子宫内膜异位症患者血清CA125测定

子宫内膜异位症患者血清ＣＡ＿（１２５）测定熊晓燕，舒明炎，高晓秋，刘惠兰，丛克家目前，子宫内膜异位症的诊断，主要依靠临床症状、体征及腹腔镜所见，而缺乏特异性手段。近年来研究发现，子宫内膜异位症患者血清ＣＡ＿（１２５）升高￣［１］。本研究对１１６例开腹...     

子宫内膜异位症患者血清中抗子宫内膜IgG抗体及CA125的测定

子宫内膜异位症 (内异症 )近年已成为一种严重影响育龄妇女生存质量的常见病。腹腔镜可早期诊断 ,但它是一种创伤性操作 ,费用高。为寻求简便、易行、无创性诊断方法 ,我们对内异症患者、正常及良性疾病对照者血清中的抗子宫内膜ＩｇＧ抗体及ＣＡ12 5值进行了测定 ,并探讨其用于临床诊断内异症的意义。一、资料和方法1.研究对象 :为 1998年 8月至 1999年 10月在我院住院经腹腔镜和开腹手术及病理检查证实为内异症的 39例患者 ,按 1985年美国生育协会修正的内异症分期法 (ＲＡＦＳ)进行分期 ,Ⅰ、Ⅱ期 8例 ,Ⅲ期 16例 ,Ⅳ期 15例 ;对照组 5 2…     

子宫内膜异位症患者血清CA125,抗子宫内膜抗体的测定

子宫内膜异位症患者血清ＣＡ１２５、抗子宫内膜抗体的测定伍俊萍张惜阴子宫内膜异位症是生育年龄妇女的常见病，我们测定子宫内膜异位症患者血清ＣＡ１２５、抗子宫内膜抗体（ＥｍＡｂ）的水平，并探讨其诊断价值。一、资料与方法１．研究对象：从我院１９９３年１２月至...     

血清CA125与抗子宫内膜抗体联合测定对子宫内膜异位症的诊断价值

目的 探讨血清CA125与抗子宫内膜抗体联合测定对于宫内膜异位症诊断的临床价值。方法 应用放射免疫法及酶联免疫吸附试验（ELISA）法测定44例子宫内膜异位症患者（EMT组）血清中CA125值及EMAb阳性情况，并与40例健康妇女对照组进行比较。结果 EMT组血清CA125值阳性率为61．4％（27／44），显著高于对照组5．0％（2／40），P〈0．05；EMT组抗子宫内膜抗体阳性率为65．9％（29／44），显著高于对照组7．5％（3／40），P〈0．05；联合测定EMT患者血清CA125值及抗子宫内膜抗体，其敏感性明显高于两者单独测定的敏感性。结论 血清CA125与抗子宫内膜抗体联合测定可提高子宫内膜异位症诊断的敏感性。     

联合测定血清EMAb和CA125对子宫内膜异位症的诊断价值

子宫内膜异位症 (ｅｎｄｏｍｅｔｒｉｏｓｉｓ ,ＥＭＴ)多见于生育期妇女 ,是引起下腹部疼痛的主要原因之一 ,其发病率各家报道不一 ,变化于 1%～ 5 0 %之间[1] 。腹腔镜是目前诊断ＥＭＴ的金标准 ,至今尚无一种简单有效的非损伤性的诊断方法 ,本文通过联合测定血清抗子宫内膜抗体 (ＥＭＡｂ)和ＣＡ12 5水平 ,以期为ＥＭＴ诊断提供一条新途径。1　资料与方法1 1　研究对象ＥＭＴ患者 34例 (ＥＭＴ组 ) ,年龄 2 1～ 4 6岁 ,平均为33 6岁 ,均为 1999年 11月至 2 0 0 1年 1月在我院妇科经手术病理诊断为ＥＭＴ住院患者。按修订的美国生育学会(…     

超声检查及血清CA125、EMAb测定诊断卵巢子宫内膜异位症的评价

超声检查及血清ＣＡ１２５、ＥＭＡｂ测定诊断卵巢子宫内膜异位症的评价张友忠许燕雪江森刘少平陈丽君（山东医科大学附属医院妇产科）卵巢是子宫内膜异位症（ｅｎｄｏｍｅｔｒｉｏｓｉｓ，ＥＭＴ）最易侵犯的部位〔１〕，近年来由于ＥＭＴ的发生率不断上升，卵巢ＥＭＴ...     

