Value Of Contrast-enhanced Ultrasound Combined With Tumor Marker CA125 And HE4 In The Diagnosis Of Endometrial Carcinoma

Objective: To explore whether the combination of contrast-enhanced ultrasound(CEUS)and serum tumor marker CA125 and HE4 can improve the accuracy of diagnosis of benign and malignant masses in endometrial carcinoma.Methods: From 2016 to 2018,52 patients were diagnosed as suspected endometrial Carcinoma,who were admitted to our hospital.All patients were tested for routine two-dimensional ultrasound examination and serum CA125 and HE4 was performed.The location,internal echo,bloodflow 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.The diagnostic results of tumor marker(CA125+HE4),CEUS and tumor marker(CA125+HE4)combined with CEUS were compared with those of postoperative pathology and clinical diagnosis.To analyze the value of contrast-enhanced ultrasound combined with tumor marker CA125 and HE4 in endometrial carcinoma,and to summarize the significance of contrast-enhanced parameters of benign and malignant mass in endometrial lesions.The receiver operating characteristic curve(ROC)was constructed and the area under curve(AUC)was calculated.The sensitivity,specificity and coincidence were compared and their diagnostic efficacy were analyzed.Results:(1)After operation and pathology,the clinical diagnosis showed that 32 of 52 masses were endometrial carcinoma and 20 were benign;(2)In CEUS,The perfusion phase of endometrial carcinoma was mainly early to enter and early to leave,the intensity of enhancement was mainly enhanced,and the enhanced uniformity was mainly inhomogeneous,The endometrial lesions perfusion patterns statistically significant difference(P < 0.05);(3)Sonographic and CEUS diagnosis of endometrial cancer myometrial invasion depth sensitivity,specificity,accuracy and area under the ROC curve were 64.29%?60%?65.38%? 0.646;76.92%?83.33%?80.77%? 0.801,respectively,The area under ROC curve of transvaginal CEUS(0.801)was the largest,and it had the highest diagnostic efficiency for myometrial invasion of endometrial carcinoma,CEUS is most effective in the diagnosis of myometrial invasion in endometrial carcinoma;(4)Sonographic,CEUS,tumor marker(CA125+HE4)and tumor marker(CA125+HE4)combined with CEUS diagnosis of endometrial cancer area under the ROC curve were 0.728,0.770,0.671,0.811,respectively,The area under ROC curve of transvaginal tumor marker(CA125+HE4)combined with CEUS(0.811)was the largest,and it had the highest diagnostic efficiency for myometrial invasion of endometrial carcinoma,tumor marker(CA125+HE4)combined with CEUS is most effective in the diagnosis of endometrial carcinoma.Conclusion:(1)CEUS has a unique advantage in the diagnosis of endometrial carcinoma,perfusion pattern is expected to become a important index of ultrasound diagnosis of endometrial carcinoma;(2)CEUS has great clinical value in the diagnosis of myometrial invasion of endometrial carcinoma.(3)The tumor marker(CA125+HE4)combined with CEUS for endometrial carcinoma improves the specificity of ultrasonography in diagnosing endometrial carcinoma,and has preliminarily demonstrated the tumor marker(CA125+HE4)combined with CEUS in the diagnosis of endometrial carcinoma.