Value Of Contrast-enhanced Ultrasound Combined With Tumor Marker CA125 In The Diagnosis Of Benign And Malignant Adnexal Masses

Objective To explore whether the combination of contrast-enhanced ultrasound(CEUS)and serum tumor marker CA125 can improve the accuracy of diagnosis of benign and malignant masses in the adnexal region.Methods From September 2016 to December 2018,96 patients(100 masses)were diagnosed as having masses in the adnexal region,who were admitted to our hospital.All patients were tested for serum CA125 and routine two-dimensional ultrasound examination was performed.The location,internal echo,blood flow of the mass were observed.On the basis of two-dimensional ultrasound,the target focus was selected and the contrast-enhanced ultrasound examination was carried out.The enhancement time,enhancement morphology and enhancement level of the lesion were observed.Then the quantitative analysis of contrast-enhanced ultrasound was carried out.The initial increase time(AT),the peak intensity(PI),the time to peak(TTP),the area under the curve area under(AUC),the mean Transit Time(mTT)were recorded.The diagnostic results of serum CA125,CEUS and serum CA125 combined with CEUS were compared with those of postoperative pathology and clinical diagnosis after follow-up.To analyze the value of contrast-enhanced ultrasound combined with tumor marker CA125 in differential diagnosis of adnexal mass,and to summarize the significance of contrast-enhanced parameters of benign and malignant mass in adnexal region.Results 1.After operation,pathology and follow-up for 6 months,the clinical diagnosis showed that 37 of 100 masses were malignant and 63 were benign.2.The sensitivity,specificity,false positive rate,false negative rate,positive predictive value,negative predictive value,accuracy,correct index and positive likelihood ratio of CEUS in the diagnosis of benign and malignant adnexal masses respectively were 81.08%,79.37%,20.64%,18.92%,69.77%,87.72%,80%,0.6,3.93,Kappa analysis showed that the kappa value was 0.585,which indicated that the method was consistent with the gold standard.3.The analysis of tic parameters showed that the peak intensity,mean transit time and area under the curve of malignant masses were higher than those of benign masses(p ≤ 0 05),while the initial increase time and peak time of malignant masses were shorter than those of benign masses.The difference is not statistically significant.4.The sensitivity,specificity,false positive rate,false negative rate,positive predictive value,negative predictive value,accuracy,correct index and positive likelihood ratio of serum CA125 in the diagnosis of benign and malignant adnexal masses respectively were 67.57%,71.43%,28.57%,32.43%,58.14%,78.95%,70%,0.39,2.37.Kappa analysis showed that the kappa value was 0.377,indicating that the method was not consistent with the gold standard.5.The sensitivity,specificity,false positive rate,false negative rate,positive predictive value,negative predictive value,accuracy,correct index and positive likelihood ratio of CEUS combined with serum CA125 in the diagnosis of benign and malignant adnexal masses respectively were 67.57%,98.41%,1.59%,32.43%,96.15%,83.78%,87%,0.66,42.50.Kappa analysis showed that the kappa value was 0.703,indicating that the method was consistent with the gold standard.6.The diagnostic efficacy of CEUS,serum CA125 and CEUS combined with serum CA125 were evaluated comprehensively.The sensitivity,false negative rate,specificity,false positive rate and positive predictive value were obtained by statistical test.The difference of accuracy was statistically significant(p≤0.05),and the results showed that contrast-enhanced ultrasound combined with serum CA125 had the highest comprehensive evaluation efficiency,and the ability to detect benign and malignant masses in the adnexal region was higher than that of the single method.The difference was statistically significant(p ≤ 0.0167).Conclusions 1.Contrast-enhanced ultrasound combined with serum tumor marker CA125 can improve the accuracy of diagnosis of benign and malignant masses in the adnexal area and provide reliable evidence for clinical diagnosis and treatment.It is worth popularizing and applying.2.In the quantitative parameters of ultrasound contrast,the peak intensity of the malignant mass,the mean transit time and the area under the curve are higher than that of the benign masses,and the difference is of statistical significance,which is helpful to the diagnosis of benign and malignant masses from the quantitative aspects of ultrasound contrast.