175例子宫内膜异位症患者血清CA125水平的回顾性分析

目的:分析子宫内膜异位症患者合并子宫内膜息肉的情况,探讨血清CA125水平与痛经、内异症rAFS分期、病灶部位的相关性,为临床上更好地解读CA125水平提供依据。方法:回顾性分析2010年1月至12月我院术中或术后病理诊断为子宫内膜异位症的175例患者的临床资料。结果:(1)20.0%的子宫内膜异位症患者合并子宫内膜息肉;(2)36.6%的内异症患者有中、重度痛经,痛经程度与血清CA125水平无相关性;(3)Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期内异症患者的平均CA125水平分别为21.5U/ml、28.4U/ml、38.6U/ml、57.1U/ml,Ⅲ～Ⅳ期内异症患者血清CA125水平高于Ⅰ～Ⅱ期患者(P<0.05);(4)腹膜型、混合型、卵巢型内异症患者血清CA125的阳性率分别为21.4%、63.0%和67.4%,混合型、卵巢型内异症患者血清CA125阳性率显著高于腹膜型(P<0.001)。结论:血清CA125水平不能作为内异症合并子宫内膜息肉的预测指标;血清CA125水平可用于辅助鉴别内异症的分期和病灶部位,但是CA125对于内异症的早期诊断缺乏敏感性。     

血清CA19-9及CA125测定诊断子宫内膜异位症

目的:探讨血清CA19-9及CA125测定对子宫内膜异位症(EMs)的诊断价值。方法:采用放射免疫法测定55例EMs患者血清CA19-9及CA125水平,并与同期门诊健康妇女(对照组)进行比较。结果:EMs组及对照组血清CA19-9和CA125检测值的中位数及阳性率分别为27.81 U/mL、43.6%,11.78 U/mL、0和24.2 U/mL、36.3%,9.02 U/mL、4.0%。两组间差异均有统计学意义(均P<0.05)。中重度(Ⅲ～Ⅳ期)EMs患者与轻度(Ⅰ～Ⅱ期)患者血清CA19-9和CA125中位数和阳性率分别为42.38 U/mL、57.9%,17.36 U/mL、11.8%和34.75 U/mL、50.0%,15.3U/mL、5.9%,不同分期间差异有统计学意义(均P<0.05)。血清CA19-9和CA125诊断EMs的敏感度、特异度及准确度分别为43.6%、100%、61.25%及36.3%、96.0%、55.0%。结论:血清CA125和CA19-9在EMs患者中均有明显升高,测定两种血清标记物水平可协助EMs的诊断;两者血清水平与EMs患者病情程度有关。     

不同部位子宫内膜异位症与血清CA125水平的关系

目的:探讨血清CA125水平与不同部位的子宫内膜异位症之间的相关性。方法:选择经手术或腹腔镜确诊的内异症患者63例和排除内异症的对照组30例,按内异症发生部位的不同分为3组:Ⅰ组(卵巢内异组)34例;Ⅱ组(阴道直肠隔内异组)15例;Ⅲ组(腹壁切口内异组)14例。Ⅳ组为对照组,系临床和病理检查排除了内异症的健康者。术前采取空腹静脉血,用化学发光法测定各组血清中CA125水平。结果:(1)卵巢内异组、阴道直肠内异组的血清CA125水平均显著高于对照组(P<0·05);腹壁切口内异组CA125水平显著低于卵巢内异组(P<0·05),而与阴道直肠隔内异症组、对照组比较无统计学差异(P>0·05);(2)以血清CA125≥35U/ml为临界值,CA125诊断各组内异症的敏感性分别为:卵巢内异症52·94%,阴道直肠内异症40·00%,腹壁切口内异症21·43%。诊断特异性为96·67%。结论:CA125在诊断子宫内膜异位症发生方面具有一定的价值,但并不是敏感指标。单凭血清CA125不能鉴别不同部位的子宫内异症。     

