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1.
术前测定血清CA125,CA19.9,CA72.4,CEA和GM—CSF在鉴别附件包 …   总被引:2,自引:0,他引:2  
目的:探讨术前测定2血清CA125、CA19.9、CA72.4、CEA和GM-CSF水平在鉴别附件包块良恶性质中的作用。方法:74例附件包块患者术前1周内采外周血,用固相免疫放射法测定各种肿瘤标志物浓度,并与术后组织学诊断比较。计算各标志物单独和联合应用诊断卵巢癌的相应诊断系统。结果:(1)CA125(临界什70U/ml)鉴别卵巢肿瘤性质的敏感性和特异性分别为85.71%和82.61%,CA19.  相似文献   

2.
目的:以凝集素制成分子探针用于检测卵巢肿瘤细胞膜标志物,即凝集素受体,并与其他肿瘤标志物的检测进行比较。方法:卵巢癌变组织经匀浆、阶段离心、酶解、分子筛等处理得到卵巢癌变细胞膜糖肽,用凝集素亲和电泳法寻找卵巢癌细胞膜标志物,通过刀豆素提纯肿瘤标志物,给兔注射制备纯化的特异性兔抗体,再用ELISA检测卵巢肿瘤患者38例血清中的凝集素受体浓度。结果:卵巢肿瘤恶性组血清凝集素受体浓度显著高于良性组(P<0.001),而且凝集素受体浓度随着卵巢癌细胞恶性程度及临床分期的增加而升高;用凝集素受体浓度值115.3U/ml或175.59U/ml作为诊断卵巢癌的界值,其阳性率分别为95.7%和73.9%,高于同时用单克隆抗体CA125(63.6%)、CA15-3(72.7%)、CA19-9(54.5%)的检测。结论:凝集素受体对卵巢癌的诊断有高度的敏感性和特异性,优于单克隆抗体。  相似文献   

3.
组织多肽抗原在卵巢癌诊断及监测中的应用   总被引:4,自引:0,他引:4  
目的评价组织多肽抗原(TPA)在卵巢癌诊断和监测中的临床价值。方法应用放射免疫方法测定了24例正常妇女、27例妇科良性疾患及60例卵巢癌患者的血清TPA及CA125值并进行比较分析。结果TPA在卵巢上皮性癌患者中的异常检出率为82%,CA125为70%,二者总的异常检出率为92%。在绝大多数正常妇女和卵巢良性肿瘤患者中,CA125和TPA在正常范围。作为卵巢癌相关标志物,TPA与CA125具有相似敏感性。19例动态观察结果显示,TPA和CA125二者与病情转归是一致的。结论TPA和CA125联合应用对卵巢癌的鉴别诊断及提高总的异常检出率具有价值。  相似文献   

4.
绝经后附件肿块203例临床分析   总被引:4,自引:0,他引:4  
回顾分析203例绝经后附件肿块患者临床资料,表明:恶性肿瘤占37.9%。单房囊性肿块的恶性率明显低于实性、囊实性、多房囊性肿块(P<0.01)。双侧肿块恶性率明显高于单侧肿块(P<0.01)。193例卵巢肿瘤患者,其中124例术前测定血CA125(临界值35U/ml),结合B超,诊断卵巢恶性肿瘤的特异性90.4%、敏感性88.2%、准确性89.5%。结论:B超结合CA125可作为绝经后卵巢恶性肿瘤早期诊断的方法。绝经后附件肿块恶性率高,尤其是双侧、实性、囊实性或囊性多房者,应尽早手术治疗。  相似文献   

