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目的探讨二维超声、彩色多普勒血流显像检查与血清CA125、CA199联合检测对卵巢上皮性癌的诊断价值。方法选取2004年6月至2008年6月上海交通大学医学院附属仁济医院妇产科收治的卵巢上皮性肿瘤患者115例,行二维超声、彩色多普勒血流检查,同时用化学发光法检测CA125、CA199水平,并将诊断结果与病理结果进行对照。结果CA125+CA199、CA125+CA199+阻力指数(RI)、CA125+CA199+超声评分(U)、CA125+CA199+RI+U联检良恶性肿瘤的敏感性分别为78.0%、86.4%、86.4%、91.5%,CA125、CA199、RI、U单检的敏感性分别为62.7%、39.0%、69.5%、61.0%,联检与单检敏感性比较,差异有统计学意义(P<0.05)。联检与病理结果的一致性和临床诊断价值也较各指标单检高,CA125、CA199、RI和U联检可提高Ⅰ～Ⅱ期卵巢上皮性癌及黏液性囊腺癌、透明细胞癌的敏感性;恶性风险指数(RMI)对卵巢上皮性癌的临床价值也较高。结论血清肿瘤标志物与二维超声、彩色多普勒血流显像联合应用能够进一步提高诊断的敏感性或特异性,并可检出更多的早期卵巢癌,RMI有望成为其联合的参考模式。
Objective To investigate the diagnostic value of two-dimensional ultrasonography, color Doppler flow imaging and serum CA125, CA199 in the diagnosis of epithelial ovarian cancer. Methods From June 2004 to June 2008, 115 cases of epithelial ovarian cancer patients admitted to Department of Obstetrics and Gynecology, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were examined by two-dimensional ultrasonography and color Doppler flow cytometry with chemiluminescence France detection of CA125, CA199 levels, and the diagnostic results and pathological results were compared. Results The sensitivity of combined detection of CA125 + CA199, CA125 + CA199 + RI, CA125 + CA199 + ultrasound, CA125 + CA199 + RI + U were 78.0%, 86.4%, 86.4%, 91.5% , CA125, CA199, RI and U were 62.7%, 39.0%, 69.5% and 61.0% respectively. There was a significant difference between the two groups (P <0.05). Coincide and pathological results of the consistency and clinical diagnostic value than the index single check high, CA125, CA199, RI and U joint examination can improve Ⅰ ~ Ⅱ ovarian epithelial carcinoma and mucinous cystadenocarcinoma, clear cell carcinoma sensitivity ; Malignant risk index (RMI) of epithelial ovarian cancer is also of high clinical value. Conclusion Combined application of serum tumor markers and two-dimensional ultrasound and color Doppler flow imaging can further improve the sensitivity or specificity of diagnosis and detect more early ovarian cancer, and RMI is expected to become its joint reference model .