目的:探讨经阴道超声联合CEA、CA125、CA153鉴别子宫腔占位性病变良恶性的价值.方法:收集2021年2月-2023年5月本院疑似子宫腔占位性病变患者117例临床资料,根据刮宫或术后病理检查结果分为恶性组及良性组,其中恶性组56例,为子宫内膜癌;良性组61例,为子宫内膜良性息肉.比较两组经阴道超声及血清指标差异,受试者工作特征曲线(ROC)分析各指标鉴别诊断子宫腔占位性病变良恶性效能.结果:超声检查收缩期峰值血流速度两组无差异(P>0.05),恶性组阻力指数小于良性组、内膜厚度大于良性组;恶性组血清癌胚抗原(CEA)、糖类抗原125、CA153水平均高于良性组(均P<0.05).ROC曲线结果显示,经阴道超声、血清CEA、CA125、CA153各指标单独或联合应用鉴别诊断子宫腔占位性病良恶性的AUC分别为0.822、0.713、0.728、0.797及0.915,均有价值,但联合诊断价值最高.结论:经阴道超声、血清CEA、CA125、CA153联合应用对宫腔占位性病变良恶性鉴别诊断效能较高,有较好的临床应用价值.
Objective:To investigate the value of the transvaginal ultrasound combined with the levels of carcinoembry-onic antigen(CEA),carbohydrate antigen(CA)125 and 153 of patients for differential diagnosing their benign or ma-lignant uterine space-occupying lesions.Methods:The clinical data of 117 patients with suspected uterine space-occup-ying lesions from February 2021 to May 2023 were collected.These patients were divided into 56 patients with malig-nant uterine space-occupying lesions(endometrial cancer)in group A and 61 patients with benign uterine space-occup-ying lesions(endometrial benign polyps)in group B according to the results of their uterine dilatation and curettage or postoperative pathological examination.The differences of the results of the transvaginal ultrasound examination and the serum indexes levels of the patients were compared between the two groups.Receiver operating characteristic(ROC)curve was used to analyze the efficacy of the result of the transvaginal ultrasound examination and the serum in-dexes levels of the patients for differential diagnosing their benign or malignant uterine space-occupying lesions.Re-sults:There was no significant difference in the peak systolic blood flow velocity of the patients between the two groups(P>0.05).The resistance index of the patients in group A was significantly lower than that of the patients in group B.The endometrial thickness of the patients in group A was significantly higher than that of the patients in group B.The levels of serum CEA,CA 125 and CA 153 of the patients in group A were significantly higher than those of the patients in group B(all P<0.05).The results of ROC curve showed that the AUC of the transvaginal ultrasound examination,the serum the CEA level,the CA 125 level,the CA 153 level,or the combination of the transvaginal ul-trasound examination and the levels of the CEA,CA125 and CA153 of the patients for differential diagnosing their be-nign or malignant uterine space occupying lesions were 0.822,0.713,0.728,0.797 and 0.915,respectively,and all of which had diagnostic values,but the combination of the transvaginal ultrasound examination and the levels of the CEA,CA125 and CA153 of the patients for differential diagnosing their benign or malignant uterine space occupying lesions had the highest value.Conclusion:The combinations of the transvaginal ultrasound examination and the levels of the CEA,CA125 and CA153 of the patients for differential diagnosing their benign or malignant uterine space occup-ying lesions have the higher efficacy and better clinical application value.