恶性肿瘤风险指数与肿瘤标志物用于盆腔包块良恶性诊断的临床价值-东南大学学报医学版

恶性肿瘤风险指数与肿瘤标志物用于盆腔包块良恶性诊断的临床价值

作者：曾磊

单位：成都市第一人民医院体检部, 四川成都 610016

分类号：R737.31

出版年·卷·期（页码）：2016·35·第六期（965-969）

摘要：

目的：探讨两种卵巢癌肿瘤标志物糖类抗原125（CA125）和人附睾分泌蛋白4（HE4）联合卵巢恶性肿瘤发病风险模型（ROMA）在盆腔包块早期良恶性诊断中的价值。方法：选择2013年12月至2015年6月来我院进行检查后诊断为盆腔包块并拟进行手术治疗的124例患者作为试验组，另选择我院体检中心同期体检合格的健康女性36例为对照组，采用酶联免疫吸附法测定所有受试者外周血中CA125和HE4的水平，并结合ROMA，将试验组患者分为高危组和低危组。将预测结果与患者病理检测结果相对比，判断恶性肿瘤风险指数联合肿瘤标志物用于盆腔包块良恶性诊断的临床价值。结果：健康对照组中27例处于绝经前，9例处于绝经后。124例患者中有77例绝经前患者，47例绝经后患者；根据124例患者的组织病理学结果，盆腔良性疾病78例，恶性疾病46例；盆腔良性疾病患者的CA125和HE4水平均显著低于盆腔恶性疾病患者（P<0.05）；根据ROMA判断，绝经后38例恶性疾病中34例判断为高危，敏感性达89.47%，9例良性疾病中7例判断为低危，特异性达77.78%；绝经前8例恶性疾病中7例判断为高危，敏感性达87.50%，69例良性疾病中65例判断为低危，特异性达94.20%。结论：恶性肿瘤风险指数联合肿瘤标志物CA125和HE4可以有效鉴别盆腔包块的良恶性，敏感性和特异性高，可以作为盆腔包块早期鉴别的临床手段。

Objective: To investigate the value of combination of two kinds of ovarian cancer tumor markers HE4 and CA125 and risk model of ovarian malignant tumor(ROMA) in the diagnosis of benign and malignant tumor in early stage of pelvic mass. Methods: 124 patients with pelvic mass coming to our hospital for surgery treatment were selected. The levels of HE4 and CA125 in peripheral blood of all patients were determined by enzyme-linked immunosorbent assay. The patients were divided into high risk group and low risk group by ROMA model. Compare the predicted results with the pathological results to evaluate the clinical value of combined tumor markers and ROMA in diagnosis of benign and malignant pelvic masses. Results: there were 77 premenopausal patients and 47 postmenopausal patients in 124 patients. According to the pathological results, there were 78 cases of pelvic benign diseases, 46 cases of malignant diseases. CA125 and HE4 levels in patients with pelvic benign disease were significantly lower than those in patients with pelvic malignant disease(P<0.05). According to ROMA model, 34 cases in 38 cases of postmenopausal malignant disease patients were high risk, and the sensitivity was 89.47%; 7 cases in 9 cases of benign disease judged as low risk, specificity reached 77.78%. The 7 cases in 8 cases of premenopausal malignant disease patients were high risk, and the sensitivity was 87.50%; 65 cases in 69 of benign disease cases judged as low risk, specificity reached 94.20%. Conclusion: The risk index of malignant tumor and CA125 and HE4 can effectively identify the benign and malignant pelvic masses, with high sensitivity and specificity, and can be used as a clinical tool for early identification of pelvic mass.

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