，高于单独CT或肿瘤标志物诊断。结论：CT联合血清CA125及HE4对卵巢上皮恶性肿瘤的诊断具有重要价值，有利于早期诊断及准确分期，值得推广应用。Abstract: Objective: To explore the diagnostic value of CT combined with serum CA125 and HE4 in ovarian epithelial malignant tumor. Methods: 156 cases of epithelial ovarian tumors (benign 72 cases, malignant 84 cases) were studied. Detections of CT and serum tumor markers CA125 and HE4 were carried out before operation, the diagnostic results were compared with pathology, for the evaluation of the diagnostic value of CT, CA125, HE4 and combined diagnosis in epithelial ovarian tumors. Results: The positive rates of serum CA125 and HE4 of malignant tumor group were higher than those of benign tumor group; The diagnostic sensitivity of CA125 for malignant tumor was higher than HE4, and the specificity was lower than HE4; the diagnostic accuracy of CA125 combined with HE4 for malignant tumor was higher than CT; the sensitivity, specificity and accuracy of CT combined with serum CA125 and HE4 for malignant tumor was 95.2%, 88.9% and 92.3% respectively, and were higher than CT or tumor markers alone. Conclusion: CT combined with serum CA125 and HE4 shows important value in the diagnosis of ovarian epithelial malignant tumor, which is conducive to early diagnosis and precise staging, and is worthy of promoting in application.
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Keywords:
- X-ray computer /
- ovary /
- epithelial malignant tumor
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图 1 156例卵巢上皮肿瘤病例入组路线图
Figure 1. Enrollment diagram of 156 cases of ovarian epithelial tumors
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图 2 46岁女性，右侧卵巢黏液性囊腺癌
Figure 2. A 46-year-old female, mucinous cystadenocarcinoma in the right ovary
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图 3 70岁女性，右侧卵巢浆液性囊腺癌
Figure 3. A 70-year-old female, serous cystadenocarcinoma in the right ovary
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图 4 43岁女性，左侧卵巢透明细胞癌
Figure 4. A 43-year-old female,clear cell carcinoma in the left ovarian
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图 5 55岁女性，右侧卵巢子宫内膜样腺癌
Figure 5. A 55-year-old female, endometrioid adenocarcinoma in the right ovarian
表 1 血清CA125、HE4在卵巢上皮良、恶性肿瘤组中阳性率的比较
Table 1 Comparison among positive rates of serum CA125 and HE4 in benign and malignant ovarian epithelial tumors
分组 CA125 HE4 恶性肿瘤组（n=84） 85.71％（72/84） 80.95％（68/84） 良性肿瘤组（n=72） 38.89％（28/72） 22.22％（16/72） χ${} ^2$ 36.94 53.81 P 0.000 0.000 
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表 2 CT、血清CA125、HE4单独及联合应用对卵巢上皮恶性肿瘤的诊断结果比较
Table 2 Comparison among the diagnostic results of CT, serum CA125, HE4 alone and combination application in epithelial ovarian cancer
诊断项目 灵敏度/％ 特异度/％ 阳性预测值/％ 阴性预测值/％ 准确率/％ CA125 85.71a 61.11 72.00 78.57 74.36 HE4 80.95 77.78b 80.95b 77.78 79.49b CA125+HE4 90.48c 83.33c 86.36c 88.24c 87.18c CT 83.33 80.56 83.33 80.56 82.05 CT+CA125+HE4 95.24d 88.89d 90.91d 94.18d 92.31d χ2 9.86 18.59 12.99 9.99 21.30 P 0.043 0.001 0.011 0.041 0.000 注：a-高于HE4；b-高于CA125；c-高于CA125、HE4及CT；d-高于CA125、HE4、CA125+HE4及CT。
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