摘要
目的 探究彩色多普勒超声、细胞角蛋白19片段抗原21-1(cytokeratin 19 fragment antigen21-1,Cyfra21-1)及铁蛋白(ferritin,Fer)与卵巢癌相关性及联合模型诊断效能分析.方法 研究对象选取桐城市人民医院2021年1月至2023年12月收治的疑似卵巢癌患者合计108例,所有患者均进行彩色多普勒超声、Cyfra21-1、Fer检测,根据患者病理学检测结果将所有患者分为恶性组(61例)及良性组(47例).比较两组患者基线资料、超声参数、Cyfra21-1、Fer水平并进行多因素回归分析,建立多因素联合模型,使用ROC曲线评估联合模型鉴别效能.结果 两组年龄、病程等基线资料比较差异无统计学意义(P＞0.05).恶性组病灶直径为(7.66±1.24)cm,实性回声检出37例,内壁伴乳头检出38例;良性组病灶直径为(5.14±1.03)cm,实性回声检出18例,内壁伴乳头检出17例.恶性组患者收缩期最高峰值血流速度(peaksystolic,PS)为(22.94±4.61)cm/s,舒张末期流速(end diastolic velocity,EDV)为(15.67±3.42)cm/s,平均流速(velocity mean,VM)为(12.43±3.15)cm/s;良性组 PS 为(15.63±4.24)cm/s,EDV 为(8.95±3.04)cm/s,VM 为(17.08±4.21)cm/s,恶性组高于良性组(P＜0.05).恶性组阻力指数(resistance index,RI)为0.35±0.06,良性组RI为0.58±0.13,恶性组低于良性组(P＜0.05).多因素回归分析显示,病灶直径、实性回声、内壁伴乳头、PS、EDV、VM、Cyfra21-1、Fer及RI均是卵巢癌独立危险因素,病灶直径、实性回声、内壁伴乳头、PS、EDV、VM、Cyfra21-l、Fer与卵巢恶性病变呈正相关,RI与卵巢癌呈负相关(P＜0.05).ROC曲线结果显示,联合模型诊断效能高于单独使用多普勒超声及Cyfra21-1、Fer.结论 使用彩色多普勒超声、Cyfra21-1及Fer联合诊断模型有助于提高卵巢癌诊断效能.
Abstract
Objective To explore the correlation between color Doppler ultrasound,Cyfra21-1,Fer and malignant ovarian lesions and the value of combined model identification.Methods A total of 108 patients with suspected ovarian cancer admitted to our hospital from Jan.2021 to Dec.2023 were selected as subjects.All pa-tients were tested by color Doppler ultrasound,Cyfra21-1 and Fer,and were divided into malignant group(61 cas-es)and benign group(47 cases)according to the pathological test results.The baseline data,ultrasound parame-ters,Cyfra21-1 and Fer levels of the two groups were compared,and multivariate regression analysis was performed to establish a multi-factor combined model,and ROC curve was used to evaluate the differential efficacy of the com-bined model.Results There was no significant difference in baseline data such as age and course of disease be-tween the two groups(P＞0.05).In the malignant group,the lesion diameter was(7.66±1.24)cm,with solid echo detection in 37 cases and inner wall with nipple detection in 38 cases.In the benign group,the lesion diameter was(5.14±1.03)cm,with solid echo detection in 18 cases and inner wall with nipple detection in 17 cases.In the ma-lignant group,PS was(22.94±4.61)cm/s,EDV was(15.67±3.42)cm/s,VM was(12.43±3.15)cm/s.PS,EDV and VM in benign group were(15.63±4.24)cm/s,(8.95±3.04)cm/s and(17.08±4.21)cm/s respectively,and those in malignant group were higher than those in benign group(P＜0.05).RI in the malignant group was 0.35±0.06,RI in the benign group was 0.58±0.13,and RI in the malignant group was lower than that in the benign group(P＜0.05).Multivariate regression analysis showed that lesion diameter,solid echo,inner wall with papilla,PS,EDV,VM,Cyfra21-1,Fer and RI were all independent risk factors for ovarian malignant lesions,and lesion diame-ter,solid echo,inner wall with papilla,PS,EDV,VM,Cyfra21-1 and Fer were positively correlated with ovarian ma-lignant lesions.RI was negatively correlated with ovarian malignant lesions(P＜0.05).ROC curve results showed that the diagnostic efficiency of the combined model was higher than that of the single use of Doppler ultrasound,Cyfra21-1 and Fer.Conclusion The combined diagnosis model of color Doppler ultrasound,Cyfra21-1 and Fer is helpful to improve the diagnostic efficiency of ovarian malignant lesions.
基金项目
安徽省重点研究和开发计划项目(1804h08020274)
NETL
NSTL
万方数据