摘要
目的:探讨经阴道彩色多普勒超声(TVCDS)联合血清人附睾分泌蛋白4(HE4)及miR-21检测诊断早期子宫内膜癌价值。方法:回顾性收集本院2017年3月-2019年1月择期手术后病理学确诊为早期子宫内膜癌91例患者(恶性病变组),同期择期手术后病理学确诊为子宫内膜良性病变86例患者(良性病变组),所有患者入院后均行TVCDS检查,并于术前完成血清HE4及miR-21表达检测,观察TVCDS影像学表现,并根据病理结果评价TVCDS、HE4、miR-21检测对早期子宫内膜癌的诊断价值。结果:TVCDS提示早期子宫内膜癌病变特点为子宫形态增大、浆膜与内层膜间的低回声晕中断、病灶侵犯子宫内膜肌层以及新生血流信号丰富,新生血管增加。两组患者病灶血流信号有差异(P<0.05),病灶血流信号恶性病变组多呈现树叉状或网状,良性病变组多呈现点状或短棒状。恶性病变组子宫内膜厚度、血清HE4和miR-21水平均高于良性病变组,而搏动指数和阻力指数均低于良性病变组(P<0.05)。彩色多普勒超声单独检测诊断的特异性80.4%,敏感性83.5%;HE4临界值为71.35 pmol/L,诊断特异性78.3%,敏感性85.9%;miR-21临界值为1.32,诊断特异性85.7%,敏感性88.4%;3项联合检测诊断的特异性(95.1%)、敏感性(94.5%)和约登指数(0.899)均高于单独检测(F=15.382,P<0.05)。结论:早期子宫内膜癌患者血清HE4和miR-21均升高,TVCDS联合HE4、miR-21检测可提高早期子宫内膜癌的诊断效能。
Objective:To investigate the value of transvaginal color Doppler ultrasound(TVCDS)combined with HE4 and microRNA-21 levels for diagnosing endometrial carcinoma early.Methods:From March 2017 to January 2019,91 patients with early endometrial cancer confirmed by pathological examination were selected in group A,and 86 patients with benign endometrial lesion confirmed by pathological examination after elective surgery were selected in group B.All patients were examined by TVCDS and their serum HE4 and microRNA-21 levels were detected before operation.The images by TVCDS of the patients in the two groups were observed.The value of TVCDS,and HE4 and microRNA-21 levels for diagnosing endometrial cancers early were evaluated based on the pathological biopsy results.Results:The results of TVCDS showed that the main features of early endometrial cancer were the enlargement of uterine morphology,interruption of hypoechoic halo between the serosa and the endometrium of uterus,lesion invasion of endometrum and myometrium of uterus,abundant signals and proliferation of neovascularization.There was significant difference in the blood flow signals of lesion of the patients between the two groups(P<0.05).The blood flow signals of lesion of the patients in group A were mostly dendritic or reticular,while those of the patients in group B were mostly punctate or short rod.The endometrial thickness,serum HE4 and microRNA-21 levels of the patients in group A were significant higher than those of the patients in group B,while the pulsation index and resistance index of the patients in group A were significant lower(P<0.05).The specificity and the sensitivity of TVCDS for diagnosing endometrial carcinoma were 80.4%and 83.5%,respectively.The critical value,the specificity,and sensitivity of HE4 level for diagnosing endometrial carcinoma were 71.35 pmol/L,78.3%,and 85.9%,respectively.The critical value,the specificity,and sensitivity of miR-21 level for diagnosing endometrial carcinoma were 1.32,85.7%,and 88.4%,respectively.The specifici
作者
任伟利
温德惠
罗兵
王嫒嫒
刘俊峰
焦桂青
REN Weili;WEN Dehui;LUO Bing;WANG Yuanyuan;LIU Junfeng;JIAO Guiqing(The First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei Province,075000)
出处
《中国计划生育学杂志》
2021年第1期189-192,F0003,共5页
Chinese Journal of Family Planning
基金
2019年张家口市科技计划项目(1921036D)。
关键词
早期子宫内膜癌
彩色多普勒超声
人附睾分泌蛋白
MIR-21
诊断价值
Endometrial carcinoma early
Color Doppler ultrasound
Human epididymis secretory protein
microRNA-21
Diagnostic value
