卵巢子宫内膜异位囊肿患者血清CA 125及临床相关因素分析

目的:探讨CA125在子宫内膜异位症的诊断意义及影响CA125水平可能存在的临床相关因素。方法:回顾性分析卵巢内异囊肿组76例,卵巢囊肿组58例及子宫腺肌症组32例血清CA125值及相关临床因素。结果:异位囊肿组CA125值(34.1±5.4)IU/ml,腺肌症组血清CA125值(30.7±4.3)IU/ml,均显著高于卵巢囊肿组。血清CA125诊断卵巢巧克力囊肿的敏感性为28.95%,特异性为92.63%。内异患者血清CA125水平随着rAFS分期期别的升高而增加。内异囊肿合并有盆腔粘连患者血清CA125值显著高于无粘连患者(P<0.05),且CA125值与rAFS分期粘连评分分值呈正相关,r=0.253,P<0.05。rAFS分期中,各个期别的痛经以及不孕的发生率没有显著差异(P>0.05)。血清CA125值与月经周期无明显相关性。不同生育和流产次数患者之间以及内异囊肿左侧、右侧或者双侧各组之间CA125水平差异无显著性(P>0.05)。结论:血清CA125在异位症患者中明显升高,尤其是重度者,可作为与卵巢囊肿鉴别诊断的辅助指标,CA125可作为术前评价内异症盆腔粘连严重程度的一个指标。

Clinical evaluation of serum CA - 125 concentrations in ovary endometriosis patients.

Objective:To investigate the factors contributing to the evaluated level of CA125 in diagnosis of endometriosis and adenomyosis.Methods:166 women undergoing surgery for ovarian cysts or adenomyosis were studied.Preoperative serum CA125 levels were compared between various pelvic conditions.Results:The mean serum CA 125 levels(IU/ml)for endometriosis and adenomyosis were 34.1±5.41 and 30.7±4.3 respectively,significantly higher than that for other cysts.The sensitivity and specificity of CA125 were 28.95% and 92.63%,respectively.Serum CA 125 levels significantly correlated with the Revised American Fertility Society classification scores.Furthermore,serum CA-125 levels were significantly higher in patients with more extensive pelvic adhesions(r=0.253,P<0.05),and did not show significant correlation with sterility and abortion.Conclusion:CA125 can be used as a diagnostic test for endometriosis,especially for the advanced stage of endometriosis,and CA125 is a useful marker for determining the severity of endometriosis pelvic adhesions.