血清CA125在卵巢上皮性癌诊断和预后中的价值

目的　探讨血清CA12 5测定在卵巢上皮性癌诊断及判断预后中的价值。方法　用放射免疫法测定 82例卵巢上皮性癌术前血清CA12 5水平。结果　以血清CA12 5>35u .ml-1为异常值 ,卵巢上皮性癌检出的阳性率 ( 95 .12 % )与以>2 0 0～ 30 0u .ml-1为异常值的阳性率 ( 92 .6 8%～ 90 .2 4% )无差异 (P >0 .0 5 ) ;在卵巢上皮性癌组织类型中 ,浆液性囊腺癌和未分化癌血清CA12 5水平高于其它类型 (P均 <0 .0 5 ) ;卵巢浆液性囊腺癌临床Ⅲ -Ⅳ期、病理Ⅱ -Ⅲ级血清CA12 5明显高于临床Ⅰ -Ⅱ期和病理Ⅰ级 (P <0 .0 0 5～ <0 .0 2 )。结论　血清CA12 5>2 0 0～ 30 0u .ml-1,卵巢上皮性癌的可能性极大 ;血清CA12 5的测定有助于卵巢上皮性癌组织类型的鉴别及预后的判断。     

卵巢上皮性癌患者血清CA125值的临床分析

卵巢上皮性癌患者血清ＣＡ１２５值的临床分析刘金玲邬谨慧李君马堪悦徐世杰焦书竹天津医科大学总医院（天津市３０００５２）卵巢癌是危及妇女生命的主要疾病之一。卵巢上皮性癌约占５０％，尽早诊断仍是一难题。血清ＣＡ１２５值是诊断卵巢上皮性癌和术后监测的主要标记...     

血清CA125,CA199,CA153在卵巢浆,粘液性囊腺癌诊断和动态观察中的价值

目的：探讨血清ＣＡ１２５、ＣＡ１９９、ＣＡ１５３对卵巢癌浆、粘液性囊腺癌的诊断和动态观察中的价值。方法：采用微粒子酶免疫测定法，于术前对４５例卵巢浆、粘液性囊腺癌和２３例附件良性疾病患者血清中的ＣＡ１２５、ＣＡ１９９、ＣＡ１５３水平进行测定，以观察其在诊断上的敏感性和特异性。对１８例卵巢浆液囊腺癌和１５例粘液囊腺癌行上述三种抗原作治疗中的动态观察，以探讨其价值。结果：此三项指标对浆、粘液卵巢癌诊断     

血清CA125、CA199、CA153在卵巢浆、粘液性囊腺癌诊断和动态观察中的价值

目的：探讨血清中ＣＡ１２５、ＣＡ１９９、ＣＡ１５３对卵巢癌浆、粘液性囊腺癌的诊断和动态观察中的价值。方法：采用微粒子酶免疫测定法，于术前对４５例卵巢浆、粘液性囊腺癌和２３例附件良性疾病患者血清中的ＣＡ１２５、ＣＡ１９９、ＣＡ１５３水平进行测定，以观察其在诊断上的敏感性和特异性。对１８例卵巢浆液囊腺癌和１５例粘液囊腺癌行上述三种抗原作治疗中的动态观察，以探讨其价值。结果：此三项指标对浆、粘液卵巢癌诊断的敏感性和特异性，ＣＡ１２５分别为７３．３％和５０．０％；ＣＡ１９９为４２．２％和７７．３％；ＣＡ１５３为１５．６％和９０．９％。卵巢癌液囊腺癌ＣＡ１２５阳性率为１００％，明显高于粘液腺癌（Ｐ＜０．０１）；而卵巢粘液囊腺癌ＣＡ１９９阳性率为７８．３％明显高于浆液腺癌（Ｐ＜０．０１）；ＣＡ１５３在两癌中的阳性率分别为１３．６％及１７．４％，两者无差异性（Ｐ＞０．０５）。治疗中动态观察显示，ＣＡ１２５与ＣＡ１９９对卵巢浆、粘腺癌经满意手术和术后１～２疗程有效化疗后的患者，可降至正常；对术中有较大残留灶者两抗原值虽有下降，但常未能达正常；对复发患者，其值亦升高。结论：ＣＡ１２５和ＣＡ１９９均是卵巢浆、粘液囊腺癌诊断和监     

