【摘要】 背景与目的:经阴道彩色多普勒超声及血清CA125术前单独诊断卵巢恶性肿瘤的准确率较低,为了提高卵巢恶性肿瘤术前诊断的准确率。本文探讨经阴道彩色多普勒超声结合CA125诊断卵巢恶性肿瘤以及术前鉴别卵巢良恶性肿瘤的价值。方法:对165例盆腔肿块的患者,术前应用阴道超声进行评分,同时加用彩色多普勒超声检查的R I值,以及临床测定的CA125值。术后对照病理结果,了解诊断符合率。结果:阴道超声对盆腔肿块评分,B超积分>9分的57例的患者中,病理检查证实为恶性肿瘤55例,诊断符合率96.5%,B超积分≤9的108例患者中,病理检查证实为良性肿瘤的有105例,诊断符合率为97.2%。R I<0.5的病例有58例,56例诊断为恶性肿瘤,诊断符合率为96.6%,R≥I0.5的病例有107例,105例诊断为良性肿瘤,良性肿瘤的诊断符合率为98.1%;69例CA125>35u/m l的恶性肿瘤病例有55例,诊断符合率为79.7%。96例CA125为35u/m l的良性肿瘤有93例,诊断符合率为96.9%。超声评分和血流R I值结合CA125综合分析肿块的良恶性,B超积分>9和R I<0.5、CA125>35u/m l共有54例,病理检查为恶性52例,诊断符合率为96.3%,B超积分为9和R I≥0.5、CA125<35u/m l共有93例,病理检查为良性93例,诊断符合率为100%。结论:B超积分>9和R I<0.5、CA125>35u/m l是卵巢恶性肿瘤的临床特异表现,是目前临床鉴别卵巢良恶性肿瘤较好的手段。更多还原

【Abstract】 Background and purpose:Neither transvaginal ultrasonograph and color Doppler ultrasonography nor serum CA₁₂₅ alone were accurate for the diagnosis of malignant ovarian tumors.This study is focused on evaluating the accuracy of transvaginal ultrasonograph combined with serum CA₁₂₅ for the diagnosis of ovarian cancer and its role in discriminating benign from malignant ovarian tumors.Methods:165 patients who had pelvic masses were examined by transvaginal ultrasonography to quantify mass scoring and by Doppler ultrasonography to measure RI value of peripheral blood flow of mass,and the serum CA₁₂₅ was also documented.All of the data has been used to analysed for correlation with the pathological diagnosis.Results:With >9 pelvic mass ultrasonography scoring,55 of 57 cases（96.5%） were diagnosed as malignant tumors.With scoring ≤9,105 of 108 cases（97.2%） were diagnosed as benign tumors.In terms of RI value,if it was <0.5,56 of 58 cases（96.6%） were malignant tumors,if RI≥0.5,105 of 107 cases（98.1%） were benign tumors.55 of 69 cases（79.7%） were proved as malignant tumors if CA₁₂₅ was >35u/ml.93 of 96 cases（96.9%） proved as benign tumors with CA₁₂₅ ≤ 35u/ml.If the combination of ultrasonography scoring,RI value and the level of serum CA₁₂₅ were used to diagnosis,52 of 54 patients with malignant tumors were diagnosed,the sensitivity for the diagnoses of malignancy was 96.3%.93 of 93 cases with benign tumor were diagnosed,the sensitivity was 100% for benign tumors.Conclusions:Ultrasongraphy mass scoring >9,RI< 0.5 of mass peripheral blood flow and CA₁₂₅ >35u/mol were observed in most of the malignant tumors.The combination of all three methods would give more accuracy for the diagnosis in terms of differentiation of benign tumor from malignant ovarian tumor.更多还原