5.
应用多项肿瘤标记物检测卵巢恶性肿瘤的研究   总被引:29,自引:4,他引:25  
目的为了提高卵巢恶性肿瘤诊断的特异性及敏感性,加强术后患者的病情追踪。我们应用5项肿瘤标记物SA,LSA,CA125,CP2,6B11Ab2进行临床观察。方法对67例卵巢恶性肿瘤及33例卵巢良性肿瘤患者进行血清检测,以38例正常妇女进行对照。结果单纯应用CA125诊断卵巢恶性肿瘤的敏感性及特异性分别为836%及859%,而5项肿瘤标记物中以任意3项及3项以上阳性为标记物诊断阳性时,检测卵巢恶性肿瘤的敏感性及特异性分别为866%及944%。临床Ⅰ、Ⅱ期患者的5项肿瘤标记物联合检测的特异性及敏感性,较CA125单项检测有明显提高。结论5项肿瘤标记物联合检测,对提高卵巢恶性肿瘤诊断的准确性及术后监测有一定意义  相似文献   

6.
肿瘤标记物联合检测对卵巢恶性肿瘤的诊断价值   总被引:5,自引:0,他引:5  
应用放免及生化法对107例卵巢肿瘤患者及50例正常健康妇女血清SF(铁蛋白)、β2-MG(β2-微球蛋白)、CEA、LDH、AFP和β-hCG进行定量检测。结果表明:①卵巢恶性肿瘤组血清SF、β2-MG、CEA及LDH含量均显著高于卵巢良性肿瘤组及正常对照组(P<0.01);SF含量与肿瘤分期呈正相关,随卵巢恶性肿瘤临床期别增高而递增。AFP、β-hCG含量在卵巢良、恶性肿瘤组间及正常对照组间均无显著差异,提示血清SF、β2-MG、CEA和LDH检测,对卵巢恶性肿瘤的诊断及卵巢良、恶性肿瘤的鉴别诊断有一定临床意义。②SF、β2-MG、CEA及LDH诊断卵巢恶性肿瘤的准确性分别为79.44%、69.16%、65.40%及56.07%,四项联合准确性可提高到83.18%,提示:联合检测可提高临床诊断价值,优于单项检测结果。联合检测并结合病史及临床检查,可作为卵巢癌的初筛检查。  相似文献   

7.
对恶性肿瘤70例(恶性组)、良性肿瘤50例(良性组)和正常健康妇女50例(对照组)尿中半抗氨酸蛋白酶(UCP)活性进行测定。结果:UCP辅助诊断恶性肿瘤的敏感性为90%、特异性为80%、准确性为86%。恶性组UCP值明显高于良性组和对照组(P<0.01)。UCP检测对卵巢癌尤为敏感,敏感性为95%,高于子宫体癌(77%)、宫颈癌(85%)。UCP、血清肿瘤标记物CA_(125)及乳酸脱氢酶(LDH)同功酶辅助诊断卵巢癌的敏感性依次为90%、85%、75%;特异性为80%、87%、85%;准确性为84%、84%、80%。UCP与CA_(125)对卵巢癌的辅助诊断有同样的价值,而且优于LDH同功酶。8例卵巢癌Ⅰ期患者,7例UCP值异常,而同组6例卵巢癌Ⅰ期患者中,无1例CA_(125)值异常,说明UCP检测对早期卵巢癌较CA_(125)更敏感。提示:UCP可能成为妇科恶性肿瘤,特别是卵巢癌的标记物。  相似文献   

8.
卵巢上皮性肿瘤组织中CA125的定位测定   总被引:3,自引:0,他引:3  
卵巢上皮性肿瘤组织中CA_(125)的定位测定邓晓谷,叶启文,彭真年本研究以卵巢癌抗原CA_(125)的单克隆抗体OA_(125)及免疫组化ABC法,对141例各型卵巢上皮性肿瘤组织中CA_(125)进行定位测定,了解浆液性囊腺癌组织CA_(125)...  相似文献   

9.
CA125、CEA、AFP、铁蛋白、β2-微球蛋白联合检测诊断卵巢癌的探讨汤荣光胡家骆刘献华卵巢恶性肿瘤发病率高,死亡原因居女性生殖系统恶性肿瘤之首。近30年来,5年存活率一直在25%~30%之间,其原因主要是因为缺乏有效的早期诊断手段。现用于临床的...  相似文献   

