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

【摘要】：目的:探討新型腫瘤標記物HE4聯(lián)合CA125及彩色多普勒超聲診斷上皮性卵巢癌的臨床價值,以及HE4在不同陽性區(qū)間的診斷意義。方法:嚴格按照納入及排除標準選取在2013年1月至2016年1月在新疆醫(yī)科大學第一附屬醫(yī)院婦科病區(qū)接受手術治療并根據(jù)術后常規(guī)病理檢查結果確診為卵巢上皮性腫瘤的207例患者作為研究對象,其中卵巢惡性腫瘤組73例、卵巢良性腫瘤組93例、交界性腫瘤組41例,對所有病人術前檢測的血清腫瘤標記物及彩色多普勒超聲結果進行回顧性分析。結果:HE4、CA125及彩色多普勒超聲檢查結果在惡性組中的陽性率明顯高于良性組,差異有統(tǒng)計學意義(分別為2cHE4=80.38,P0.005;2cCA125=93.02,P0.005;2c超聲=31.48,P0.005);HE4、CA125及彩色多普勒超聲檢查單獨診斷上皮性卵巢癌的靈敏度、特異度、準確度、陽性預測值、陰性預測值分別是75.34%、92.47%、84.94%、88.71%、82.69%;90.41%、84.95%、87.35%、82.50%、91.86%及73.97%、69.89%、71.67%、65.85%、77.38%。三者聯(lián)合診斷上皮性卵巢癌的靈敏度、特異度、準確度、陽性預測值、陰性預測值分別是98.63%、54.84%、74.10%、63.16%、98.08%。當HE4值大于105.10 pmol/L時,卵巢惡性腫瘤組所占比例大于卵巢良性腫瘤組,差異有統(tǒng)計學意義(2c=7.22,P0.005)。結論:新型血清腫瘤標記物HE4聯(lián)合CA125及彩色多普勒超聲可顯著提高術前診斷卵巢癌的正確性,減少漏誤診率,對早期篩查和診斷卵巢癌、從而及時治療并改善預后有著重要的臨床價值。
[Abstract]:Objective: to evaluate the clinical value of new tumor marker HE4 combined with CA125 and color Doppler ultrasound in the diagnosis of epithelial ovarian cancer and the diagnostic significance of HE4 in different positive regions. Methods: from January 2013 to January 2016, the patients received surgical treatment in the gynecological ward of the first affiliated Hospital of Xinjiang Medical University according to the inclusion and exclusion criteria, and were diagnosed as ovarian epithelium according to the results of postoperative routine pathological examination. A total of 207 cancer patients were included in the study. There were 73 cases of ovarian malignant tumor, 93 cases of benign ovarian tumor and 41 cases of borderline tumor. The results of serum tumor markers and color Doppler ultrasound were analyzed retrospectively. Results the positive rate in malignant group was significantly higher than that in benign group. The difference was statistically significant (2cHE4H _ 4, 80.38, P 0.005 ~ (0.005), P _ (0.005) P _ (0.005), P _ (0.005) ~ (2c), the sensitivity and specificity of color Doppler ultrasound in diagnosing epithelial ovarian cancer, respectively. The accuracy, the positive predictive value, the negative predictive value were 75.34 and 92.477.94, respectively. They were 88.71and 82.690.491.90.41 and 87.35m 82.5091.86% and 73.97765.8577.8577.38. respectively. The results showed that the accuracy, the positive predictive value and the negative predictive value were 88.71% and 84.95%, 87.35%, 82.50% and 77.38%, respectively, and 73.97%, 65.85% and 77.38%, respectively. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the three diagnostic methods were 98.63 and 54.84 respectively. When the HE4 value was more than 105.10 pmol/L, the proportion of ovarian malignant tumor group was larger than that of ovarian benign tumor group, and the difference was statistically significant (P 0.005). Conclusion: the new serum tumor marker HE4 combined with CA125 and color Doppler ultrasound can significantly improve the accuracy of preoperative diagnosis of ovarian cancer, reduce the rate of misdiagnosis, early screening and diagnosis of ovarian cancer. It has important clinical value to treat and improve prognosis in time.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R737.31

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