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目的研究术前超声联合肿瘤标志物预测附件包块良恶性质的临床价值。方法回顾性分析2009年1月至2010年10月间,于同济大学附属第一妇婴保健院收治的475例附件包块患者,术前超声评估附件包块性质(包括肿块大小,回声性质和血流信号)和肿瘤标志物(CA125、CA199、AFP、CEA和CA153)检查,与最终手术病理结果比较。结果手术石蜡病理提示卵巢恶性肿瘤100例,交界性肿瘤50例,良性肿瘤325例。术前超声提示囊性肿块183例,其中良性144例(78.7%)、恶性19例(10.4%);超声提示混合性肿块247例,其中良性160例(64.8%)、恶性58例(23.5%);超声提示实性肿块45例,其中良性21例(46.7%)、恶性23例(51.1%)。超声提示混合性或实性肿块与囊性肿块相比,卵巢恶性肿瘤病率显著增加(27.7%vs.10.4%)(P<0.001)。提出卵巢肿瘤预测模型1、2、3,模型1:CA125≥35kU/L+超声混合或实性;模型2:CA125≥100kU/L+超声混合或实性;模型3:CA125≥35kU/L+CA199≥37kU/L+超声混合或实性。结论超声提示附件混合性或实性包块同时合并CA125升高者,卵巢恶性肿瘤发生率显著增高。
Objective To study the clinical value of preoperative ultrasonography combined with tumor markers in predicting the benign and malignant properties of accessory mass. Methods A retrospective analysis of 475 cases of adnexal mass patients admitted to the First Affiliated MCH Hospital of Tongji University from January 2009 to October 2010 was performed to evaluate the quality of the accessory mass (including tumor size, echogenicity and Flow signal) and tumor markers (CA125, CA199, AFP, CEA and CA153) were compared with the final surgical pathology results. Results The surgical paraffin pathology showed 100 cases of ovarian malignancies, 50 cases of borderline tumors and 325 cases of benign tumors. There were 183 cases of cystic mass preoperatively, of which 144 cases were benign (78.7%) and 19 (10.4%) were malignant. Ultrasound showed 247 cases of mixed masses, of which 160 cases were benign (64.8%) and 58 cases were malignant Ultrasound showed 45 cases of solid tumors, of which 21 cases were benign (46.7%) and 23 cases were malignant (51.1%). Ultrasound prompted mixed or solid mass compared with cystic masses, the incidence of ovarian cancer was significantly increased (27.7% vs. 10.4%) (P <0.001). Proposed ovarian tumor prediction model 1, 2, 3, model 1: CA125 ≥ 35kU / L + ultrasound mixing or solid; Model 2: CA125 ≥ 100kU / L + ultrasound mixing or solid; Model 3: CA125 ≥ 35kU / L + CA199 ≥ 37kU / L + ultrasonic mixing or solid. Conclusion Ultrasound prompted mixed or solid mass at the same time CA125 elevated, the incidence of ovarian cancer was significantly increased.