现代妇产科进展2018，Vol.27Issue(1)：23-27,5.DOI:10.13283/j.cnki.xdfckjz.2018.01.006
CA125/HE4和超声影像指标在不同类型盆腔包块的分布特征及恶性风险中的评估价值
The distribution features of CA125/HE4 with ultrasonography in pelvic mass and malig-nant risk evaluation of ovarian cancer
摘要
Abstract
Objective:To observe the malignant predictive value of serum CA125/HE4 combined with ultrasonic imaging index for different types of pelvic mass,and to explore the op-timal assessment of the risk of ovarian cancer. Methods:The surgery cases of pelvic mass, in Gynecology Department of Southwest Hospital from Jan. 2015 to June 2016,were analyzed ret-rospectively. Based on the postoperative pathologic results,305 cases were divided into three groups:benign (223 cases),borderline tumor(12 cases) and ovarian cancer(70 cases). The sensitivity and specificity of CA125/HE4 and ultrasonic imaging for predicting malignant risk were evaluated. Results:CA125 and HE4 in epithelial ovarian cancer group increased statisti-cally compared with those in benign and non-epithelial ovarian cancer group ( P<0 . 001 ) . CA125 and HE4 had no statistically significant difference between benign and non-epithelial o-varian cancer group ( P>0 . 05 ) . CA125 in borderline group had no statistically difference com-pared with that in ovarian cancer group (P=0. 31),but HE4 values in borderline group were significantly lower than that in ovarian cancer group ( P<0 . 05 ) . Without HE4 elevated or CA125 increased in endometriosis cysts,there existed statistical difference between endometrio-sis cysts and epithelial ovarian cancer ( P<0 . 001 ) . Ultrasonic imaging indicators including in-ternal blood flow,papilla structure,solid tissue,ascites,diameter>100mm and multiple cysts, had negative risk predictive value from 78. 0％ to 86. 9％. The specificities of the ascites,inter-nal blood flow,and papilla structure were more than 90％. Combined indicators of ultrasonic im-ages and serum,the premenopause logistic model of the risk of ovarian cancer was established. Conclusions:Increased CA125 and HE4 were mainly in epithelial ovarian cancer and border-line group,which could distinguish them accurately away from benign pelvic mass. For endome-triosis cyst,HE4 could be used as an identification predictor of malignance risk in that it only had CA125 increase. In spite of low sensitivity,ultrasonic indicators had high negative risk pre-dictive value and specificity to distinguish malignance. The predictive premenopausal model es-tablished is operationally friendly and practical for malignant risk evaluation.关键词
盆腔包块/CA125/HE4/超声影像/恶性风险Key words
Pelvic mass/CA125/HE4/Ultrasonography/Malignant risk分类
医药卫生引用本文复制引用
何海洋,凌开建,阎萍,李宇迪,梁志清..CA125/HE4和超声影像指标在不同类型盆腔包块的分布特征及恶性风险中的评估价值[J].现代妇产科进展,2018,27(1):23-27,5.基金项目
重庆市科学技术项目:社会事业与民生保障科技创新专项(一般)(No:cstc2015shmszx0440) （一般）
