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[目的]研究盆腔检查(PE)、超声检查(US)及血清CA125水平在鉴别卵巢良恶性包块方面的作用及3项检查联合应用的价值。[方法]对拟手术治疗的卵巢包块患者在术前均行PE ,US及血清CA125测定。[结果]绝经前妇女中8 5 %(11/130)为卵巢恶性肿瘤 ,绝经后妇女中36 3 %(29/80)为卵巢恶性肿瘤 ,PE的敏感性、特异性、阳性预测值、阴性预测值及准确性的百分率分别为62 5 %、82 4 %、45 5%、90.3 %及78 6% ;CA125的上述诊断指数分别为85 0 %、80 6 %、50 7 %、95 8%及81 4 % ;US的上述诊断指数分别为95 0%、94 1%、79 2%、98 8 %及94 3 %。在3种检查方法中 ,US的各项指数最好 ,尤其是在绝经后妇女。如果3项检查均为阴性 ,则所有患者的卵巢包块均为良性 ;如3项检查均为阳性 ,则95.2 %患者卵巢包块为恶性。[结论]PE、血清CA125测定及US在术前诊断卵巢包块良恶性方面均有一定作用 ,但是他们也都有各自的不足 ,如三者联合应用则在鉴别卵巢包块良、恶性方面具有更大价值。
[Objective] To investigate the role of pelvic examination (PE), ultrasonography (US) and serum CA125 levels in differentiating benign and malignant ovarian masses and the value of three combined tests. [Methods] The patients undergoing ovarian mass surgically treated with PE, US and serum CA125 were measured before operation. [Results] 85% (11/130) of premenopausal women were ovarian malignant tumors, and 36.3% (29/80) of postmenopausal women were ovarian malignant tumors. The sensitivity, specificity, positive predictive value and negative The predictive value and accuracy were 62.5%, 82.4%, 45.5%, 90.3% and 78.6% respectively. The diagnostic indexes of CA125 were 85.0%, 80.6%, 50.7% and 95.8% And 81 4% respectively. The above diagnostic indexes of US were 95 0%, 94 1%, 79 2%, 98 8% and 94 3% respectively. Among the three examinations, the best US indices are, especially in postmenopausal women. If all three tests were negative, all patients had a benign ovarian mass; all three were positive, and 95.2% of the patients had ovarian masses that were malignant. [Conclusion] The determination of PE, serum CA125 and US in the diagnosis of benign and malignant ovarian masses have a certain effect, but they also have their own deficiencies, such as the combination of the three in the identification of ovarian masses with benign and malignant Greater value.