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目的探讨经腹部和经阴道超声检查联合CA125和CA199辅助诊断子宫内膜癌的临床价值。方法分析105例2013年1月-2016年1月间秦皇岛市妇幼保健院收治的子宫内膜癌患者的临床资料,使用经腹部和经阴道超声检查对患者子宫进行检查,并采用化学发光免疫定量分析法对患者血浆中CA125及CA199水平进行检测。结果早期子宫内膜癌患者的子宫增大及子宫内膜增厚程度均显著低于中晚期患者,差异有统计学意义(t=7.185、2.391,P<0.05),早期子宫内膜癌患者与中晚期患者的病灶内血流、病灶回声、肿瘤浸及部位、肿瘤浸润子宫肌层及淋巴转移等经腹部和经阴道超声检查表现差异有统计学意义(χ~2=11.873、8.801、4.687、5.793、39.054,P<0.05);早期子宫内膜癌患者的CA125、CA199及CA125+CA199的阳性率均显著低于中晚期患者,差异有统计学意义(χ~2=41.348、42.41、44.35,P<0.05);单组采用经腹部和经阴道超声检查对早期子宫内膜癌患者进行诊断的符合率显著低于经腹部和经阴道超声检查+CA125+CA199,差异有统计学意义(χ~2=14.841,P<0.05),但中晚期患者采用两者方法的符合率差异无统计学意义(χ~2=0.000,P>0.05)。结论采用经腹部和经阴道超声检查联合CA125+CA199辅助诊断子宫内膜癌可有效提高患者的临床检出率。
Objective To investigate the clinical value of transabdominal and transvaginal ultrasonography combined with CA125 and CA199 in the diagnosis of endometrial cancer. Methods The clinical data of 105 cases of endometrial cancer admitted to Qinhuangdao MCH hospital from January 2013 to January 2016 were analyzed. The uterus of the patients were examined by transabdominal and transvaginal ultrasonography and analyzed by chemiluminescence immunoassay Analysis of patients with plasma CA125 and CA199 levels were detected. Results The incidence of uterine enlargement and endometrial thickening in patients with early stage endometrial carcinoma were significantly lower than those in advanced stage patients (t = 7.185, 2.391, P <0.05). Patients with early endometrial cancer In middle and advanced stage, there were significant differences in the transabdominal and transvaginal ultrasonographic examination of intracranial blood flow, lesion echogenicity, tumor infiltration and location, tumor infiltration myometrium and lymph node metastasis (χ ~ 2 = 11.873,8.801,4.687, 5.793,39.054, P <0.05). The positive rates of CA125, CA199 and CA125 + CA199 in patients with early endometrial cancer were significantly lower than those in advanced patients (χ ~ 2 = 41.348,42.41,44.35, P <0.05). The coincidence rates of transabdominal and transvaginal ultrasonography in the diagnosis of early endometrial cancer were significantly lower in single group than in transabdominal and transvaginal ultrasonography + CA125 + CA199, with significant difference (χ ~ 2 = 14.841, P <0.05). However, there was no significant difference in the coincidence rate between the two groups (χ ~ 2 = 0.000, P> 0.05). Conclusion The transabdominal and transvaginal ultrasound combined with CA125 + CA199 in the diagnosis of endometrial cancer can effectively improve the clinical detection rate of patients.