经阴道超声联合血清sB7-H4、YKL-40、SDF-1对卵巢恶性肿瘤的诊断价值OA

Objective To explore the diagnostic value of transvaginal ultrasound combined with serum sol-uble B7-4(sB7-H4),human cartilage glycoprotein-39(YKL-40)and stromal cell-derived factor-1(SDF-1)for ovarian malignant tumors.Methods A total of 148 patients with ovarian tumors who underwent surgical treatment in the hospital from March 2022 to March 2024 were selected as the research subjects,who were di-vided into malignant group(n=57)and benign group(n=91)according to the results of pathological exami-nation.The serum levels of sB7-H4,YKL-40 and SDF-1 in the two groups were detected and compared.Color Doppler ultrasound was used to observe the blood flow in the lesions,and the pulsatility index(PI)and resist-ance index(RI)were recorded.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of serum sB7-H4,YKL-40 and SDF-1 for ovarian malignant tumors.The four-fold table method was used to analyze the diagnostic efficiency of transvaginal ultrasound combined with serum sB7-H4,YKL-40 and SDF-1 for ovarian malignant tumors,and the four items were analyzed in combination in series.Results Compared with the benign group,the proportions of blurred tumor morphology,irregular echo and no capsule,and the serum levels of sB7-H4,YKL-40 and SDF-1 in the malignant group were significantly in-creased(P<0.05),while PI and RI were significantly decreased(P<0.05).The diagnostic results of trans-vaginal ultrasound combined with serum sB7-H4,YKL-40 and SDF-1 for ovarian malignant tumors were con-sistent with the gold standard(Kappa=0.773,P<0.001).The diagnostic results of transvaginal ultrasound,serum sB7-H4,YKL-40 and SDF-1 alone were also consistent with the gold standard respectively(Kappa=0.627,0.704,0.684,0.662,all P<0.001).The results of ROC curve analysis showed that the areas under the curve(AUCs)of serum sB7-H4,YKL-40 and SDF-1 in diagnosing ovarian malignant tumors were 0.889,0.881 and 0.883 respectively,and the optimal cut-off values were 78.15 μg/L,60.34 pg/mL and 5.66 μg/L respectively.The sensitivity,specificity and accuracy of transvaginal ultrasound combined with serum sB7-H4,YKL-40 and SDF-1 in diagnosing ovarian malignant tumors were 80.70％,96.70％and 90.54％respectively.The sensitivity of the four-combined diagnosis of ovarian malignant tumors was significantly lower than that of transvaginal ultrasound alone(P<0.05),the specificity was significantly higher than that of transvaginal ultrasound,serum sB7-H4,YKL-40 and SDF-1 alone(P<0.05),and the accuracy was significantly higher than that of transvaginal ultrasound alone(P<0.05).Conclusion The serum levels of sB7-H4,YKL-40 and SDF-1 in patients with ovarian malignant tumors are significantly up-regulated,and transvaginal ultrasound combined with serum sB7-H4,YKL-40 and SDF-1 can effectively improve the accuracy of diagnosing ovarian malignant tumors,providing certain reference for clinical formulation of reasonable treatment plans.