Shen Zhi Yong, Shen Ai Jun, Yang Shao Ling, Wu Ming Feng
Department of Radiology, Nantong University Affiliated Nantong Tumor Hospital, Nantong.
Ultrasound in Medicine Departments, Shanghai Fengxian Central Hospital/Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, Shanghai, China.
Ultrasound Q. 2019 Mar;35(1):45-53. doi: 10.1097/RUQ.0000000000000394.
To assess the efficacy of the combination of sonographic morphology score (SMS) with CA125 and HE4 for detecting recurrent pelvic ovarian carcinoma (OC). Data of 58 OC patients treated in our hospital between 2014 and 2016 were analyzed. After cytoreductive surgery and routine chemotherapy, all patients were followed up by transvaginal ultrasound examination (SMS for pelvic masses based on volume and structure scores) and tumor marker (serum CA125 and HE4) detection. Clinical diagnosis of recurrent OC was based on physical examination, magnetic resonance imaging, and punctured pathology for pelvic masses. Receiver operating characteristic (ROC) curves of SMS and the tumor markers were generated, and areas under the curve (AUC) values were assessed. There were 26 patients with tumor recurrence and 32 cases with no recurrence. Magnetic resonance imaging had 100% sensitivity and specificity. The areas under the ROC curves of SMS, CA125, HE4, and SMS-CA125-HE4 were 0.816, 0.825, 0.737, and 0.903, respectively. There was no significant difference in AUC values between SMS and CA125 or HE4. There were significant differences in AUC values between SMS-CA125-HE4 and SMS (Z = 2.48, P = 0.042), CA125 (Z = 2.38, P = 0.046), and HE4 (Z = 6.48, P = 0.016), respectively. With a cutoff value of SMS, 5; CA125, 35 U/mL; HE4, 105 pmol/L, the sensitivity, specificity, positive prognostic value, and negative prognostic value of SMS-CA125-HE4 for recurrent OC assessment were 0.9231, 0.8438, 0.8276, and 0.931, respectively. SMS-CA125-HE4 was correlated with recurrent OC (χ = 30.7428, P < 0.0001). Ultrasound combined with tumor markers may improve the diagnostic efficiency of recurrent OC.
评估超声形态学评分(SMS)联合CA125和HE4检测复发性盆腔卵巢癌(OC)的疗效。分析了2014年至2016年在我院接受治疗的58例OC患者的数据。在进行细胞减灭术和常规化疗后,所有患者均接受经阴道超声检查(根据体积和结构评分对盆腔肿块进行SMS评分)以及肿瘤标志物(血清CA125和HE4)检测。复发性OC的临床诊断基于体格检查、磁共振成像以及盆腔肿块穿刺病理检查。绘制了SMS和肿瘤标志物的受试者操作特征(ROC)曲线,并评估曲线下面积(AUC)值。有26例患者出现肿瘤复发,32例未复发。磁共振成像的敏感性和特异性均为100%。SMS、CA125、HE4以及SMS-CA125-HE4的ROC曲线下面积分别为0.816、0.825、0.737和0.903。SMS与CA125或HE4的AUC值之间无显著差异。SMS-CA125-HE4与SMS(Z = 2.48,P = 0.042)、CA125(Z = 2.38,P = 0.046)和HE4(Z = 6.48,P = 0.016)的AUC值之间分别存在显著差异。当SMS的临界值为5;CA125为35 U/mL;HE4为105 pmol/L时,SMS-CA125-HE4对复发性OC评估的敏感性、特异性、阳性预测值和阴性预测值分别为0.9231、0.8438、0.8276和0.931。SMS-CA125-HE4与复发性OC相关(χ = 30.7428,P < 0.0001)。超声联合肿瘤标志物可能提高复发性OC的诊断效率。