盆腔、超声检查和CA125测定鉴别卵巢良恶性包块分析

目的：研究盆腔检查（ＰＥ）、超声检查（ＵＳ）及血清ＣＡ１２５水平在鉴别卵巢良恶性包块方面的作用及３项检查联合应用的价值。方法：对似手术治疗的卵巢包块患者在术前均行ＰＥ，ＵＳ及血清ＣＡ１２５测定。结果：绝经前妇女中８．５％（１１／１３０）为卵巢恶性肿瘤，绝经后妇女中３６．３％（２９／８０）为卵巢恶性肿瘤，ＰＥ的敏感性、特异性、阳性预测值、阴性预测值及准确性的百分率分别为６２．５％、８２．４％、４５．５％、９０．３％及７８．６％；ＣＡ１２５的上述诊断指数分别为８５．０％、８０．６％、５０．７％、９５．８％及８１．４％；ＵＳ的上述诊断指数分别为９５．０％、９４．１％、７９．２％、９８．８％及９４．３％。在３种检查方法中，ＵＳ的各项指数最好，尤其是在绝经后妇女。如果３项检查均为阴性，则所有患者的卵巢包块均为良性；如３项     

CA125对卵巢恶性肿瘤诊断价值的评价

CA125是一种在胚胎发育过程中存在于体腔上皮化生组织(如卵巢上皮与子宫内膜等组织)细胞表面的抗原.免疫组化发现,CA125存在于胎儿消化道上皮细胞、羊膜、成人胸腺、腹腔间皮细胞、输卵管内皮、子宫及宫颈内膜中,出生后消失.在成人及胎儿卵巢上皮细胞中并未发现CA125的存在,但在卵巢癌细胞中,CA125重新出现,子宫内膜异位症、附件炎、胸膜、腹膜疾病及肝硬化等情况下,CA125亦可呈阳性表现.我们旨在探讨血清CA125对卵巢恶性肿瘤的诊断价值.     

端粒酶反转录酶与CA125在卵巢上皮性肿瘤组织中的原位表达及临床意义

目的:探讨端粒酶反转录酶(TRT)与CA125在卵巢上皮性肿瘤组织中的原位表达及临床意义。方法:收集93例卵巢上皮性肿瘤(良性47例、交界性15例、恶性31例),应用免疫组织化学S蛳P法检测肿瘤组织中TRT及CA125的原位表达,将结果进行统计学分析。结果:TRT的表达在良性(17.02%,8/47)和交界性(46.67%,7/15)以及恶性(90.32%,28/31)间的差异均有显著性意义(P<0.01);CA125的表达在良性(23.40%,11/47)和恶性(67.74%,21/31)间的差异有显著性意义(P<0.01),TRT的表达在浆液性肿瘤与黏液性肿瘤之间差异无显著性意义(P>0.05);CA125在各组浆液性肿瘤均明显高于黏液性肿瘤组,相比较差异有显著性意义(P<0.05);TRT和CA125在浆液性肿瘤的表达有一致性,相关性分析有显著性相关(P<0.01),在黏液性肿瘤中表达不相关(P>0.05)。结论:TRT和CA125的表达与卵巢上皮组织肿瘤的良恶性有关,尤其在卵巢浆液性肿瘤中TRT酶的活性与CA125呈正相关,二者的共同检测对诊断卵巢上皮组织肿瘤的类型和恶性程度有重要的临床意义。     

