本文選題：腫瘤標(biāo)記物 + 上皮性卵巢癌　； 參考：《新疆醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:研究常用腫瘤標(biāo)記物CA125、CA199、HE4和LDH單項(xiàng)及聯(lián)合檢測(cè)在卵巢良惡性腫瘤鑒別診斷中的臨床價(jià)值。方法:用化學(xué)發(fā)光微粒子免疫檢測(cè)法和酶速率法檢測(cè)新疆醫(yī)科大學(xué)附屬腫瘤醫(yī)院在2013年1月~2015年12月期間收治的220例上皮性卵巢癌、78例卵巢上皮性交界性腫瘤、120例卵巢成熟性畸胎瘤和162例卵巢子宮內(nèi)膜異位囊腫患者術(shù)前血清中腫瘤標(biāo)記物濃度。結(jié)果:(1)上皮性卵巢癌組的CA125、CA199、HE4和LDH平均濃度水平顯著高于其它三組(P0.05)。(2)HE4診斷上皮性卵巢癌的靈敏度為73.18%,特異度為98.89%,Youden指數(shù)為72.07%,ROC曲線下面積為0.952,綜合其他評(píng)價(jià)指標(biāo)可得出HE4診斷能力最好。(3)CA125、CA199、HE4、LDH四項(xiàng)聯(lián)合檢測(cè)診斷上皮性卵巢癌的靈敏度為97.73%,特異度為25.00%,ROC曲線下面積為0.973,其診斷價(jià)值最高。(4)CA125、HE4診斷卵巢漿液性腺癌和卵巢子宮內(nèi)膜樣癌的靈敏度較高,CA199診斷卵巢黏液性腺癌和卵巢透明細(xì)胞癌的靈敏度較高,而LDH診斷各病理類型的上皮性卵巢癌的靈敏度均不高。(5)CA125、CA199和HE4診斷早期上皮性卵巢癌的靈敏度較高,而LDH的靈敏度較低。(6)CA125、CA199診斷卵巢上皮性交界性腫瘤和卵巢子宮內(nèi)膜異位囊腫的靈敏度和特異度較高,CA199診斷卵巢成熟性畸胎瘤的靈敏度和特異度高于CA125。(7)CA125、CA199聯(lián)合檢測(cè)提高了診斷卵巢上皮性交界性腫瘤、卵巢成熟性畸胎瘤和卵巢子宮內(nèi)膜異位囊腫的靈敏度。結(jié)論:(1)CA125、CA199、HE4、LDH四項(xiàng)聯(lián)合檢測(cè)是診斷上皮性卵巢癌比較理想的腫瘤標(biāo)記物組合。(2)CA125、CA199聯(lián)合檢測(cè)能提高對(duì)卵巢上皮性交界性腫瘤、卵巢成熟性畸胎瘤和卵巢子宮內(nèi)膜異位囊腫的診斷能力。
[Abstract]:Objective: To study the clinical value of the common tumor markers CA125, CA199, HE4 and LDH in the differential diagnosis of ovarian benign and malignant tumors. Methods: 220 cases of epithelial ovary in the Affiliated Cancer Hospital of Xinjiang Medical University were detected by the chemiluminescent particle immunoassay and enzyme rate method in the December ~2015 January 2013. Cancer, 78 cases of ovarian epithelial borderline tumors, 120 cases of ovarian mature teratoma and 162 cases of ovarian endometriosis cysts before operation, the concentration of tumor markers in serum. Results: (1) the level of CA125, CA199, HE4 and LDH in the epithelial ovarian cancer group was significantly higher than that of its three groups (P0.05). (2) the sensitivity of HE4 to the diagnosis of epithelial ovarian cancer. The specificity was 73.18%, the specificity was 98.89%, the Youden index was 72.07%, the area under the ROC curve was 0.952. The best diagnostic ability of the HE4 was best. (3) CA125, CA199, HE4, LDH four combined detection for the diagnosis of epithelial ovarian cancer was 97.73%, the specificity was 25%, the area under the ROC curve was 0.973, and the diagnostic value was the highest. (4) CA125, HE4 The sensitivity of the diagnosis of ovarian serous adenocarcinoma and ovarian endometrioid carcinoma is high. The sensitivity of CA199 in the diagnosis of ovarian mucinous and ovarian clear cell carcinoma is high, while the sensitivity of LDH in the diagnosis of epithelial ovarian cancer is not high. (5) CA125, CA199 and HE4 are sensitive to the early diagnosis of epithelial ovarian cancer, and the spirit of LDH is very high. The sensitivity and specificity of CA199 in the diagnosis of ovarian epithelial borderline tumors and ovarian endometriosis cysts were higher (6) (6). The sensitivity and specificity of CA199 for the diagnosis of ovarian mature teratoma were higher than that of CA125. (7) CA125. The combined detection of CA199 enhanced the diagnosis of ovarian epithelial borderline tumors, ovarian mature teratoma, and the diagnosis of ovarian mature teratoma. The sensitivity of ovarian endometriosis cysts. Conclusion: (1) the combined detection of CA125, CA199, HE4, and LDH is an ideal combination of tumor markers for the diagnosis of epithelial ovarian cancer. (2) the combined detection of CA125 and CA199 can improve the diagnostic ability of ovarian epithelial borderline tumors, ovarian mature teratoma and ovarian endometriosis cysts.

【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R737.31

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