10.
应用免疫放射分析方法对141例经手术后病理证实的卵巢上皮性癌病人(其中浆液性乳头状囊腺癌69例,子宫内膜样腺癌24例,粘液性癌16例,未分化癌26例,透明细胞癌6例)进行血清CA_(125)测定。对其中50例手术前CA_(125)阳性病人,在术后1~3个月进行两次以上的血清CA_(125)测定,观察疗效和CA_(125)水平变化间的相关性,对1例浆液性癌病人术后2个月始,每两周测定一次血清CA_(125)连续测定10个月。结果:浆液性癌阳性率为94%,子宫内膜样腺癌阳性率为79%,粘液性癌均为阴性,未分化癌阳性率为38%,透明细胞癌均为阳性。全部病人疗效为完全缓解的21例,术后CA_(125)水平较术前明显下降(P<0.001),疗效为进展的22例,术后CA_(125)值较术前明显增高(P<0.001),疗效为无改变的7例,手术前、后CA_(125)值,差异无显著性(P>0.05)。提示:CA_(125)免疫放射分析对卵巢上皮性癌有较高的敏感性和特异性,对疗效观察有参考价值。  相似文献   

11.
The serum levels of CA 125 (cutoff limit, 65 U/ml), CA19.9 (cutoff, 40 U/ml), CA 15.3 (cutoff, 32 U/ml), CA72.4 (cutoff, 3.8 U/ml), and TATI (cutoff, 22 ng/ml) were preoperatively measured in 90 patients with epithelial ovarian cancer and in 254 patients with benign ovarian pathology. CA125 had a sensitivity of 75.6%, a specificity of 86.6%, and a diagnostic accuracy of 83.7% for epithelial ovarian cancer; CA19.9 had a sensitivity of 35.6%, a specificity of 81.1%, and a diagnostic accuracy of 69.2%; CA15.3 had a sensitivity of 57.1%, a specificity of 93.9%, and a diagnostic accuracy of 84.6%; CA72.4 had a sensitivity of 70.7%, a specificity of 91.8%, and a diagnostic accuracy of 86.2%; and TATI had a sensitivity of 47.3%, a specificity of 95.3%, and a diagnostic accuracy of 82.9%. CA 125 was the most sensitive marker for nonmucinous tumors, while CA19.9 and CA72.4 were the antigens more frequently expressed by mucinous malignancies. The sensitivities of serum CA 125 (81.1% vs 50.0%; P = 0.01) and TATI (55.2% vs 18.8%; P = 0.02) were higher in patients above 50 years of age than in younger patients while specificities were quite similar in both age groups. The association of serum CA125 and CA19.9 had a significantly higher sensitivity (93.2% vs 81.1%; P = 0.03) and a slightly lowered specificity (78.9% vs 86.0%; P = 0.46) than CA125 assay alone in the differential diagnosis of ovarian masses in patients above 50 years of age.  相似文献   

12.
探讨术前测定患者血清CA12 5、CA19 9、CA72 4、CEA和GM -CSF水平在鉴别附件包块良恶性质中的作用。方法 :74例附件包块患者术前 1周内采外周血 ,用固相免疫放射法测定各种肿瘤标志物浓度 ,并与术后组织学诊断比较。计算各标志物单独和联合应用诊断卵巢癌的相应诊断参数。结果 :( 1)CA12 5(临界值 70U/ml)鉴别卵巢肿瘤性质的敏感性和特异性分别为 85 71%和 82 61% ,CA19 9(临界值 30U/ml)分别为 4 2 86%和 73 33% ,CA72 4 (临界值 3 8U/ml)分别为 53 57%和 90 90 % ,CEA(临界值 5ng/ml)分别为 4 6 4 3%和 4 8 89% ;( 2 )联合应用肿瘤标志物 :CA12 5联合CA19 9的敏感性和特异性分别为 89 2 9%和 73 33% ;CA12 5联合CA72 4的敏感性和特异性分别为 89 2 9%和 75 56% ;CA12 5联合CEA的敏感性和特异性分别为 92 86%和 4 0 0 0 % ;( 3)如果去除 9例子宫内膜异位症 ,CA12 5、CA19 9、CA72 4和CEA的特异性分别增至 89 19% ,80 55% ,94 2 9%和4 7 2 2 %。结论 :此项研究应用的肿瘤标志物中以CA12 5最为敏感。将CA12 5临界值定为 70U/ml时诊断效果最佳。CA72 4的特异性最高 ,但诊断卵巢癌的敏感性低。CEA的诊断价值有限 ,GM -CSF则无价值。CA12 5与其他肿瘤标志物联合检测时诊断的特异性会部分丧失。?  相似文献   

