超声引导下穿刺活检联合肿瘤标志物检查用于卵巢相关疾病诊断的探究
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摘要
目的探讨分析超声引导下穿刺活检联合肿瘤标志物检查对卵巢相关疾病诊断的应用价值。方法选择2015年5月至2017年5月海南西部中心医院进行彩色B超检查疑似卵巢肿瘤的87例患者为研究对象。87例患者均采取超声引导下穿刺活检和血清肿瘤标志物CA199、CA125、CEA水平检查,以患者手术病理检查结果作为金标准,分析超声引导下穿刺活检与肿瘤标志物检查对卵巢良恶性肿瘤的诊断价值。结果超声仪引导下穿刺病理检查结果与手术病理检查结果相符率为96.6%;以手术病理检查结果为标准,比较卵巢良性和恶性肿瘤患者的血清肿瘤标志物水平,结果显示,良性肿瘤患者CA125、CA199水平均显著低于恶性肿瘤患者(P<0.05)。受试者工作特征曲线(Receiver operating characteristic, ROC)分析结果显示,超声引导下穿刺活检ROC曲线下面积为0.961,肿瘤标志物ROC曲线下面积为0.816,两者联合ROC曲线下面积为0.987。结论超声引导下穿刺活检鉴别诊断卵巢良恶性肿瘤诊断符合率高,配合血清肿瘤标志物筛查,有助于临床诊断效能的提高,值得临床推广。
Objective To explore the diagnostic value of ultrasound guided biopsy combined with tumor markers in the diagnosis of ovarian related diseases. Methods 87 suspected patients with ovarian tumor underwent color ultrasound in the Western Central Hospital of Hainan from May 2015 to May 2017 were selected. All the patients received ultrasound guided biopsy and detection of serum tumor markers CA199, CA125 and CEA levels with surgical and pathological examination results as the gold standard to analyze the diagnostic value of ultrasound guided biopsy and tumor markers examination in benign and malignant ovarian neoplasms. Results The consistent rate between ultrasound guided biopsy results and pathological results was 96.6%. The serum tumor markers in ovarian benign and malignant tumors were compared according to surgical pathology results. The results showed that the levels of CA125 and CA199 in benign group were significantly lower than those in malignant group(P<0.05). Receiver operating characteristic(ROC) analysis showed that the area under the ROC curve in ultrasound guided biopsy was 0.961, and that in tumor marker was 0.816, and the area in the ultrasound guided biopsy combined with tumor marker was 0.987. Conclusions Ultrasound guided biopsy is of high diagnostic accuracy in differentiating benign and malignant ovarian tumors, which combined with serum tumor markers is helpful for the improvement of clinical diagnostic efficiency and worthy of clinical promotion.
Objective To explore the diagnostic value of ultrasound guided biopsy combined with tumor markers in the diagnosis of ovarian related diseases. Methods 87 suspected patients with ovarian tumor underwent color ultrasound in the Western Central Hospital of Hainan from May 2015 to May 2017 were selected. All the patients received ultrasound guided biopsy and detection of serum tumor markers CA199, CA125 and CEA levels with surgical and pathological examination results as the gold standard to analyze the diagnostic value of ultrasound guided biopsy and tumor markers examination in benign and malignant ovarian neoplasms. Results The consistent rate between ultrasound guided biopsy results and pathological results was 96.6%. The serum tumor markers in ovarian benign and malignant tumors were compared according to surgical pathology results. The results showed that the levels of CA125 and CA199 in benign group were significantly lower than those in malignant group(P<0.05). Receiver operating characteristic(ROC) analysis showed that the area under the ROC curve in ultrasound guided biopsy was 0.961, and that in tumor marker was 0.816, and the area in the ultrasound guided biopsy combined with tumor marker was 0.987. Conclusions Ultrasound guided biopsy is of high diagnostic accuracy in differentiating benign and malignant ovarian tumors, which combined with serum tumor markers is helpful for the improvement of clinical diagnostic efficiency and worthy of clinical promotion.
引文
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[13] 侯娟娟,虎淑妍,刘婷婷,等.血清肿瘤标志物在卵巢癌早期诊断中的临床价值[J].中国免疫学杂志,2014,30(8):1101-1104,1107.
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[15] Kulkarni-Datar K,Orsulic S,Foster R,et al.Ovarian tumor initiating cell populations persist following paclitaxel and carboplatin chemotherapy treatment in vivo[J].Cancer Lett,2013,339(2):237-246.
[16] 王劲松,李青,程雪,等.HNF-1β和Napsin A联合检测在卵巢透明细胞癌诊断中的价值[J].中华病理学杂志,2015,44(12):874-878.
[17] Vranes HS,Klaric′ P,Kuna K,et al.Detection of ovarian cancer by determination of CA 125 in different patohistologycal types of tumor according to age[J].Coll Antropol,2012,36(2):425-429.
