经阴道彩色多普勒超声联合血清HE4检测对子宫内膜癌的诊断价值

doi:10.3969/j.issn.1671-7171.2017.09.017

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摘要【目的】分析经阴道彩色多普勒超声(TV-CDS)联合血清人附睾蛋白(HE4)检测对子宫内膜癌的诊断价值。【方法】回顾性分析2014年3月至2017年3月期间在本院因阴道不规则出血进行检查的206例患者的临床资料,将患者按病理检查结果分为子宫内膜癌组和良性病变组。所有患者采用TV-CDS观察全子宫形态,测量子宫内膜厚度、子宫内膜血流,计算子宫内膜体积;采用酶联免疫吸附试验(Elisa法)检测血清HE4水平。【结果】子宫内膜癌组子宫最大径、内膜厚度及内膜体积均大于子宫良性病变组,差异具有统计学意义(P＜0.05);子宫内膜癌组血清HE4水平高于良性病变组,差异具有统计学意义(P＜0.05)。TV-CDS联合血清HE4检查对子宫内膜癌及子宫良性病变的诊断正确率分别为94.02%和92.13%,高于单用两种方法,漏诊率及误诊率分别为5.98%和7.87%,低于单用两种方法,之间差异均具有统计学意义(P＜0.05)。TV-CDS联合血清HE4诊断子宫内膜癌的敏感度为94.02%、特异度为94.38%、阳性预测值为95.65%、阴性预测值为92.31%,约登指数为0.884,均远超TV-CDS及血清HE4检测,差异具有统计学意义(P=0.006)。【讨论】TV-CDS联合血清HE4检测较单用两种检测手段检测能够显著提高对子宫内膜癌的诊断效能,对指导临床有重要意义。

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关键词 ：超声检查, 多普勒, 彩色, 附睾分泌蛋白质类/分析, 子宫内膜肿瘤/诊断, 回顾性研究

Abstract：【Objective】To study the clinical value of transvaginal color Doppler sonography(TV-CDS)plus human epididymis protein 4(HE4)test for endometrial cancer diagnosis.【Methods】Clinical information of 206 patients with irregular vaginal bleeding, who were examined in our hospital from March,2014 to March, 2017, were studied and divided into the endometrial cancer (EC)group and the benign diseases(BD)group. The uterine morphology was observed, the thickness and blood flow of endometrium were measured and the endometrial volume was calculated by TV-CDS examination. The serum HE4 was detected by Elisa assay.【Results】The uterine maximum diameter, endometrial thickness and volume of the EC group were significantly larger than those of the BD group(P＜0.05). The level of serum HE4 in the EC group was significantly higher than that in the BD group(P＜0.05). The accuracy rates of TV-CDS plus serum HE4 test for diagnosis of endometrial cancer and benign diseases were 94.02% and 92.13%,respectively, which were significantly higher than those of either method alone(P＜0.05). The false negative rate and the false positive rate were 5.98% and 7.87%, which were significantly lower than those of either method alone(P＜0.05). The sensitivity of TV-CDS plus serum HE4 for diagnosing endometrial cancer was 94.02%, the specificity was 4.38%, positive predictive value was 95.65%, negative predictive value was 92.31% and Youden index was 0.884,which were all significantly higher than those of TV-CDS or serum HE4 test alone(P＜0.05).【Conclusion】TV-CDS plus serum HE4 test can efficiently improve the diagnostic efficacy for endometrial cancer more than using either of the two methods alone. Therefor it is a useful tool for clinical practice.

Key words： Ultrasonography, Doppler, Color Epididymal Secretory Proteins/AN Endometrial Neoplasms/DI Retrospective Studies

收稿日期: 2017-07-26

PACS:

R737.33

引用本文:

刘群,苏文辉,张琼珍. 经阴道彩色多普勒超声联合血清HE4检测对子宫内膜癌的诊断价值[J]. 医学临床研究, 2017, 34(9): 1720-1723.
LIU Qun, SU Wen-hui, ZHANG Qiong-zhen. Clinical Value of Transvaginal Color Doppler Sonography plus Human Epididymis Protein 4 Test for Endometrial Cancer Diagnosis. JOURNAL OF CLINICAL RESEARCH, 2017, 34(9): 1720-1723.

链接本文:

http://www.jcr.net.cn/CN/10.3969/j.issn.1671-7171.2017.09.017 或 http://www.jcr.net.cn/CN/Y2017/V34/I9/1720

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