13.
OBJECTIVE: To evaluate, in patients with benign and malignant ovarian cysts, serum samples and ovarian intracystic fluids for the presence of tumor markers such as CA 125, CA 15.3, tissue polypeptide antigen (TPA), CA 19.9 and the carcinoembryonic antigen (CEA). MATERIAL AND METHOD: We studied overall 64 patients with ovarian pathology. Sixteen patients were affected by functional cysts, 28 women by benign cystic tumors and 20 by cystoadenocarcinomas. RESULTS: Average serum levels of all but CA 15.3, TPA and CEA tumor markers of benign cystic ovarian tumors were higher than those of functional cysts. All but CA 19.9 mean intracystic fluid markers levels were more elevated in benign tumors than in functional cysts. In patients with malignant cystic tumors, all but CEA mean serum marker levels were higher than those of benign tumors; furthermore even all mean intracystic levels of markers were more elevated than those of benign tumors. CONCLUSION: This study confirmed the high positivity of tumor markers such as CA 125, CA 15.3, TPA, CA 19.9 and CEA in both the serum and intracystic fluid of patients with malignant epithelial ovarian tumors.  相似文献   

14.
The combined value of four tumor markers, in the follow-up of endometrial adenocarcinoma, is analyzed. Cancer antigen 125 (CA 125), squamous cell carcinoma antigen (SCC), carbohydrate antigen 19.9 (CA 19.9) and carbohydrate antigen 15.3 (CA 15.3) were used in 213 evaluations from 105 patients. Sensitivity as regards recurrence or progression of disease was 45% (CA 125), 9% (SCC), 51% (CA 19.9) and 21% (CA 15.3). Specificities as regards the 'no evidence of disease' ranged from 95% to 99%. Single tumor marker efficiency ranged from 90% for CA 125 to 84% for SCC (p = 0.08). With the two tumor marker combination sensitivity increased up to 77% achieved with CA 125-CA 19.9, but efficiency increased only slightly (92.0% for CA 125-SCC). In the best three tumor marker combination, a sensitivity of 85% was achieved (CA 125-CA 19.9-CA 15.3), and an efficiency of 92.2%. The simultaneous use of the four tumor markers did not improve assay results. The possibility of recurrence or progression of disease in some combinations was very low (4.6% when CA 125 and CA 19.9 negative, 3% when CA 125, CA 19.9 and CA 15.3 negative), a fact to be considered in order to avoid aggressive management in such cases. The tumor markers were of limited value for the prediction of recurrences. The suggestion of recurrence when the increase in tumor markers was the only finding was confirmed in only 7%, while confirmation was made in 100% when there was another pathological finding.  相似文献   

15.
CA125 is currently the most widely used tumor marker for ovarian epithelial cancer. The aim of this article is to provide guidelines for the routine clinical use of CA125 in patients with ovarian cancer. Due to lack of sensitivity for stage I disease and lack of specificity, CA125 is of little value in the detection of early ovarian cancer. At present, therefore, CA125, either alone or in combination with other modalities, cannot be recommended for screening for ovarian cancer in asymptomatic women outside the context of a randomized controlled trial. Preoperative levels in postmenopausal women, however, may aid the differentiation of benign and malignant pelvic masses. Serial levels during chemotherapy for ovarian cancer are useful for assessing response to treatment. Although serial monitoring following initial chemotherapy can lead to the early detection of recurrent disease, the clinical value of this lead-time is unclear. CA125 is the ovarian cancer marker against which new markers for this malignancy should be judged.  相似文献   

