本文選題：HE4CA125 + 超聲��； 參考：《大連醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：探討HE4、CA125、超聲在卵巢癌診斷及與卵巢子宮內(nèi)膜異位囊腫（巧囊）鑒別診斷中的臨床應(yīng)用價值 方法：回顧性分析本院卵巢癌患者40例（簡稱卵巢癌組）、巧囊患者70例（簡稱巧囊組）及卵巢良性腫瘤患者62例（簡稱良性腫瘤組）的術(shù)前血清HE4、CA125水平及超聲結(jié)果，與術(shù)后病理診斷的關(guān)系，通過比較其敏感性、特異性探討個指標的臨床價值。 結(jié)果：1.血清CA125水平的中位數(shù)在卵巢癌組、巧囊組、良性腫瘤組分別：334.1u/ml、56.0u/ml、13.5u/ml,兩兩組的相比較，差異均有顯著意義（P0.01）。 2.血清HE4水平的中位數(shù)卵巢癌組、巧囊組、良性腫瘤組分別223.7pmol/l、46.1pmol/l、45.2pmol/l，卵巢癌組高于巧囊組、良性腫瘤組的指標（P0.01），巧囊組與良性腫瘤組的水平比較，差異無統(tǒng)計學(xué)意義（P0.05） 3.超聲在卵巢癌組、巧囊組、良性腫瘤組的符合率為67.5%、95.9%、77.4%，巧囊組的符合率高于卵巢癌與良性腫瘤組的符合率（P0.01）,卵巢癌組與良性腫瘤組相比較，差異無統(tǒng)計學(xué)意義（P0.05）。 4.Ⅰ期卵巢癌患者的HE4、CA125及超聲的陽性率分別為63.6%、81.8%、63.6%，兩兩比較差異統(tǒng)計學(xué)意義（P0.05），Ⅱ期卵巢癌患者的HE4、CA125及超聲的陽性率均為66.7%,兩兩比較差異統(tǒng)計學(xué)意義(P0.05),Ⅲ-Ⅳ期卵巢癌患者的HE4、CA125及超聲的陽性率分別為92.3%、92.3%、69.2%，兩兩比較差異無統(tǒng)計學(xué)意義（P0.05）。 5.診斷卵巢癌方面，CA125單項檢測的靈敏度上均高于HE4和超聲，HE4單檢測的特異度、準確率上均高于超聲及CA125；診斷巧囊方面上，超聲單項檢測的靈敏度和準確率上高于HE4和CA125，三者聯(lián)合檢測的靈敏度、特異度及準確率均高于三項中任意一項單檢的指標。 結(jié)論：1.HE4在卵巢癌診斷及鑒別診斷的特異度和準確度高于超聲和CA125，在診斷巧囊上，，超聲診斷的準確性比HE4和CA125均高。 2.三者聯(lián)合檢測較單項檢測時，可進一ki提高卵巢癌診斷和鑒別診斷的準確率。
[Abstract]:Objective: To investigate the clinical value of HE4, CA125 and ultrasonography in the differential diagnosis of ovarian cancer and ovarian endometriosis cyst.
Methods: 40 cases of ovarian cancer, 70 cases of ovarian cancer, 62 cases of ovarian benign tumors and 62 cases of benign ovarian tumors (benign tumor group) were analyzed retrospectively. The relationship between the preoperative serum levels and the results of CA125 and ultrasound and the postoperative pathological diagnosis were compared. By comparing their sensitivity and specificity, the clinical price of the index was discussed. Value.
Results: 1. the median of serum CA125 levels in the ovarian cancer group, the ingenious capsule group and the benign tumor group: 334.1u/ml, 56.0u/ml, 13.5u/ml, and the 22 groups were significantly different (P0.01).
2. the serum HE4 level in the median ovarian cancer group, the cyst group, the benign tumor group 223.7pmol/l, the 46.1pmol/l, the 45.2pmol/l, the ovarian cancer group is higher than the clever capsule group, the benign tumor group index (P0.01), the comparison between the skillful capsule group and the benign tumor group, the difference is not statistically significant (P0.05).
The coincidence rate of 3. ultrasound in ovarian cancer group, ingenious capsule group and benign tumor group was 67.5%, 95.9%, 77.4%. The coincidence rate of ovarian cancer group was higher than that of ovarian cancer and benign tumor group (P0.01). There was no statistical difference between ovarian cancer group and benign tumor group (P0.05).
The positive rates of HE4, CA125 and ultrasound in 4. stage ovarian cancer patients were 63.6%, 81.8%, 63.6% and 22, respectively (P0.05). The positive rates of HE4, CA125 and ultrasound in stage II ovarian cancer patients were 66.7%, 22 were statistically significant (P0.05). The positive rates of HE4, CA125 and ultrasound in stage III - IV ovarian cancer patients were 9, respectively. The difference between 2.3%, 92.3%, 69.2% and 22 was not statistically significant (P0.05).
5. in the diagnosis of ovarian cancer, the sensitivity of single detection of CA125 was higher than that of HE4 and ultrasound. The specificity and accuracy of HE4 single detection were higher than that of ultrasound and CA125; the sensitivity and accuracy of single detection were higher than HE4 and CA125, and the sensitivity, specificity and accuracy of the combined detection were higher than those of three. An indicator of a single check.
Conclusion: the specificity and accuracy of 1.HE4 in the diagnosis and differential diagnosis of ovarian cancer are higher than that of ultrasound and CA125, and the accuracy of ultrasonic diagnosis is higher than that of HE4 and CA125 in the diagnosis of skillful sacs.
2. the combined detection of three can increase the accuracy of diagnosis and differential diagnosis of ovarian cancer by one ki.

【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R737.31

【參考文獻】

相關(guān)期刊論文 前2條

1 陳學(xué)軍;鄭偉;王良;張翔;;卵巢子宮內(nèi)膜異位囊腫患者血清CA 125及臨床相關(guān)因素分析[J];中國婦幼保健;2008年04期

2 朱蘭;腫瘤標記物在婦科領(lǐng)域中的應(yīng)用[J];中國實驗診斷學(xué);2002年05期

本文編號：1795463