本文選題：卵巢腫瘤 + 磁共振成像　； 參考：《蘭州大學》2014年碩士論文

【摘要】：目的：探討MRI、血清人附睪分泌蛋白4在卵巢交界性腫瘤與Ⅰ期上皮性卵巢癌鑒別診斷中的價值。 方法：收集經(jīng)手術病理證實的卵巢交界性腫瘤32例,Ⅰ期卵巢癌24例,觀察腫瘤的MRI表現(xiàn),內容包括腫瘤位置、大小、分隔數(shù)和分隔厚度、結節(jié)或乳頭狀突起(實性成分)的最大徑、有無腹膜種植及腹水,并檢測所有患者術前血清HE4含量。計量資料采用獨立樣本t檢驗；計數(shù)資料采用X2檢驗,當有理論頻數(shù)1或所得概率接近檢驗水平時,采用Fisher確切概率法檢驗。實性成分最大徑、分隔厚度、實性成分和厚分隔對應的血清HE4鑒別兩組腫瘤的最佳臨界值及其敏感度、特異度采用ROC曲線分析；實性成分、厚分隔和血清HE4診斷卵巢交界性腫瘤和Ⅰ期卵巢癌的總確診率采用Logistic回歸分析。 結果：(1)兩組腫瘤位置、大小、分隔數(shù)差異無統(tǒng)計學意義,實性成分、厚分隔率的差異有統(tǒng)計學意義(P0.05),實性成分的最大徑、分隔厚度差異有統(tǒng)計學意義(P0.05)。(2)雙側分布、大小、分隔數(shù)分別對應的兩組腫瘤血清HE4含量差異無統(tǒng)計學意義；出現(xiàn)實性成分、厚分隔的Ⅰ期卵巢癌組血清HE4含量明顯高于卵巢交界性腫瘤組(P0.05)；ROC曲線分析得出實性成分和厚分隔對應的血清HE4鑒別兩組腫瘤的最佳臨界值及其敏感度、特異度分別為108.95pmol/L、58%、87%,105.42pmol/L、55%、84%。Logistic回歸分析得出實性成分、厚分隔、HE4含量診斷兩組腫瘤的總確診率為78.6%(卵巢交界性腫瘤組為75.0%,Ⅰ期卵巢癌組為83.3%)。 結論：MRI能為卵巢交界性腫瘤與Ⅰ期卵巢癌鑒別診斷提供一定的信息,Ⅰ期卵巢癌出現(xiàn)實性成分和厚分隔的概率高于卵巢交界性腫瘤,Ⅰ期卵巢癌實性成分的最大徑、分隔厚度大于卵巢交界性腫瘤。Ⅰ期卵巢癌實性成分、厚分隔對應的血清HE4含量高于卵巢交界性腫瘤,MRI表現(xiàn)結合血清HE4含量有助于卵巢交界性腫瘤與Ⅰ期卵巢癌的術前鑒別診斷。
[Abstract]:Objective: to investigate the value of MRI and human epididymal secretory protein 4 in differential diagnosis of ovarian borderline tumor and stage I epithelial ovarian carcinoma. Methods: 32 cases of borderline ovarian tumors and 24 cases of stage I ovarian cancer were collected. The MRI findings of the tumors, including tumor location, size, number of separations and thickness of septum, were observed. The largest diameter of nodules or papillary processes (solid components), with or without peritoneal implants and ascites, and serum HE4 levels were measured in all patients before operation. The measurement data are tested by independent sample t test, and the counting data by X2 test. When the theoretical frequency is 1 or the probability is close to the test level, the exact probability method of Fisher is used. The maximum diameter, septal thickness, solid component and thick-spaced serum HE4 were used to identify the optimal critical value and sensitivity of the two groups of tumors. The specificity was analyzed by ROC curve. The total diagnostic rate of ovarian borderline tumor and stage I ovarian cancer with thick septum and serum HE4 was analyzed by Logistic regression analysis. Results (1) there was no significant difference in tumor location, size and septal number between the two groups. There were significant differences in solid component and thick septal rate between the two groups (P 0.05). The maximum diameter of solid component and the difference in thickness between the two groups were statistically significant. There was no significant difference in serum HE4 content between the two groups. The level of serum HE4 in stage I ovarian cancer with thick separation was significantly higher than that in borderline ovarian tumor group (P 0.05). The optimal critical value and sensitivity of solid component and serum HE4 corresponding to thick separation were obtained. The specificity was 108.95 pmol / L ~ (58) and 105.42 pmol / L ~ 5555 ~ (55) ~ (84). Logistic regression analysis showed that the total diagnosis rate of the two groups was 78.6% (75.0% in ovarian borderline tumor group, 83.3% in stage I ovarian cancer group). Conclusion the differential diagnosis of ovarian borderline tumor and stage I ovarian cancer can be provided by Mr imaging. The probability of realistic components and thick separation in stage I ovarian cancer is higher than that in borderline ovarian tumor, and the maximum diameter of solid component in stage 鈪，

本文編號：1939835