16.
OBJECTIVES: The serum tumor marker CA 125 is elevated in most clinically advanced ovarian carcinomas. Because these elevations may precede clinical detection by a year or more, CA 125 is potentially useful for early detection as part of an ovarian cancer screening program. However, CA 125 is often not elevated in clinically detected cancer and is frequently elevated in women with benign ovarian tumors. CA 125 may be more useful in conjunction with one or more other tumor biomarkers. Additional markers could play a role if, when used with CA 125, they identify some carcinomas missed by CA 125 (i.e., they improve sensitivity), rule out false positives (i.e., improve specificity), or are able to detect the same cancers earlier. METHODS: We have evaluated a composite marker (CM) that combines CA 125 and a previously described soluble mesothelin related (SMR) marker in sera from 52 ovarian cancer cases, 43 controls with benign ovarian tumors, and 220 normal risk controls who participated in a screening program, including 25 healthy women having two serum samples collected 1 year apart. CA 125, SMR, and CM were evaluated for their ability to identify clinical disease and for their temporal stability, which assesses their ability to obtain even greater sensitivity when used in a longitudinal screening program. RESULTS: CM has the best sensitivity, with specificity equal to CA 125. Importantly, CM has temporal stability at least as high as CA 125. CONCLUSION: The CM may outperform CA 125 alone in a longitudinal screening program as well as in a diagnostic setting.  相似文献   

17.
目的:探讨血浆溶血磷脂酸(LPA)在卵巢上皮癌患者血浆中的表达水平,及其与血清CA125和经阴道彩色多普勒超声(TV-CDUS)联合应用诊断卵巢上皮癌的临床价值。方法:术前检测卵巢上皮癌48例,卵巢良性肿瘤30例的LPA、CA125,以20例健康者作为对照,卵巢肿瘤患者同时经阴道超声评分和TV-CDUS检查。结果:卵巢癌患者LPA水平明显高于卵巢良性肿瘤组和健康对照组,差异有统计学意义(P0.05),LPA水平在良性肿瘤组与健康对照组之间无显著差异(P0.05)。单独应用LPA、CA125、TV-CDUS检测诊断卵巢癌的敏感性和特异性分别为87.5%、79.16%、81.25%和80%、70%、86%,各组间敏感性和特异性比较,无显著差异(P0.05)。LPA、CA125、TV-CDUS 3项联合检测诊断卵巢癌的敏感性和特异性为95.80%和94%,与单独应用CA125检测特异性比较,差异有统计学意义(P0.05)。LPA诊断卵巢癌的敏感性和特异性与卵巢癌分期和病理类型无关(P0.05),CA125诊断卵巢癌的敏感性和特异性与卵巢癌的分期和病理类型有关(P0.05)。结论:卵巢上皮癌患者血浆LPA水平明显升高,有望成为卵巢上皮癌诊断的敏感指标,联合检测血浆LPA、血清CA125与TV-CDUS有助于术前卵巢癌的诊断。  相似文献   