CA125与子宫内膜抗体测定用于诊断子宫内膜异位症

测定了４２例妇女血清和腹腔液ＣＡ＿（１２５）及子宫内膜抗体（ＥＭＡｂ）水平，其中经腹腔镜诊断为子宫内膜异位症者２８例（观察组），无子宫内膜异位症者１４例（对照组）。结果表明：观察组血清ＥＭＡｂ的吸光度为０．４４±０．１３，明显高于对照组的０．３４±０．０７，但两组间血清ＣＡ＿（１２５）差异无显著性；两含用于诊断的敏感性分别为７１．４３％和８２．１４％，特异性为５７．２１％和５７．１４％。两组腹腔液中ＥＭＡｂ差异无显著性；两组腹腔液ＣＡ＿（１２５）和ＥＭＡｂ水平均明显高于血清。     

对子宫腺肌病患者血清CA125及EMAb的临床评价

目的：探讨血清CA125及子宫内膜抗体（EMAb)测定，对子宫腺肌病的诊断及疗效评估的临床价值。方法：经术后病理学检查确诊子宫腺肌病患者63例和子宫肌瘤患者45例，均于术前及术后测定两组血清CA125水平和EMAb。结果：子宫腺肌病组术前血清CA125平均水平及EMAb阳性率均高于子宫肌瘤组，两者相比差异有显著性（P＜0．001及P＜0．01）。联合测定血清CA125水平和EMAb，以两者均阳性为诊断标准，诊断子宫腺肌病的敏感性为54．63％，特异性为100％。子宫腺肌病组术后血清CA125水平和EMAb阳性率均较术前下降，差异有显著性（P＜0．01及P＜0．05）。结论：测定血清CA125及EMAb对子宫腺肌病有较好的辅助诊断价值，联合检测更能提高诊断的正确性，并可作为评价子宫腺肌病疗效的敏感指标。     

CA125对子宫内膜癌检测及临床意义

目的 探讨血清CA25值对子宫内膜癌早期诊断、监测病情变化和预测预后的价值。方法 用免疫化学法检测55例子宫内膜癌患者和16例良性子宫病变患者血清CA125水平。结果 良性子宫病变和44例手术分期为I期的子宫内膜癌患者血清CA125阳性率分别为19．4％和27．3％，两者相比，P＞0．05，无显著性差异（P＞0．05）。手术分期为I期和10例晚期病人（Ⅲ期＋Ⅳ期）血清CA125的阳性率各为27．3％和70％，两者相比，有显著性差异（P＜0．05）。30例Ia期＋Ib期和14例Ic期病人血清CA1254的阳性率分别为20％和47．8％，两者相比，无显著性差异（P＞0．05）。病理分级中30例G1、20例G2、5例G3血清CA1254的阳性率分别为20％、45％、80％，三者相比，相互之间有显著性差异（P＜0．05）。结论 血清CA125的检测对早期诊断子宫内膜癌缺乏敏感性，对早期内膜癌患者预测手术分期，Ic期无明显的参考价值，但与手术分期和病理分级密切相关，可能对预测预后提供一定的参考价值。     

Serum CA 125 levels before, during and after treatment for endometriosis

Objectives: The aim of this study was to assess the treatment of endometriosis with a gonadotropin-releasing hormone (GnRH) agonist in terms of changes to the extent of disease and to CA 125 levels as well as to recurrence during follow-up. Methods: The levels of serum CA 125 were evaluated in 66 patients with endometriosis diagnosed and staged by laparoscopy according to the revised American Fertility Society classification, who received a 6-month course of a GnRH agonist. Serum CA 125 levels were measured before, during (3 and 6 months after the initiation of therapy) and 6 months after cessation of therapy. Results: Patients with minimal and mild endometriosis had significantly higher mean pretreatment values than control subjects in the luteal phase of the cycle or than postmenopausal women (P < 0.05), but the overall mean value was still below 35 U/ml. Levels of CA 125 fell during treatment to those found in normal controls, but rose again after the end of treatment. The sensitivity and specificity of CA 125 were 75% and 83.3%, respectively, and its positive predictive value as a marker of recurrence was 46.36%. Conclusion: These data suggest that CA 125 may be a reliable indicator for monitoring the efficacy of GnRH agonist treatment of endometriosis, but its value as a predictor of recurrence is low, probably due to the suppression of all CA 125 sources such as endometrium, ovaries and implants.     

