| 张 亮,黄 震,袁德利,韩 哲,宰 丹,刘 辉.超声造影联合HE4、CA125、CA153在子宫内膜癌诊断中的价值研究[J].,2021,(22):4358-4362 |
| 超声造影联合HE4、CA125、CA153在子宫内膜癌诊断中的价值研究 |
| The Value of Contrast-enhanced Ultrasound Combined with HE4, CA125, CA153 in the Diagnosis of Endometrial Cancer |
| 投稿时间：2021-03-06 修订日期：2021-03-31 |
| DOI：10.13241/j.cnki.pmb.2021.22.033 |
| 中文关键词: 子宫内膜癌 超声造影 HE4 CA125 CA153 诊断 |
| 英文关键词: Endometrial cancer Contrast ultrasound HE4 CA125 CA153 Diagnosis |
| 基金项目:辽宁省科学技术计划项目（201602208） |
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| 中文摘要: |
| 摘要 目的：为提高对子宫内膜癌的早期诊断，本研究对超声造影联合肿瘤标志物人附睾蛋白4（human epididymis protein-4，HE4）血清糖类抗原125（carbohydrate antigen 125，CA125）及153（CA153）在子宫内膜癌中的诊断价值进行研究。方法：以80例疑似子宫内膜癌患者为研究组，另以80例于本院体检的健康女性为对照组。对患者进行超声造影检查，比较两组血清HE4、CA125以及CA153水平，考察超声造影联合HE4、CA125及CA153对子宫内膜癌的诊断作用。结果：本研究中80例疑似患者中，子宫内膜癌患者有49例，子宫内膜良性病变患者31例，而超声造影检查显示子宫内膜癌患者有41例，良性病变39例，与金标准检查结果有一定的差异，单纯的超声造影检查对子宫内膜癌的诊断有局限性。子宫内膜癌和良性病变患者的病变区灌注的时间、增强强度以及增强均度都有显著差异（P<0.05）。对照组血清HE4、CA125及CA153水平分别为82.31±15.45 pmol/mL、22.31±6.21 U/mL、16.45±4.91 U/mL，研究组血清HE4、CA125及CA153水平分别为159.28±24.01 pmol/mL、42.88±5.73 U/mL、28.30±3.76 U/mL，经统计，研究组各项指标均显著高于对照组（P<0.05）。超声造影的灵敏度为79.3 %、特异度为67.34 %、阳性似然比为2.54、阴性似然比为0.25、阳性预测值为84.63 %、阴性预测值为60.51 %及符合率为72.19 %；联合检测的灵敏度为86.58 %、特异度为78.92 %、阳性似然比为3.11、阴性似然比为0.23、阳性预测值为93.19 %、阴性预测值为67.42 %及符合率为77.90 %。结论：超声造影联合HE4、CA125及CA153检测对子宫内膜癌诊断价值更高，HE4、CA125及CA153能辅助提高超声造影的诊断效果。 |
| 英文摘要: |
| ABSTRACT Objective: In order to improve the early diagnosis of endometrial cancer, this study studied the diagnostic value of contrast-enhanced ultrasound combined with tumor markers HE4, CA125 and CA153 in endometrial cancer. Methods: Eighty patients with suspected endometrial cancer were taken as the study group, and 80 healthy women who received physical examination in our hospital were taken as the control group. The patients were examined by contrast-enhanced ultrasound, the serum levels of HE4, CA125 and CA153 were compared between the two groups, and the diagnostic effect of contrast-enhanced ultrasound combined with HE4, CA125 and CA153 on endometrial cancer was investigated. Results: Among the 80 suspected patients in this study, 49 were with endometrial cancer and 31 were with endometrial benign lesions. Contrast-enhanced ultrasound showed 41 patients with endometrial cancer and 39 patients with benign lesions, which were compared with the gold standard examination. There are some differences in the results, and simple contrast-enhanced ultrasound has limitations in the diagnosis of endometrial cancer. Patients with endometrial cancer and benign lesions had significant differences in the time of perfusion, enhancement intensity and enhancement average of the lesion area (P<0.05). The serum levels of HE4, CA125 and CA153 in the control group were 82.31±15.45 pmol/mL, 22.31±6.21 U/mL, 16.45±4.91 U/mL, and the serum levels of HE4, CA125 and CA153 in the study group were 159.28±24.01 pmol/mL, respectively. 42.88±5.73 U/mL and 28.30±3.76 U/mL. According to statistics, the indicators of the study group were significantly higher than those of the control group (P<0.05). The sensitivity of contrast-enhanced ultrasound is 79.3 %, the specificity is 67.34 %, the positive likelihood ratio is 2.54, the negative likelihood ratio is 0.25, the positive predictive value is 84.63%, the negative predictive value is 60.51 %, and the coincidence rate is 72.19 %, combined detection The sensitivity is 86.58 %, the specificity is 78.92 %, the positive likelihood ratio is 3.11, the negative likelihood ratio is 0.23, the positive predictive value is 93.19 %, the negative predictive value is 67.42 %, and the coincidence rate is 77.90 %. Conclusion: Contrast-enhanced ultrasound combined with HE4, CA125 and CA153 is more valuable in the diagnosis of endometrial cancer. HE4, CA125 and CA153 can assist in improving the diagnostic effect of contrast-enhanced ultrasound. |
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