超声造影技术联合血清CA12-5、CEA、HE-4检查诊断卵巢良恶性肿瘤的临床价值研究

摘要 目的：研究超声造影技术联合血清糖类抗原125（CA12-5）、癌胚抗原（CEA）及人附睾分泌蛋白4（HE-4）检查诊断卵巢良恶性肿瘤的临床价值。方法：将我院从2019年1月～2020年3月收治的83例卵巢肿瘤患者纳入研究。将其按照病理学诊断结果分成恶性组40例与良性组43例，按照是否发生淋巴结转移将恶性组分为转移亚组18例和未转移亚组22例。比较恶性组和良性组各项超声造影指标水平和血清CA12-5、CEA及HE-4水平，比较转移亚组和未转移亚组血清CA12-5、CEA及HE-4水平。通过受试者工作特征（ROC）曲线分析超声造影技术联合血清CA12-5、CEA及HE-4在卵巢良恶性肿瘤中的诊断能效。分析血清CA12-5、CEA及HE-4与卵巢恶性肿瘤患者淋巴结转移的关系。结果：恶性组超声造影增强强度及增强速率均高于良性组，而增强时间短于良性组（P＜0.05）。恶性组血清CA12-5、CEA及HE-4水平均高于良性组（P＜0.05）。超声造影技术联合血清CA12-5、CEA及HE-4诊断卵巢肿瘤良恶性的曲线下面积、灵敏度及特异度分别为0.947、0.96、0.93，高于超声造影技术单独检测或血清CA12-5、CEA及HE-4联合检测。转移亚组患者的血清CA12-5、CEA及HE-4水平均高于未转移亚组患者（P＜0.05）。结论：超声造影技术联合血清CA12-5、CEA及HE-4检查诊断卵巢良恶性肿瘤的价值较高，且联合检测血清CA12-5、CEA及HE-4水平有助于判断淋巴结转移情况，具有较高的临床应用价值。

Clinical Value of Contrast-enhanced Ultrasound Combined with Serum CA12-5, CEA and HE-4 in the Diagnosis of Benign and Malignant Ovarian Tumors

ABSTRACT Objective: To study the clinical value of contrast-enhanced ultrasound combined with serum carbohydrate antigen 125 (CA12-5), carcinoembryonic antigen (CEA) and human epididymal secreted protein 4 (HE-4) in the diagnosis of benign and malignant ovarian tumors. Methods: 83 patients with ovarian tumor who were admitted to our hospital from January 2019 to March 2020 were included in the study. According to the pathological diagnosis, the patients were divided into 40 cases of malignant group and 43 cases of benign group. According to whether there was lymph node metastasis, the malignant group was divided into 18 cases of metastasis subgroup and 22 cases of non metastasis subgroup. The levels of each contrast-enhanced ultrasound index and serum CA12-5, CEA and HE-4 in malignant group and benign group were compared. The levels of each contrast-enhanced ultrasound index and serum CA12-5, CEA and HE-4 in metastasis subgroup and non metastasis subgroup were compared. The diagnostic efficiency of contrast-enhanced ultrasound combined with serum CA12-5, CEA and HE-4 in ovarian benign and malignant tumors were analyzed by receiver operating characteristics (ROC) curve. Meanwhile, the relationship between serum CA12-5, CEA and HE-4 and lymph node metastasis in patients with ovarian cancer was analyzed. Results: The enhancement intensity and enhancement rate of contrast-enhanced ultrasound in the malignant group were higher than those in the benign group, and the enhancement time was shorter than that in the benign group (P<0.05). The serum levels of CA12-5, CEA and HE-4 in the malignant group were all higher than those in the benign group (P<0.05). The area under the curve, the sensitivity and the specificity of serum CA12-5, CEA and HE-4 in the diagnosis of ovarian tumors were 0.947, 0.96 and 0.93, respectively, which were higher than that of CEA alone or CA12-5, CEA and HE-4 combined detection. The levels of CA12-5, CEA and HE-4 in patients with metastasis subgroup were higher than those in patients with non metastasis subgroup (P<0.05). Conclusion: Contrast-enhanced ultrasound combined with serum CA12-5, CEA and HE-4 is of high value in the diagnosis of benign and malignant ovarian tumors. Combined detection of serum levels of CA12-5, CEA and HE-4 is helpful to determine lymph node metastasis, which is worthy of clinical application.