18.
The levels of CA125, CA19.9, CA15.3 CA72.4, and TATI were serially measured during and after chemotherapy in 43 patients with epithelial ovarian cancer having elevated concentrations of one or more of the antigens before initial surgery. The value of 35 U/ml was chosen as cutoff level of CA125 for the monitoring of disease. Changes in the serum levels of CA125, CA19.9, CA15.3, CA72.4, and TATI correlated with the clinical course of disease in 87.4% of 215, 76.3% of 80, 71.3% of 122, 76.0% of 167, and 48.5% of 101 instances, respectively. After the sixth course of monthly primary chemotherapy, elevated antigen levels were strong predictors of persistent disease, while normal antigen values were associated with both positive and negative second-look findings. It is worth noting that antigen levels above the cut-off limits before the third course, but still in the normal range after the sixth course, seemed to be predictive of positive second-look findings. Among patients with elevated antigen levels at diagnosis, clinical detection of neoplastic progression after treatment was stopped was preceded by an elevation of serum CA125 in 93.3% of 15 patients, of serum CA19.9 in 80.0% of 5 patients, of serum CA15.3 in 66.7% of 9 patients, of serum CA72.4 in 81.8% of 11 patients, and of serum TATI in 40% of 10 patients. In patients with positive CA125 assay at diagnosis, the concomitant evaluation of the other antigens did not seem to be of additional benefit for monitoring epithelial ovarian cancer. However, the measurement of the other tumor markers could represent an interesting biochemical tool for the management of patients with negative CA125 assay. In particular the evaluation of serum CA19.9 or CA72.4 could be very useful in the monitoring of patients with mucinous ovarian cancer, which often fails to express CA125 antigen.  相似文献   

19.
The values for CA125, TPA, IAP, CEA, and ferritin in sera were measured simultaneously in 68 healthy nonpregnant females and 133 patients with various gynecological diseases, and examined by stepwise discriminant analysis. The usefulness and the limits for diagnosis of various gynecological diseases were investigated for each tumor marker. Also, the diagnostic usefulness of stepwise discriminant analysis employing the values for five tumor markers in sera was studied for gynecological malignancies compared with that of measuring serum CA125 alone. Because the mean values for CA125 in sera were increased specifically in the ovarian cancer patient group compared with those of other tumor markers in sera, the measurement of serum CA125 was considered to be more useful in diagnosing ovarian cancer than that of the other tumor markers. The mean values for CA125 in sera, however, were also increased more significantly in the groups of patients with endometriosis and normal pregnancies than in the group of healthy nonpregnant females (p less than 0.005). In the stepwise discriminant analysis employing the values for CA125 and four other tumor markers in sera, the diagnostic usefulness of each tumor marker was demonstrated in the early diagnosis, the differential diagnosis, and the determination of complete remission after several therapies for ovarian cancers.  相似文献   

20.
Aim Our aim was to confirm that preoperative CA 125 serum level can be useful for discrimination between benign and malignant masses in the pelvis.Methods Preoperative CA 125 serum level was analyzed retrospectively in 121 patients who had surgery because of a malignant ovarian tumor and in 91 patients with benign masses in the pelvis. The cutoff serum level CA 125 between benign and malignant masses in the pelvis was 35 and 65 IU/ml.Results Of those patients with a malignant ovarian tumor, 65.3% had menopause whereas only 31.5% of those with a benign tumor did so. The average age of the patients with a malignant tumor was 54.2 years and of those with a benign tumor 46.8 years. The preoperative CA 125 serum level was higher than 35 IU/ml in 80.2% and higher than 65 IU/ml in 72.7% of all analyzed patients with a malignant tumor, whereas it was 23.9% and 9.8% respectively in patients with a benign mass. In early stage ovarian cancer disease (borderline stage, I/II) the preoperative CA 125 serum level was higher than 35 IU/ml in 67.8% and in 52.5% higher than 65 IU/ml. In advanced stages (III/IV), it was higher than 35 and 65 IU/ml in 96.1%. After therapy the CA 125 serum level dropped below 35 IU/ml in 70.8% and after three chemotherapy courses in 78.1%. A CA 125 level less than 35 IU/ml was achieved by therapy in 84.2% patients with an early stage disease (I/II) and in 62.1% in advanced stages (III/IV). The calculated sensitivity was 80.2% and negative 74.5% (CA 125 higher than 35 IU/ml) and 72.7%, 90.2%, 90.7%, 71.6% respectively (CA 125 higher than 65 IU/ml).Conclusion Preoperative determination of CA 125 is a very useful method to discriminate between benign and malignant masses in the pelvis.  相似文献   

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