多普勒超声联合血清可溶性间皮素相关肽及癌胚 抗原检测对早期卵巢癌的预测价值

Diagnostic value of ultrasound examination combined with soluble mesothelin related proteins and carcinoembryonic antigen in ovarian cancer

摘要:

目的 探讨多普勒超声联合血清可溶性间皮素相关肽（SMRP）及癌胚抗原（CEA）检测对早期卵 巢癌的预测价值。方法 选取2015 年1 月-2017 年1 月该院收治的120 例卵巢肿块患者依据病理诊断结果分为 卵巢癌组（55 例）和良性肿瘤组（65 例），另选取同期来该院体检的50 例正常女性作为健康人群组。所有患者 均行彩色多普勒超声检查，同时采集外周血测定血清SMRP、CEA 水平。与病理诊断结果作比较，分析多普勒 超声、SMRP 和CEA 单独应用及联合诊断卵巢癌的诊断效能。结果 卵巢癌组、良性肿瘤组、健康人群组3 组 间血清SMRP、CEA 水平比较，差异有统计学意义（F =68.546 和31.367，均P =0.000）；卵巢癌组血清SMRP 和CEA 水平高于良性肿瘤组和健康人群组（P <0.05）。良性肿瘤组与健康对照组上述指标比较差异无统计 学意义（P >0.05）。卵巢癌组超声血流参数阻力指数（RI）和搏动指数（PI）低于良性肿瘤组（P <0.05）。 超声联合血清SMRP、CEA 水平联合检测的敏感性（92.7%）高于其他4 项检测的敏感性（83.6%、72.7%、 75.0% 及80.0%）（P <0.05）。联合检测在提高卵巢癌检测敏感性的同时，还保持较高的特异性（80.0%），超 声联合血清SMRP、CEA 水平联合检测的ROC 曲线下面积（0.846）大于各指标单独检测（0.810、0.665 及 0.730）（P <0.05）。结论 超声联合血清SMRP、CEA 水平检测可提高卵巢癌诊断的敏感性，并能够保持较高 的特异性，对于卵巢癌的的早期筛查诊断具有一定价值。

Abstract:

Objective To explore the diagnostic value of ultrasound examination combined with soluble mesothelin related proteins (SMRP) and carcinoembryonic antigen (CEA) in ovarian cancer. Methods A total of 120 patients admitted into our hospital from January 2015 to January 2017 with pathological diagnose of ovarian cancer were involved and divided into two groups: cancer group and benign tumor group. Totally 50 healthy pregnant women were subjected to healthy control group. All received ultrasound examination. Serum levels of SMRP and CEA were measured. Diagnostic efficacy of these markers was identified through statistical analysis. Results There was no statistically significant difference in serum levels of SMRP and CEA between benign tumor group and healthy control group while those in cancer group were increased compared with the other two groups (P < 0.05). The resistance index (RI) and pulsatile index (PI) of ultrasonic blood flow parameters in ovarian cancer group were significantly decreased when compared with those in benign tumor group (P < 0.05). Diagnostic sensitivity of ultrasound combined with SMRP and CEA was 92.7%, which was dramatically higher than that of ultrasound, SMRP or CEA (92.7% vs 83.6%, P < 0.05; 92.7% vs 72.7%, P < 0.05; 92.7% vs 80.0%, P < 0.05, respectively). Still, combination of ultrasound, SMRP and CEA exerted high value of specificity (80%). Area under curve of ultrasound combined with SMRP and CEA was 0.846, which was greatly upregulated compared with individual index of ultrasound, SMRP or CEA (0.846 vs 0.810, P < 0.05; 0.846 vs 0.665, P < 0.05; 0.846 vs 0.730, P < 0.05, respectively). Conclusion The combination of ultrasound, serum SMRP and CEA may be a reliable diagnostic marker in ovarian cancer with high sensitivity and specificity.