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[背景]探讨彩色多普勒超声波检查、CA125水平测定及术中冰冻病理检查在卵巢良性及交界性肿瘤鉴别诊断中的应用价值.[病例报告]选择卵巢上皮交界性肿瘤34例及卵巢良性肿瘤36例的临床资料进行回顾性对比分析.卵巢良性肿瘤中壁厚(厚度>2mm)者为11例(30.6%),交界性肿瘤为29例(85.3%);良性中检测到肿瘤囊壁血流信号者为10例(27.8%),交界性肿瘤为26例(76.5%);交界性肿瘤患者中CA125阳性者为24例(70.6%),平均值为(130.81±32.65)U/mL,良性肿瘤患者中CA125阳性者为6例(16.7%),平均值为(24.38±2.27)U/mL;相比较差异均有统计学意义(P<0.01).交界性肿瘤患者中15例行保守性手术治疗,19例行根治性手术治疗;23例行术中冰冻病理检查.良性肿瘤患者中29例行保守性手术治疗,7例行根治性手术治疗;术中冰冻病理检查结果与术后病理检查结果相符.交界性肿瘤患者中4例失访,随访期间仅1例保守性手术治疗后复发恶变,再次手术后行辅助化学治疗,至今肿瘤无复发迹象;其余患者随访至今未见复发.[讨论]彩色多普勒超声波检查及CA125水平测定联合应用对卵巢良性及交界性肿瘤的鉴别诊断有意义.术中冰冻病理检查是术中及时更改术式的有效依据.
[Background] To investigate the value of color Doppler ultrasound, CA125 levels and intraoperative frozen pathological examination in the differential diagnosis of benign and borderline ovarian tumors. [Case Report] Select 34 cases of ovarian epithelial borderline tumors and benign ovarian tumors The clinical data of 36 cases were retrospectively analyzed.Of 11 cases (30.6%) of the benign ovarian tumors, the borderline tumors were 29 (85.3%) in benign ovarian tumors, The borderline tumors were 26 (76.5%) in 10 (27.8%) and 24 (70.6%) CA125 positive in borderline tumors with an average of (130.81 ± 32.65) U / mL, Among the benign tumor patients, CA125 was positive in 6 cases (16.7%) with an average of (24.38 ± 2.27) U / mL, with significant difference between the two groups (P <0.01) .15 cases of borderline tumors were conservative 19 cases were treated by radical surgery, 23 cases were performed intraoperative frozen pathological examination, 29 cases were treated by conservative operation in benign tumor and 7 cases were treated by radical surgery. The results of intraoperative frozen pathological examination and postoperative The results of the pathological examination were consistent.4 cases of borderline tumors were lost to follow-up, and only 1 case of conservative surgery Recurrence of malignant transformation after re-operation after adjuvant chemotherapy, so far no signs of tumor recurrence; the rest of the patients were followed up so far no recurrence. [Discussion] color Doppler ultrasound and CA125 levels in combination for benign and borderline ovarian tumors Differential diagnosis is meaningful.Operation intraoperative frozen pathology is an effective basis for intraoperative changes in surgical procedures.