目的 探讨经阴道超声(TVUS)联合血清糖类抗原19-9(CA19-9)、糖类抗原125(CA125)水平对卵巢肿瘤良恶性的诊断效能.方法 选取2022年1月至2024年3月江苏省无锡市太湖医院收治的卵巢肿瘤患者为研究对象.应用彩色多普勒超声诊断仪行TVUS检查并记录相关参数,采用酶联免疫吸附法检测血清CA19-9、CA125水平.以卵巢肿瘤良恶性为因变量,多因素Logistic回归分析其影响因素,绘制受试者工作特征(ROC)曲线,分析TVUS联合血清CA19-9、CA125水平对卵巢肿瘤良恶性的诊断效能.结果 本研究共纳入符合入选标准的患者138例,根据病理检查结果将其分为恶性组(n=55)和良性组(n=83).恶性组病灶直径(7.00±1.49)cm大于良性组(6.33±1.33)cm,舒张期最低峰值血流速度(Vd)、收缩期最高峰值血流速度(Vs)和血清CA19-9、CA125水平均高于良性组[(13.10±2.95)cm/s vs(10.90±3.16)cm/s;(18.68±5.85)cm/s vs(15.53±4.93)cm/s;44.37(5.84,98.51)U/mL vs 0.30(9.65,30.35)U/mL;114.59(30.65,242.13)U/mL vs 28.11(12.94,43.35)U/mL;P均<0.05].卵巢肿瘤良恶性的独立危险因素为Vd(OR=1.247,95％CI:1.062～1.464,P=0.007)、Vs(OR=1.204,95％CI:1.004～1.444,P=0.045)、CA19-9(OR=1.047,95％CI:1.017～1.079,P=0.002)、CA125(OR=1.032,95％CI:1.014～1.050,P<0.001).TVUS联合血清CA19-9、CA125水平诊断卵巢肿瘤良恶性的曲线下面积为0.927(95％CI:0.871～0.965),高于TVUS[0.752(95％CI:0.671～0.821)]、血清CA19-9[0.682(95％CI:0.598～0.759)]、CA125[0.777(95％CI:0.699～0.844)]的单独预测效果(P均<0.05).结论 卵巢恶性肿瘤患者行TVUS过程中Vd、Vs速度加快,血清CA19-9、CA125水平升高,TVUS联合血清CA19-9、CA125水平对于卵巢肿瘤良恶性具有较高的诊断效能.
Diagnostic Efficacy of Transvaginal Ultrasound Combined with Serum CA19-9 and CA125 Levels in Differentiating Benign and Malignant Ovarian Tumors
Objective To explore the diagnostic efficacy of transvaginal ultrasound (TVUS) combined with serum car-bohydrate antigen 19-9 (CA19-9) and carbohydrate antigen 125 (CA125) levels in distinguishing benign from malignant ovar-ian tumors. Methods Patients with ovarian tumors admitted to Wuxi Taihu Hospital from January 2022 to March 2024 were included in this study. TVUS was performed using a color Doppler ultrasound diagnostic system,and relevant parameters were recorded. Serum CA19-9 and CA125 levels were measured using enzyme-linked immunosorbent assay. Logistic regression analysis was applied to identify factors influencing the nature of ovarian tumors. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of TVUS combined with serum CA19-9 and CA125 levels in differentiating tumor malignancy. Results A total of 138 patients were included,with 55 classified into the malignant group and 83 into the benign group based on patholog-ical examination. The malignant group showed larger lesion diameters (7.00±1.49 cm vs 6.33±1.33 cm) and higher diastolic minimum peak flow velocity (Vd),peak systolic flow velocity (Vs),and serum CA19-9 and CA125 levels compared to the benign group[(13.10±2.95 cm/s vs 10.90±3.16 cm/s),(18.68±5.85 cm/s vs 15.53±4.93 cm/s),44.37 (5.84,98.51) U/mL vs 20.30 (9.65,30.35) U/mL;114.59 (30.65,242.13) U/mL vs 28.11 (12.94,43.35) U/mL;all P<0.05].Independent risk factors for malignancy included Vd (OR=1.247,95％CI:1.062 to 1.464,P=0.007),Vs (OR=1.204,95％CI:1.004 to 1.444,P=0.045),CA19-9 (OR=1.047,95％CI:1.017 to 1.079,P=0.002),and CA125 (OR=1.032,95％CI:1.014 to 1.050,P<0.001). The area under the curve for TVUS combined with serum CA19-9 and CA125 was 0.927 (95％CI:0.871 to 0.965),significantly higher than the predictive ability of TVUS,CA19-9,or CA125 alone[0.752 (95％CI:0.671 to 0.821),0.682 (95％CI:0.598 to 0.759),and 0.777 (95％CI:0.699 to 0.844),respectively;all P<0.05]. Conclusion Malignant ovarian tumors are associated with increased Vd and Vs velocities in TVUS and elevated serum CA19-9 and CA125 levels. The combination of TVUS and serum CA19-9 and CA125 levels demonstrates high diagnostic efficacy in distinguishing benign from malignant ovarian tumors.
Ovarian tumorBenign and malignantTransvaginal ultrasoundCarbohydrate antigen 19-9Carbohydrate antigen 125Diagnostic energy efficiency
万方数据
维普