联合检测HE4与OPN及CA125对卵巢癌诊断价值的探讨

目的:探讨血清人附睾分泌蛋白4(HE4)、骨桥蛋白(OPN)和CA125水平联合检测对卵巢恶性肿瘤的诊断价值.方法:在30例卵巢癌患者(卵巢癌组)、30例卵巢良性肿瘤患者(卵巢良性肿瘤组)和30例患子宫肌瘤等妇科疾病但卵巢正常者(对照组)中,采用酶联免疫吸附试验(ELISA)法检测HE4、OPN,全自动化学发光分析系统检测血清CA125.HE4参考范围0～80ρmol/L;OPN计算临界值为30 ng/mL,≥30 ng/mL为阳性;CA125≥35 U/mL为阳性.通过制作受试者工作特征(ROC)曲线,以曲线下面积(AUC)反映诊断的准确性.结果:1)各组血清肿瘤标志检测结果显示,卵巢癌患者HE4,CA125、OPN水平明显高于对照组以及卵巢良性肿瘤组,差异有统计学意义,F值分别为39.23、84.03和104.09,P＜0.01;而卵巢良性肿瘤患者与对照组之间差异均无统计学意义,P＞0.05.2)HE4在不同组织类型卵巢癌中的表达不同,卵巢浆液性癌(95.23％)和内膜样癌(100.00％)中高表达,透明细胞癌(0)和黏液性癌(0)不表达.3)OPN在卵巢癌Ⅲ～Ⅳ期患者中的含量明显高于Ⅰ～Ⅱ期患者,且与肿瘤转移有关,有淋巴结转移患者明显高于无转移者.4)以卵巢良性肿瘤组及卵巢正常组为对照,CA125+ HE4+OPN、CA125+HE4、CA125+OPN、HE4和CA125为盆腔恶性肿瘤诊断指标,ROC曲线下面积依次为0.91.0.90、0.85、0.85和0.80.在特异性为98.3％时,各肿瘤标志诊断盆腔恶性肿瘤的敏感度依次是73.3％、70.0％、66.6％、63.3％和20.0％.特异度为95.0％时,敏感度80.0％、76.6％、70.0％、70.0％和40.0％.特异度是90.0％时,敏感度83.3％、80.0％、76.6％、73.3％和56.6％.结论:CA125+ HE4+OPN3种肿瘤标志联合检测对提高卵巢恶性肿瘤的诊断价值有一定的意义.     

血清Mesothelin和CA125联合检测在上皮性卵巢癌诊断中的意义

目的:研究联合检测血清Mesothelin和CA125在上皮性卵巢癌诊断中的临床意义.方法:采用定量酶联免疫吸附试验(ELISA)检测上皮性卵巢癌患者31例,良性卵巢肿瘤32例和正常妇女30例血清中的Mesothelin和CA125水平.结果:上皮性卵巢癌患者的Mesothelin水平明显高于良性卵巢肿瘤患者和正常对照组(P<0.01),良性卵巢肿瘤组患者与正常对照组的差异无显著性(P>0.05).不同类型的上皮性卵巢癌的Mesothelin的差异无显著性(P>0.05).Mesothelin和CA125联合检测对上皮性卵巢癌诊断的灵敏度和正确率明显高于单项检测CA125或Mesothelin(P值均<0.05).结论:血清Mesothelin和CA125联合检测可提高上皮性卵巢癌的早期诊断率.     

血清Mesothelin和CA125联合检测在上皮性卵巢癌诊断中的意义

目的：研究联合检测血清Mesothelin和CA125在上皮性卵巢癌诊断中的临床意义。方法：采用定量酶联免疫吸附试验（ELISA）检测上皮性卵巢癌患者31例,良性卵巢肿瘤32例和正常妇女30例血清中的Me-sothelin和CA125水平。结果：上皮性卵巢癌患者的Mesothelin水平明显高于良性卵巢肿瘤患者和正常对照组（P〈0.01）,良性卵巢肿瘤组患者与正常对照组的差异无显著性（P〉0.05）。不同类型的上皮性卵巢癌的Mesothelin的差异无显著性（P〉0.05）。Mesothelin和CA125联合检测对上皮性卵巢癌诊断的灵敏度和正确率明显高于单项检测CA125或Mesothelin（P值均〈0.05）。结论：血清Mesothelin和CA125联合检测可提高上皮性卵巢癌的早期诊断率。     

