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目的探讨经阴道彩色多普勒超声联合血清脂联素(ADPN)对子宫内膜癌的诊断价值。方法分析2016年1月-2017年6月该院收治的44例子宫内膜癌患者(观察组)的临床资料,另选取同时期47例子宫内膜良性病变患者作为对照组。结果观察组患者子宫内膜平均厚度明显大于对照组,观察组患者子宫内膜中心血流波动指数(PI)、阻力指数(RI)低于对照组,差异均有统计学意义(均P<0.05)。观察组患者病灶血流信号多以网状(25.00%)和树杈状(31.82%)为主,对照组病灶血流信号多以点状(36.17%)、短棒状(27.66%)为主,两组患者病灶血流信号类型比较,差异有统计学意义(P<0.05);观察组患者血清ADPN低于对照组,而CA125、胰岛素样生长因子-1(IGF-1)水平高于对照组(P<0.05)。当ADPN取值为3.11μg/ml时,诊断敏感度为86.36%,特异度为72.34%,诊断价值优于CA125、IGF-1;经阴道多普勒超声联合血清ADPN诊断符合率明显高于超声单一诊断,差异有统计学意义(χ2=7.543,P=0.006)。结论经阴道多普勒超声联合ADPN可以弥补单纯超声诊断对子宫内膜癌诊断的局限性,诊断符合率较高,可以降低子宫内膜癌漏诊率。
Objective To investigate the diagnostic value of transvaginal color Doppler ultrasonography combined with serum adiponectin (ADPN) in endometrial carcinoma. Methods The clinical data of 44 patients with endometrial carcinoma (observation group) admitted from January 2016 to June 2017 in our hospital were analyzed. Another 47 patients with benign endometrial lesions were selected as the control group. Results The average thickness of endometrium in the observation group was significantly higher than that in the control group. The endocardial blood flow fluctuation index (PI) and resistance index (RI) in the observation group were significantly lower than those in the control group (all P <0.05 ). The blood flow signals in the observation group were mainly reticular (25.00%) and tree-branch (31.82%). The blood flow signals in the control group were mostly punctate (36.17%) and short rod-shaped (27.66% The difference of blood flow signal types between the two groups was statistically significant (P <0.05). The serum ADPN in the observation group was lower than that in the control group, while the levels of CA125 and IGF-1 were higher than those in the control group (P <0.05). When the value of ADPN was 3.11μg / ml, the diagnostic sensitivity was 86.36% and the specificity was 72.34%, the diagnostic value was better than that of CA125 and IGF-1. The diagnostic accuracy of transvaginal Doppler ultrasound and serum ADPN was significantly higher than that of ultrasound Single diagnosis, the difference was statistically significant (χ2 = 7.543, P = 0.006). Conclusion Transvaginal Doppler ultrasound combined with ADPN can make up for the limitations of simple ultrasound diagnosis of endometrial cancer diagnosis with a high coincidence rate, can reduce the rate of missed diagnosis of endometrial cancer.