| 摘要: |
| ［摘要］ 目的 探讨阴道超声联合血清Ki-67、甲胎蛋白（AFP）鉴别卵巢未成熟畸胎瘤和卵巢成熟畸胎瘤的应用价值。方法 招募2023年1月至2024年7月安康市中心医院收治的卵巢畸胎瘤患者135例，依据术后病理结果将其分为卵巢成熟畸胎瘤组（n=108）和卵巢未成熟畸胎瘤组（n=27）。采用多因素logistic回归分析有助于鉴别卵巢未成熟畸胎瘤和卵巢成熟畸胎瘤的因素，采用受试者工作特征（ROC）曲线分析血清Ki-67、AFP水平鉴别卵巢未成熟畸胎瘤和卵巢成熟畸胎瘤的效能，采用Kappa一致性分析探讨阴道超声检查结果与病理检查结果的一致性。比较不同检查方法鉴别卵巢未成熟畸胎瘤和卵巢成熟畸胎瘤的效能。结果 多因素logistic回归分析结果显示，螺旋动脉搏动指数、螺旋动脉阻力指数、子宫动脉搏动指数、子宫动脉阻力指数、内膜厚度、血流指数、血管指数、血管化血流指数、AFP、Ki-67是有助于鉴别卵巢未成熟畸胎瘤和卵巢成熟畸胎瘤的因素（P<0.05）。ROC曲线分析结果显示，血清Ki-67［AUC（95%CI）=0.767（0.354～0.946）］、AFP［AUC（95%CI）=0.714（0.321～0.934）］水平均能较好鉴别卵巢未成熟畸胎瘤和卵巢成熟畸胎瘤（P<0.05）。Kappa一致性分析结果显示，阴道超声检查判定结果与病理检查结果的一致性较好（Kappa=0.606，P<0.001）。阴道超声检查联合血清Ki-67、AFP鉴别卵巢未成熟畸胎瘤和卵巢成熟畸胎瘤的准确率达93.33%，高于单项检查指标以及血清Ki-67联合AFP检查。结论 阴道超声联合血清Ki-67、AFP可有效鉴别卵巢未成熟畸胎瘤和卵巢成熟畸胎瘤，有助于临床早期识别高危患者，指导临床制订治疗方案，值得推荐。 |
| 关键词: 阴道超声 甲胎蛋白 Ki-67 卵巢成熟畸胎瘤 卵巢未成熟畸胎瘤 鉴别诊断 |
| DOI：10.3969/j.issn.1674-3806.2026.05.09 |
| 分类号:R 737.31 |
| 基金项目:陕西省重点研发计划项目（编号：2022SF-2170） |
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| Study on the application value of vaginal ultrasound combined with serum Ki-67 and AFP in differentiating immature ovarian teratoma from mature ovarian teratoma |
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DING Kun, YUAN Shenglan, TAN Hongjun
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Department of Ultrasound Medicine, Ankang Central Hospital, Ankang 725000, China
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| Abstract: |
| ［Abstract］ Objective To explore the application value of vaginal ultrasound combined with serum Ki-67 and alpha-fetoprotein(AFP) in differentiating immature ovarian teratoma from mature ovarian teratoma. Methods A total of 135 patients with ovarian teratoma who were admitted to Ankang Central Hospital from January 2023 to July 2024 were recruited and divided into mature ovarian teratoma group(n=108) and immature ovarian teratoma group(n=27) according to the postoperative pathological results. Multivariate logistic regression was used to analyze the factors that were helpful in differentiating immature ovarian teratoma from mature ovarian teratoma. The receiver operating characteristic(ROC) curve was used to analyze the efficacy of serum Ki-67 and AFP levels in differentiating immature ovarian teratoma from mature ovarian teratoma. Kappa consistency analysis was used to explore the consistency between vaginal ultrasound examination results and pathological examination results. The efficacy of different examination methods in differentiating immature ovarian teratoma from mature ovarian teratoma was compared. Results The results of multivariate logistic regression analysis showed that spiral artery pulsatility index, spiral artery resistance index, uterine artery pulsatility index, uterine artery resistance index, endometrial thickness, blood flow index, vascular index, vascularization flow index, AFP and Ki-67 were the factors that were helpful in differentiating immature ovarian teratoma from mature ovarian teratoma(P<0.05). The results of ROC curve analysis showed that the levels of serum Ki-67［AUC(95%CI)=0.767(0.354-0.946)］ and AFP［AUC(95%CI)=0.714(0.321-0.934)］ could well differentiate immature ovarian teratoma from mature ovarian teratoma(P<0.05). The results of Kappa consistency analysis indicated a good consistency between the diagnostic results of vaginal ultrasound examination and pathological examination(Kappa=0.606, P<0.001). The accuracy rate of vaginal ultrasound examination combined with serum Ki-67 and AFP in differentiating immature ovarian teratoma from mature ovarian teratoma was 93.33%, which was higher than that of a single examination indicator and the combined examination of serum Ki-67 and AFP. Conclusion Vaginal ultrasound combined with serum Ki-67 and AFP can effectively differentiate immature ovarian teratoma from mature ovarian teratoma, which is helpful for the early identification of high-risk patients and guiding the formulation of treatment regimens in clinical practice. It is worthy of recommendation. |
| Key words: Vaginal ultrasound Alpha-fetoprotein(AFP) Ki-67 Mature ovarian teratoma Immature ovarian teratoma Differential diagnosis |
