摘要
目的探讨卵巢上皮性肿瘤的临床特征,并评估糖类抗原125(CA125)、人附睾蛋白4(HE4)、卵巢恶性肿瘤风险预测模型(ROMA)及D-二聚体对鉴别卵巢上皮性肿瘤良恶性质的价值。方法选取2019年12月至2021年5月在武汉大学人民医院妇科住院接受治疗的123例卵巢上皮性肿瘤患者作为研究对象,其中包括良性肿瘤患者61例,恶性肿瘤患者62例。收集所有患者的临床资料及血清肿瘤标志物、D-二聚体水平,并绘制受试者工作特征(ROC)曲线比较不同指标鉴别卵巢上皮性肿瘤良恶性质的价值。结果68.85%的卵巢良性肿瘤患者由体检发现,而61.29%的恶性肿瘤患者因出现腹痛、腹胀症状而就诊。绝经后病例中恶性肿瘤占77.08%(37/48),明显高于良性肿瘤;恶性肿瘤患者血清CA125、HE4、ROMA指数及D-二聚体均高于良性肿瘤患者。ROMA指数鉴别诊断卵巢上皮性肿瘤良恶性质的灵敏度高于CA125、HE4,CA125、HE4及ROMA指数联合检测可进一步提高诊断灵敏度,HE4诊断的特异度最高。将患者按照绝经情况分组,ROMA指数在绝经前后的截断值分别为11.73%、28.59%。结论围绝经期及绝经后女性应增加体检次数,早期发现卵巢肿瘤并加以处理;血清HE4、CA125、ROMA指数可用于卵巢上皮性肿瘤良恶性质的鉴别,ROMA指数对卵巢上皮性肿瘤良恶性质鉴别诊断的价值优于CA125和HE4单独检测。
Objective To investigate the clinical characteristics of ovarian epithelial tumors, and evaluate the value of carbohydrate antigen 125(CA125), human epididymis protein 4(HE4), risk of ovarian malignancy algorithm(ROMA)and D-dimer in the differential diagnosis of benign and malignant ovarian epithelial tumors. Methods A total of 123 patients with ovarian epithelial tumor hospitalized in the Renmin Hospital of Wuhan University from December 2019 to May 2021 were selected as the research subjects, including 61 patients with benign tumor and 62 patients with malignant tumor. Clinical data, serum tumor markers and D-dimer levels of all patients were collected, and receiver operating characteristic(ROC) curves were drawn to compare the value of different indicators in differentiating benign and malignant ovarian epithelial tumors. Results 68.85% of patients with benign ovarian tumor were found by physical examination, while 61.29% of patients with malignant tumor were treated for abdominal pain and abdominal distension. Malignant tumor accounted for 77.08%(37/48) of postmenopausal cases, which was significantly higher than benign tumor. Serum CA125, HE4, ROMA index and D-dimer are higher in patients with malignant tumor than in patients with benign tumor. The sensitivity of ROMA index in differential diagnosis of benign and malignant ovarian epithelial neoplasms is higher than that of CA125, HE4, and the combination of CA125, HE4 and ROMA index can further improve the diagnostic sensitivity. The specificity of HE4 was the highest. When patients were grouped by menopause, the ROMA index cut-off values before and after menopause were 11.73% and 28.59%, respectively. Conclusions Realizing the importance of physical examinations in perimenopausal and postmenopausal women is beneficial to early detection and management of ovarian tumors. Serum HE4, CA125 and ROMA index can be used in the prediction of benign and malignant ovarian epithelial tumors. ROMA index is better in the differential diagnosis of benign and malignant o
作者
孙朋星
谭爱丽
洛若愚
SUN Pengxing;TAN Aili;LUO Ruoyu(Department of Gynecology,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)
出处
《中国性科学》
2022年第7期39-43,共5页
Chinese Journal of Human Sexuality
基金
国家自然科学基金(81801421)。
