摘要
目的:探讨经阴道彩超结合癌胚抗原(CEA)、甲胎蛋白(AFP)构建的logistics回归模型在鉴别诊断未成熟性畸胎瘤和成熟性畸胎瘤中的应用价值。方法:回顾性收集本院2019年3月-2021年12月本院就诊的80例畸胎瘤患者临床资料,病理结果显示为成熟性畸胎瘤48例(成熟组),未成熟性畸胎瘤32例(未成熟组),检测血清CEA、AFP水平,经阴道彩超检查患者子宫及附件中肿块边界、包膜、形态、内部回声情况;logistics回归分析未成熟性畸胎瘤的影响因素;受术者工作特征曲线(ROC)分析血清CEA、AFP水平及logistics回归模型诊断未成熟性畸胎瘤价值。结果:未成熟组血清CEA、AFP水平及超声瘤体边界不清晰、包膜缺损/无包膜、形态不规则比例均高于成熟组,内部回声为囊实混合性比例低于成熟组(均P<0.05)。血清CEA、AFP诊断未成熟性畸胎瘤的曲线下面积(AUC)分别为0.865、0.838。以超声下瘤体包膜(X_(2))、内部回声(X_(4))、CEA(X_(5))、AFP(X_(6))建立的logistics回归模型为Log(P)=0.865+1.174X_(2)+1.085X_(4)+1.039X_(5)+1.051X_(6),对此模型进行似然比检验(χ^(2)=36.482,P=0.000)拟合效果较好,logistics回归模型诊断未成熟性畸胎瘤的AUC为0.931(95%CI:0.877-0.985),诊断未成熟性畸胎瘤效果较高。结论:经阴道彩超下瘤体包膜、内部回声及血清CEA、AFP联合建立的logistics回归模型对鉴别诊断未成熟性与成熟性畸胎瘤有较高临床价值。
Objective:To investigate the application value of the logistic regression model constructed by transvaginal color Doppler ultrasound combined with carcinoembryonic antigen(CEA)and alpha-fetoprotein(AFP)levels for differential diagnosing immature teratoma and mature teratoma.Methods:The clinical data of 80 patients with teratoma from March 2019 to December 2021 were collected retrospectively.The pathological results showed that 48 cases were mature teratoma(in group A)and 32 cases were immature teratoma(in group B).The serum CEA and AFP levels of the patients in the two groups were detected,and the tumor boundary,capsule,morphology and internal echo of the uterus and the adnexa uteri of the patients in the two groups were examined by transvaginal color Doppler ultrasound.Logistic regression was used to analyze the influencing factors of immature teratoma of the patients.Receiver operator characteristic(ROC)curve was used to analyze the serum CEA and AFP levels of the patients,and Logistic regression model was used to analyze the values of the serum CEA and AFP levels of the patients for diagnosing their immature teratoma.Results:The levels of serum CEA and AFP,and the proportions of unclear boundary,capsule defect/no capsule,and irregular shape of tumor by ultrasound in group B were significantly higher than those in group A,and the proportion of mixed cyst and solid echo of the patients in group B were significantly lower than those of the patients in group A(all P<0.05).The area under curve(AUC)of serum CEA and AFP level of the patients for diagnosing their immature teratoma were 0.865 and 0.838,respectively.The logistic regression model based on tumor capsule(X_(2))and internal echo(X_(4))by ultrasound,and CEA level(X_(5))and AFP level(X6)was Log(P)=0.865+1.174X_(2)+1.085x4+1.039x5+1.051x6,and the imitative effect by the likelihood ratio test was better(χ^(2)=36.482,P=0.000).The AUC of logistic regression model for diagnosing immature teratoma was 0.931(95%CI:0.877-0.985),and AUC of which for diagnosing immature teratoma was higher.Conclusion:The value of logistic regression model constructed by transvaginal color Doppler ultrasound combined with serum CEA and AFP levels for differential diagnosing immature and mature teratoma is higher.
作者
赵燕
孙飞
郭爱玲
ZHAO Yan;SUN Fei;GUO Ailing(Taihe People's Hospital,Anhui Province,236600)
出处
《中国计划生育学杂志》
2022年第8期1790-1794,共5页
Chinese Journal of Family Planning
