本文選題：卵巢癌　切入點(diǎn)：HE4　出處：《山西醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的研究血清人附睪分泌蛋白4(HE4)和糖類抗原125(CA125)的生物學(xué)特性及其在卵巢癌診斷中的臨床意義,同時(shí)聯(lián)合經(jīng)腹部及經(jīng)陰道超聲檢查,探索一種靈敏、準(zhǔn)確且特異性高檢測(cè)方法,探討腫瘤標(biāo)志物血清檢測(cè)及超聲影像兩種檢查方法的相關(guān)性及聯(lián)合檢查敏感度,旨在為提高卵巢癌的期診斷提供科學(xué)的依據(jù)。 方法收集2008年1月至2012年6月在山西省腫瘤醫(yī)院婦科因卵巢占位就診有完整臨床資料并均有組織病理學(xué)確診的卵巢占位患者161例,其中良性腫瘤75例,惡性腫瘤患者86例,健康對(duì)照組150例,采用電化學(xué)發(fā)光法和酶聯(lián)免疫吸附法檢測(cè)良性病變患者、惡性病變患者及健康對(duì)照組血清HE4、CA125水平,同時(shí)收集超聲聲像圖,按照聲像圖特點(diǎn)進(jìn)行評(píng)分。SPSS13.0軟件進(jìn)行統(tǒng)計(jì)學(xué)處理 結(jié)果86例卵巢癌患者血清CA125陽性率為91.9%,HE4陽性率為59.3%,明顯高于75例卵巢良性病變患者的46.7%和4.0%,在卵巢惡性組CA125在各個(gè)分期中的水平比較,各分期之間無明顯差異(P0.05)；HE4在各個(gè)分期中水平比較,對(duì)于Ⅰ期、Ⅱ期和Ⅲ期、Ⅳ期兩者之間有顯著差異(P0.05)。本研究結(jié)果提示,血清HE4聯(lián)合CA125檢測(cè)對(duì)于早期卵巢癌的診斷較在初診卵巢疾病患者中可提供重要的信息。腹部超聲及TRUS檢查卵巢癌患者評(píng)分值為4.89±1.64,敏感度為69.7%,均明顯高于卵巢良性病變組及健康對(duì)照組,經(jīng)統(tǒng)計(jì)學(xué)處理,差異具有顯著性(P0.05)。HE4、CA125、超聲評(píng)分及三者聯(lián)合敏感度分別為75.2%、96.2%、67.9%和98.8%,特異度分別為85.1%、66.7%、61.3%和96.1%,血清CA125、HE4及超聲聯(lián)合檢測(cè)的敏感性及特異性均明顯高于單項(xiàng)檢測(cè),差異有統(tǒng)計(jì)學(xué)意義(P0.05) 結(jié)論血清HE4、CA125聯(lián)合檢測(cè)對(duì)卵巢占位診斷的敏感性和特異性明顯高于各個(gè)單項(xiàng)檢測(cè)。血清HE4水平在卵巢癌分期中有顯著差異,可聯(lián)合CA125對(duì)于卵巢癌患者的分期診斷提供重要提示。超聲聯(lián)合血清HE4、CA125檢查對(duì)卵巢癌診斷的特異性和敏感性明顯高于超聲單項(xiàng)檢查。血清HE4、CA125和超聲聯(lián)合檢查不僅明顯的提高卵巢癌檢出的陽性率和敏感性,為早期診斷卵巢癌提供有效的臨床依據(jù)
[Abstract]:Objective to study the biological characteristics of human epididymal secretory protein (Hepididymis) and carbohydrate antigen 125 (CA125) and its clinical significance in the diagnosis of ovarian cancer, and to explore a sensitive, accurate and specific method for diagnosis of ovarian cancer by transabdominal and transvaginal ultrasound. To explore the correlation and sensitivity of serum detection of tumor markers and ultrasound imaging in order to provide scientific basis for improving the stage diagnosis of ovarian cancer. Methods from January 2008 to June 2012, 161 cases of ovarian occupying were collected from gynecology department of Shanxi Cancer Hospital, including 75 cases of benign tumor and 86 cases of malignant tumor, which had complete clinical data and confirmed by histopathology. Serum levels of HE4CA-125 were detected by electrochemiluminescence and enzyme-linked immunosorbent assay (Elisa) in 150 healthy controls, and ultrasound images were collected at the same time. According to the characteristics of sonogram, the software SPSS 13.0 is used for statistical processing. Results the positive rate of serum CA125 in 86 patients with ovarian cancer was 91.9 and 59.3, which was significantly higher than that in 75 patients with benign ovarian disease (46.7% and 4.0). There was no significant difference among stages (P 0.05) and there was significant difference between stage 鈪，

本文編號(hào)：1579248