摘要
目的 明确诊断卵巢交界性肿瘤(BOT)、Ⅰ期上皮性卵巢癌(EOC),对临床选择治疗方式有关键意义。本研究以动态增强磁共振(DCE-MRI)参数结合糖类抗原199(CA199)、CA125、(HE4)人附睾蛋白4鉴别诊断BOT与Ⅰ期EOC,分析其临床应用的可行性。方法 收集2018年1月—2022年4月阜阳市肿瘤医院收治BOT患者95例(BOT组),I期EOC患者62例(EOC组)。对比2组DCE-MRI征象、定量参数及CA199、CA125、HE4表达水平,并分析不同检查对BOT与Ⅰ期EOC的诊断效果。结果 2组常规形态学比较差异无统计学意义(均P>0.05);EOC组达峰时间(TTP)值低于BOT组,对比剂最大浓度(Cmax)、AUC、最大线性斜率(MS)值均高于BOT组(均P<0.05)。EOC组CA125、HE4、CA199表达水平均高于BOT组(均P<0.05)。ROC曲线结果显示:DCEMRI参数(TTP、Cmax、AUC、MS)和CA199、CA125、HE4对BOT与Ⅰ期EOC鉴别曲线下面积(AUC)分别为0.789、0.682、0.799、0.786、0.792、0.789、0.816,联合诊断的AUC值为0.956,高于四者单独诊断(P<0.05),联合诊断灵敏度、特异度分别为97.60%、94.80%。结论 BOT与Ⅰ期EOC在DCE-MRI参数及CA199、CA125、HE4表达水平中存在差异,DCE-MRI联合血清学指标对两者鉴别诊断可行性高。
Objective Diagnosis of borderline ovarian tumor(BOT)and stage I epithelial ovarian cancer(EOC)is of key significance for clinical selection of treatment.In this study,dynamic enhanced MRI(DCE-MRI)parameters combined with glycoantigen 199(CA199),CA125,and human epididymal protein 4(HE4)were used to dfferentially diagnose BOT and stage I EOC,and analyze the feasibility of the clinical application.Methods A total of 95 BOT patients admitted to Fuyang Cancer Hospital from January 2018 to April 2022 were collected as BOT group,and 62 stage I EOC patients were collected as EOC group.The DCE-MRI signs,quantitative parameters,and expression levels of CA199,CA125,and HE4 were compared between the two groups,and the diagnostic effects of different examinations on BOT and stage I EOC were analyzed.Results There was no difference in conventional morphology between the two groups(all P>0.05).The time to peak(TTP)values of EOC group were lower than those of BOT group,while the contrast agent maximum concentration(Cmax),area under curve(AUC)and maximum linear slope(MS)values of EOC group were higher than those of BOT group(all P<0.05).Expression levels of CA125,HE4 and CA199 in EOC group were higher than those in BOT group(all P<0.05).ROC curve results show DCE-MRI parameters(TTP,Cmax,AUC,MS)combined with CA199,CA125,HE4 for BOT and Stage I EOC were 0.789,0.682,0.799,0.786,0.792,0.789,0.816,respectively.The AUC value of combined diagnosis was 0.956,which was higher than that of the four patients diagnosed alone(P<0.05).The sensitivity and specificity of combined diagnosis were 97.60%and 94.80%,respectively.Conclusion There are differences in DCE-MRI parameters and CA199,CA125,HE4 expression levels between BOT and stage I EOC,and DCE-MRI combined with serological indicators is highly feasible for the differential diagnosis of the two.
作者
李兴武
叶国柳
LI Xingwu;YE Guoliu(Department of Oncology and Gynecology,Fuyang Cancer Hospital,Fuyang,Anhui 236000,China;不详)
出处
《中华全科医学》
2023年第9期1512-1515,1519,共5页
Chinese Journal of General Practice
基金
安徽省高校科研项目(2022AH051428)。
关键词
动态增强磁共振
血清因子
卵巢交界性肿瘤
Ⅰ期上皮性卵巢癌
Dynamic contrast-enhanced magnetic resonance
Serum factors
Ovarian borderline tumors
Stage I epithelial ovarian cancer
作者简介
通信作者:叶国柳,E-mail:657406599@qq.com。
