合併CA-125及超音波以鑑別卵巢腫瘤之良惡性

Combined CA-125 Test and Ultrasonography in the Presurgical Evaluation of Ovarian Mass

趙淑武(Suk-Wu Chiu) ； 何師竹(Shiu-Chu Ho) ； 洪耀欽(Yao-Ching Hung) ； 李玉華(Yu-Hua Lee)

《The Kaohsiung Journal of Medical Sciences》 7卷8期 (1991/08) Pp. 429-434

https://doi.org/10.6452/KJMS.199108.0429

摘要

卵巢腫瘤之為良性或惡性決定其預後好壞及處理方式之不同。過去單獨使用血中CA-125值或超音波檢查來分辨卵巢腫瘤之為良惡性，已廣為臨床醫師們接受並行之有年。若能合併CA-125值及超音波檢查一起來評估，是否可增加其準確性？乃是本篇所要探討的目的。
台中榮民總醫院自1982年10月至1989年9月，所有罹患卵巢腫瘤而經開刀證實者，並於手術前曾抽血測CA-125值及做超音波檢查，共收集到238病例。惡性腫瘤機（包括上皮癌及非上皮癌）共44例而良性腫瘤者共194例。超音波之評分標準側沿用Gadducci等人所提之方法。最後由電腦計算出各組統計資料。
結果顯示合併CA-125值≧65U/ml及超音波分數≧8分，比單獨使用CA-125值或超音波檢查，有更理想的準確性。其敏感度為77.3%，特異性為81.4%及準確性為80.7%。
我們的結論是血中CA-125值不失為輔助超音波來鑑別診斷卵巢之良惡性的-良好工具。

並列摘要

Clinicians are urgently searching for ways of differentiating a malignant for a benign ovarian mass. How to approach or what is the prognosis? Some have shown the CA-125 test combined with ultrasonography to be highly sensitive and specific, when compared to single parameter. We examined 238 patients who underwent laparotomy for adnexal mass. Of these 44 were found to suffer from malignant tumors and 194 from benign from malignant tumors and 194 from benign lesions. Before the operation, CA-125 level was measured; pelvic ultrasonography was performed on each patient and the sonographic data were evaluated on an echostructural scoring system. After a sophisticated computer assisted analysis, the results of the combined tests were CA-125 ≧ 65U/ml or US score ≧8 with a sensitivity of 77.3%, a specificity of 81.4% and a diagnostic accuracy of 80.7%. Therefore we confirm the CA-125 may be considered as a useful adjunct to sonography in the differential diagnosis of adnexal mass.

並列關鍵字

tumor marker ； ultrasonography ； ovarian cancer