摘要
目的探讨阴道彩色多普勒超声(以下简称阴道彩超)参数联合肿瘤标志物癌抗原125(CA125)对子宫内膜癌病理分级和预后评估中的临床应用价值。方法选取2020年1月至2023年9月西电集团医院收治的112例子宫内膜癌患者作为子宫内膜癌组,选取同期115例子宫内膜增生患者作为对照组。所有纳入对象均采用彩色多普勒超声检查,并测量病灶收缩期峰值流速(PSV)、搏动指数(PI)、阻力指数(RI),并检测血清CA125水平。比较2组间超声参数及CA125的差异,分析上述参数对子宫内膜癌病理分级及预后评估效能。结果子宫内膜癌组PSV、CA125均高于对照组,RI、PI均低于对照组(P<0.05)。病理分级高级别组子宫内膜癌PSV、CA125均高于低级别组,RI、PI均低于低级别组(P<0.05)。受试者工作特征(ROC)曲线分析显示,PSV、RI、PI联合CA125评估子宫内膜癌病理分级的AUC为0.910,高于单一指标PSV(0.805)、RI(0.820)、PI(0.815)、CA125(0.802),差异均有统计学意义(Z=6.885、8.542、7.842、6.652,P<0.001)。预后不良组FIGO分期Ⅲ~Ⅳ期比例、病理分级G3占比、PSV及CA125均高于预后良好组,RI、PI均低于预后良好组(P<0.05)。多因素Logistic逐步回归分析显示,FIGO分期Ⅲ~Ⅳ期(OR=3.717)、病理分级G3(OR=1.744)及PSV≥20.33 cm/s(OR=2.347)、RI<0.35(OR=3.043)、PI<0.40(OR=3.401)、CA125≥334.11 U/mL(OR=4.679)均为影响子宫内膜癌预后不良的独立危险因素(P<0.05)。结论阴道彩超参数(PSV、PI、RI)联合CA125检测可有效评估子宫内膜癌病理分级及预后,二者联合诊断效能优于单一指标,具有较高的临床应用价值。
Objective To investigate the clinical value of transvaginal color Doppler ultrasound(hereinafter referred to as transvaginal ultrasound)parameters combined with the tumor marker carbohydrate antigen 125(CA125)in the pathological grading and prognostic evaluation of endometrial cancer.Methods A total of 112 patients with endometrial cancer admitted to Xidian Group Hospital from January 2020 to September 2023 were selected as the endometrial cancer group,and 115 patients with endometrial hyperplasia during the same period were selected as the control group.All enrolled subjects underwent color Doppler ultrasound examination,and the peak systolic velocity(PSV),pulsatility index(PI),and resistance index(RI)of the lesion were measured.Serum CA125 levels were also detected.The differences in ultrasound parameters and CA125 between the two groups were compared,and the value of the above parameters in evaluating the pathological grading and prognosis of endometrial cancer was analyzed.Results The endometrial cancer group had significantly higher PSV and CA125 levels than the control group,while RI and PI were significantly lower(P<0.05).The high-grade endometrial cancer group exhibited higher PSV and CA125 levels than the low-grade group,with lower RI and PI(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that the combination of PSV,RI,PI,and CA125 for assessing pathological grading of endometrial cancer yielded an AUC of 0.910,which was higher than that of PSV(0.805),RI(0.820),PI(0.815),or CA125(0.802)alone(Z=6.885,8.542,7.842,6.652;P<0.001).The poor prognosis group had a higher proportion of FIGO stageⅢ-Ⅳ,pathological grade G3,PSV,and CA125 levels compared to the good prognosis group,while RI and PI were significantly lower(P<0.05).Multivariate logistic regression analysis revealed that FIGO stageⅢ-Ⅳ(OR=3.717),pathological grade G3(OR=1.744),PSV≥20.33 cm/s(OR=2.347),RI<0.35(OR=3.043),PI<0.40(OR=3.401),and CA125≥334.11 U/mL(OR=4.679)were independent risk factors for poor prognosis in endometrial cancer(P<0.05).Conclusion The combination of transvaginal ultrasound parameters(PSV,PI,RI)and CA125 can effectively evaluate the pathological grading and prognosis of endometrial cancer,with superior diagnostic performance compared to individual indicators,demonstrating high clinical value.
作者
刘天鹰
牛华
段欣
张改
谢晴
郑小叶
苏莎莎
LIU Tianying;NIU Hua;DUAN Xin;ZHANG Gai;XIE Qing;ZHENG Xiaoye;SU Shasha(Department of Ultrasound,Xidian Group Hospital,Xi'an,Shaanxi 710077,China;Department of Ultrasound,Xi'an Third Hospital,Xi'an,Shaanxi 710018,China)
出处
《转化医学杂志》
2025年第5期43-47,共5页
Translational Medicine Journal
基金
陕西省重点研发计划项目(2022SF-397)。
关键词
阴道彩色多普勒超声参数
肿瘤标志物
子宫内膜癌
病理分级
预后
评估价值
Vaginal color Doppler ultrasound parameters
Tumor markers
Endometrial cancer
Pathological grading
Prognosis
Evaluation value