血清及腹腔液CA125测定对子宫腺肌病的诊断价值

目的探讨血清及腹腔液CA125测定对子宫腺肌病的诊断价值.方法采用免疫化学发光法测定28例子宫腺肌病和25例子宫肌瘤患者血清及腹腔液(110稀释)CA125水平.结果子宫腺肌病患者血清CA125水平高于子宫肌瘤患者,差异有显著性(P＜0.01).两组间腹腔液CA125水平差异无显著性(P=0.18).腹腔液CA125水平明显高于血清CA125水平(P＜0.01),但二者无明显相关性(P＞0.50).腺肌病患者血清CA125水平受子宫大小、大体病理类型、使用性激素等因素影响.结论如用于子宫腺肌病的辅助诊断,血清CA125测定较腹腔液CA125测定敏感.腹腔液中CA125的主要来源可能为腹膜上皮细胞.     

动态监测CA125 EMAb对子宫动脉栓塞术治疗子宫腺肌病的疗效评价

目的采用血清CA125、子宫内膜抗体(EMAb)动态监测,评价子宫动脉栓塞术(UAE)治疗子宫腺肌病的疗效.方法 2002年3月至2004年3月对就诊于广州市妇婴医院、中山大学附属第三医院的86例确诊为子宫腺肌病患者,在UAE术前及术后连续动态监测血清CA125、EMAb之变化.结果血清CA125水平在UAE后第4周开始下降至(89±11.3)kU/L,和术前(128±44.3)kU/L比较,差异有显著性意义(P<0.05);术后CA125稳定下降,至18个月降至正常水平(<35kU/L);血清EMAb术前52例阳性,第2个月开始下降,和术前比较术后EMAb阳性率差异有显著性意义(P<0.05).结论血清CA125、EMAb动态监测UAE治疗子宫腺肌病的疗效,其方法简单且具有临床实用意义.     

CA 125 normalization with chemotherapy is independently predictive of survival in advanced endometrial cancer

Objective

Changes in CA 125 with chemotherapy predict outcome for epithelial ovarian cancer. There is no such data for advanced endometrial cancer.

Method

Retrospective review of all women receiving carboplatin and paclitaxel for advanced endometrial cancer at any of the institutions of the British Columbia Cancer Agency between September 1995 and September 2006.

Results

185 newly diagnosed women were treated. Univariable analysis for progression-free survival identified as adverse predictors: grade 3, positive residual, age > 60, deep myometrial invasion, increasing stage/substage, papillary serous subtype, presence of cervical involvement, ECOG 1 or greater, CA 125 above 35 either preoperatively or at start of cycle 1 and CA 125 greater than 24 at the start of cycle 3. Upon multivariate analysis, CA 125 above 24 at cycle 3, grade 3 and positive residual remained as independent predictors. The single most important factor identified by decision tree analysis was CA 125 level at cycle 3.

Conclusion

As with epithelial ovarian cancer, changes in CA 125 are highly predictive of outcome for advanced, chemotherapy treated endometrial cancer.     

Usefulness of CA19-9 versus CA125 for the diagnosis of endometriosis

OBJECTIVE: To investigate the clinical value of the serum CA19-9 level in comparison with the serum CA125 level for diagnosing and determining the severity of endometriosis. DESIGN: Retrospective study. SETTING: Department of Comprehensive Reproductive Medicine in a university hospital. PATIENT(S): One hundred one women with endometriosis and 22 without endometriosis participated in this study. INTERVENTION(S): Blood samples were collected before the operation (laparoscopy, oophrectomy, cystectomy, and/or hysterectomy), and tissue samples of ovarian chocolate cysts were collected during the operation. MAIN OUTCOME MEASURE(S): The serum CA19-9 and CA125 levels and the localization of these antigens in ovarian chocolate cysts. RESULT(S): The mean serum CA19-9 levels in patients at all stages of endometriosis were significantly higher than those in patients without endometriosis, and serum CA19-9 levels significantly correlated with the Revised American Fertility Society classification scores. Intense staining of CA19-9 was observed in 15 of the 20 samples of ovarian chocolate cysts. CONCLUSION(S): CA19-9 is a useful marker for determining the severity of endometriosis.