彩色多普勒超声联合血清CA125检测在上皮性卵巢癌患者术后复发诊断中的应用价值.doc

彩色多普勒超声联合血清CA125检测在上皮性卵巢癌患者术后复发诊断中的应用价值 高玉婷△，欧阳晓平 （江苏省扬州市妇幼保健院超声医学科，江苏，扬州，225000） 摘要 目的：评价经阴道彩色多普勒超声联合血清CA125检测在上皮性卵巢癌患者术后复发诊断中的临床应用价值。方法：对53例上皮性卵巢癌术后患者定期进行彩色多普勒超声检查及血清CA125的检测。观察二维超声图像，应用彩色多普勒血流分级标准，将所得结果与手术病理结果作对照，观察其诊断价值。结果：经阴道彩色多普勒超声、CAl25单独检测对卵巢癌复发的诊断敏感性分别为91.3％、75.0％，特异性分别为90.0％、65.5％，准确性分别为90.6％、66.0％；二者联合检测对卵巢癌复发的诊断敏感性、特异性分别为100％、93.1％，准确性达96．2％(P0．05)。结论：彩色多普勒超声联合血清CA125检测可提高卵巢癌III期患者术后复发诊断的敏感性、特异性及准确性，有助于早期发现卵巢癌的术后复发。 关键词 阴道超声；卵巢癌；CA125；多普勒影像 Value of color Doppler ultrasonographic measurements combined with CA l25 detection in the surveillance of ovarian malignant tumors after operation．GAO Yu-ting，. （Department of Ultrasound, Yangzhou maternal and child care service centre, 225000,Yangzhou, China.） ABSTRACT Objective To evaluate the value of color Doppler ultrasonographic measurements combined with CA l25 detection in the surveillance of ovarian malignant tumors after operation． Methods 53 cases of ovarian malignant tumors after operation were examined by Color Doppler ultrasonographic measurements． The level of CA l25 was measured，and the results were evaluated compared with the results of pathological diagnosis. Results The diagnostic sensitivity of Color Doppler ultrasonographic Or CA125 alone was 91.3％and 75.0％；The specificity was 90.0％and 65.5％；The accuracy was 90.6％and 66.0％. While the diagnostic sensitivity of Color Doppler ultrasonographic combined with CA125 was100％，the specificity was 93.1％，and the accuracy rate rose to 96.2％ (P0.05)．Conclusion The combination of Color Doppler examination and tumor marker CA125 can improve sensitivity and specificity in diagnosis of recurrence of ovarian cancer. Key Words:Transvaginal ultrasonography; Ovarian cancer; CA125; Color Doppler imaging 前言 　卵巢癌占妇科恶性肿瘤的25%，在女性致死性癌症中牌第4位，但死亡率在妇科恶性肿瘤中居首位，患者5年生存率仅为27%。主要原因除了起病隐匿难以早期发现外，治疗后的复发是影响卵巢癌患者存活率的重要因素。大多数进展期卵巢癌患者在标准治疗后几个月或几年内会复发，即使首次治疗后完全缓解的患者，仍然有近50％的人会复发[1]。因而，早期发现及诊断卵巢癌复发对改善患者预后及提高生活质量具有重要意义。以往以二次剖腹探查及术后动态检测CAl25为随访卵巢癌的标准[2]。但剖腹探查作为有创性检查对改善患者预后、提高治疗效果尚存争