[18] 宋晓翠,滕洪涛,张建海,等.联合检测血清HE4和CA125在卵巢癌早期诊断及病情监测中的价值[J].实用医学杂志,2012,28(14):2380-2382.
[19] Cai Y,Zhai JJ,Feng BB,et al.Expression of glucose transporter protein 1 and p63 in serous ovarian tumor[J].J Obstet Gynaecol Res,2014,40(7):1925-1930.
[20] 周小铃,谈思维.各期卵巢恶性肿瘤诊断中肿瘤标志物联合检测的意义[J].国际检验医学杂志,2016,37 (12):1685-1687.
[2] Zhang F,Zhang ZL.The diagnostic value oftransvaginal sonograph (TVS),color Doppler,and serum tumor marker CA125,CEA,and AFP in ovarian cancer[J].Cell Biochem Biophys,2015,72(2):353-357.
[3] Taskinen S,Fagerholm R,Lohi J,et al.Pediatric ovarian neoplastic tumors:Incidence,age at presentation,tumor markers and outcome[J].Acta Obstet Gynecol Scand,2015,94(4):425-429.
[4] 齐冬雪,张春芳,张昶,等.SALL4、CD30、D2-40和glypican-3在卵巢生殖细胞肿瘤中的表达及应用[J].诊断病理学杂志,2017,24(5):358-362.
[5] 邵海玲,肖庆,卢琳,等.彩色多普勒超声联合肿瘤标志物CA125、CA724对卵巢良恶性肿瘤的鉴别诊断价值[J].现代肿瘤医学,2017,25(14):2314-2317.
[6] Lu J,Li XF,Kong LX,et al.Expression and significance of cyclooxygenase-2 mRNA in benign and malignant ascites[J].World J Gastroenterol,2013,19(40):6883-6887.
[7] Sang M,Wu X,Fan X,et al.Multiple MAGE-A genes as surveillance marker for the detection of circulating tumor cells in patients with ovarian cancer[J].Biomarkers,2014,19(1):34-42.
[8] 荣秀娟.卵巢交界性肿瘤的研究进展[J].肿瘤研究与临床,2017,29(10):714-717.
[9] Roy L,Samyesudhas SJ,Carrasco M,et al.ARID3B increases ovarian tumor burden and is associated with a cancer stem cell gene signature[J].Oncotarget,2014,5(18):8355-8366.
[10] 刘凯,夏进东.MRI联合血清Caspase-3含量检测在卵巢囊腺肿瘤良恶性诊断中的意义[J].河北医学,2016,22(5):753-755.
[11] Horta M,Cunha TM,Marques RC,et al.Ovarian sertoli-leydig cell tumor with heterologous elements of gastrointestinal type associated with elevated serum alpha-fetoprotein level:An unusual case and literature review[J].J Radiol Case Rep,2014,8(11):30-41.
[12] 陈慧,王晶.卵巢交界性肿瘤的临床特征及诊治进展[J].现代肿瘤医学,2015,23(17):2525-2528.
[13] 侯娟娟,虎淑妍,刘婷婷,等.血清肿瘤标志物在卵巢癌早期诊断中的临床价值[J].中国免疫学杂志,2014,30(8):1101-1104,1107.
[14] Shaaban AM,Rezvani M,Elsayes KM,et al.Ovarian malignant germ cell tumors:Cellular classification and clinical and imaging features[J].Radiographics,2014,34(3):777-801.
[15] Kulkarni-Datar K,Orsulic S,Foster R,et al.Ovarian tumor initiating cell populations persist following paclitaxel and carboplatin chemotherapy treatment in vivo[J].Cancer Lett,2013,339(2):237-246.
[16] 王劲松,李青,程雪,等.HNF-1β和Napsin A联合检测在卵巢透明细胞癌诊断中的价值[J].中华病理学杂志,2015,44(12):874-878.
[17] Vranes HS,Klaric′ P,Kuna K,et al.Detection of ovarian cancer by determination of CA 125 in different patohistologycal types of tumor according to age[J].Coll Antropol,2012,36(2):425-429.
[18] 宋晓翠,滕洪涛,张建海,等.联合检测血清HE4和CA125在卵巢癌早期诊断及病情监测中的价值[J].实用医学杂志,2012,28(14):2380-2382.
[19] Cai Y,Zhai JJ,Feng BB,et al.Expression of glucose transporter protein 1 and p63 in serous ovarian tumor[J].J Obstet Gynaecol Res,2014,40(7):1925-1930.
[20] 周小铃,谈思维.各期卵巢恶性肿瘤诊断中肿瘤标志物联合检测的意义[J].国际检验医学杂志,2016,37 (12):1685-1687.
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