CA125联合多参数MRI对卵巢肿瘤诊断效能评估

Diagnostic efficiency of CA125 combined with multi-parameter MRI in differential diagnosis of malignant and benign ovarian tumors

关键词:  CA125  多参数MRI  卵巢肿瘤

Key words:  CA125  multi-parameter MRI  ovarian tumors

摘要:

目的通过CA125、多参数MRI（MRI增强信号强度比值及ADC值）成像技术对卵巢肿瘤良恶性进行定性诊断，评估其诊断效能。方法回顾性分析经手术病理证实卵巢肿瘤61例（良性33例，恶性28例）的术前血清CA125、多参数MRI资料，进行卵巢良恶性肿瘤的诊断效能评估。结果CA125诊断卵巢良恶性肿瘤的灵敏度75%，特异度72.73%，约登指数47.73%，阳性预测值72.41%，阴性预测值78.13%，准确性75.41%。MRI增强信号强度比值诊断卵巢良恶性肿瘤的灵敏度75%，特异度90.91%，约登指数65.91%，阳性预测值87.5%，阴性预测值80%，准确性73.4%。通过ADC值诊断卵巢良恶性肿瘤的灵敏度92.86%，特异度75.76%，约登指数68.61%，阳性预测值76.47%，阴性预测值92.59%，准确性83.61%。三者联合诊断卵巢良恶性肿瘤的灵敏度100%，特异度75.76%，约登指数75.76%，阳性预测值80%，阴性预测值100%，准确性85.25%。结论通过联合CA125、多参数MRI成像对卵巢良恶性肿瘤的性质诊断具很高的灵敏度和阴性预测值，诊断效能达到最优化。

Abstract:

ObjectiveTo evaluate the efficiency of CA125 combined with multi-parameter MRI(MRI enhancement signal intensity ratios and ADC values) in differential diagnosis of benign and malignant ovarian tumors. MethodsSixty-one patients with ovarian tumors diagnosed by surgery and histopathology were enrolled in the study, including 33 cases of benign tumor and 28 cases of malignant tumor. The diagnostic efficiency of preoperative serum CA 125 and multi-parameter MRI in differentiation of benign and malignant ovarian tumors was evaluated. ResultsThe sensitivity, specificity, Youden’s index, negative predictive value, positive predictive value and accuracy of CA125 for differential diagnosis of ovarian benign and malignant tumors were 75%, 72.73%, 47.73%, 72.41%, 78.13% and 75.41%, respectively; those of MRI enhancement signal intensity ratios were 75%, 90.91%, 65.91%,87.5%, 80% and 73.4%, respectively; those of ADC value were 92.86%, 75.76%, 68.61%, 76.47%, 92.59% and 83.61%, respectively. For differential diagnosis of the ovarian benign and malignant tumors, the combination of CA 125, MRI enhancement signal intensity ratios and ADC values had a diagnostic sensitivity, specificity, Youden’s index, negative predictive value, positive predictive value and accuracy of 100.0%, 75.76%, 75.76%, 80.0%, 100.0% and 82.25%, respectively. ConclusionThe combination of CA125 and multi-parameter MRI imaging has high sensitivity, specificity and accuracy in the differential diagnosis of the benign and malignant ovarian tumors with an optimized diagnostic efficiency.