CA125和阻力指数在卵巢恶性肿瘤术前诊断中的应用

目的:评价血清CA125和血流阻力指数(RI)术前预测卵巢肿瘤良恶性的价值。方法:对126例卵巢肿瘤病人术前进行血清CA125测定、彩色多普勒检测(准确测定肿瘤内部血流阻力指数),联合CA125和RI对卵巢肿瘤良、恶性进行预测,比较其敏感性、特异性、阳性预测值及准确性。结果:CA125和RI联合评估卵巢恶性肿瘤的敏感性、特异性、阳性预测值及准确性分别为97.5%、93.0%、86.7%、94.4%。结论:术前CA125和RI联合评估能显著提高卵巢肿瘤良恶性诊断的准确性。     

血清MIC-1和CA125在卵巢上皮癌诊断及预后中的应用研究

目的：探讨巨噬细胞抑制因子-1（MIC-1）和CA125的卵巢癌诊断和预后判断价值。方法通过检测92例未经治疗的卵巢上皮癌患者（观察组）和96例健康女性（对照组）血清样本中的MIC-1和CA125水平,分析血清MIC-1和CA125水平与卵巢癌的关系;通过ROC曲线评价MIC-1和CA125单项及联合应用的卵巢癌诊断效能;通过对其中74例卵巢癌患者按术后残瘤大小和首次化疗敏感性结果分组,比较两组治疗前MIC-1和CA125水平,评价MIC-1和CA125的疗效评价价值;并通过分析68例患者的MIC-1和CA125水平与无瘤生存时间（relapse free survival,RFS）的关系评价其预后判断价值。结果观察组血清MIC-1水平显著高于对照组（P＜0.001）;MIC-1诊断卵巢癌的ROC（AUC=0.945）与CA125的ROC（AUC=0.966）比较差异无统计学意义,MIC-1和CA125联合应用的卵巢癌诊断效能显著提高（AUC=0.966）。术前CA125水平与术后残瘤大小显著相关（P=0.07）;术前血清MIC-1水平与化疗敏感性显著相关（P=0.001）,并且血清MIC-1水平与患者RFS呈负相关。结论 MIC-1和CA125联合检测可提高卵巢癌的诊断率,MIC-1高水平预示卵巢上皮癌患者存在较大的耐药风险,且MIC-1可作为预测卵巢癌患者生存期的独立指标。     

肺癌血清CA125测定的诊断价值

目的探索血清CA125在肺癌诊断中的价值.方法检测69例肺癌、38例良性肺疾病和25例健康人的血清CA125.随访40例肺癌患者治疗后血清CA125的变化.结果肺癌组血清CA125(124.9±175.9 u/ml)高于良性疾病组和健康人组(28.1±21.7 u/ml,18.2±7.1 u/ml).以CA125>35u/ml为阳性界值,则正常健康人均为阴性.对诊断肺癌的敏感性为53.6%(37/69).Ⅰ、Ⅱ期肺癌血清CA125阳性率(20%,28%)与良性疾病组(15.8%)无显著差异,Ⅲ、Ⅳ期肺癌CA125阳性率分别为61.0%、72.7%显著高于良性疾病组.血清CA125增高的40例肺癌患者经治疗后,CA125浓度降至正常范围内者38例.结论血清CA125对晚期肺癌有诊断价值.可作为判断预后的参考指标.     

超声联合CA125和癌胚抗原诊断卵巢癌的临床研究

目的探讨超声结合CA125和癌胚抗原(CEA)检查对卵巢癌的诊断意义。方法选取2009年3月至2014年2月在江苏省如东县中医院就诊的88例疑似卵巢癌患者,采用回顾性分析法,比较超声检查与超声+CA125+CEA联合检查卵巢癌的诊断结果。结果超声+CA125+CEA检查良性卵巢疾病的灵敏度、特异性和准确率明显高于超声检查;检查卵巢癌的灵敏度和准确率明显高于超声检查,差异有统计学意义(P<0.05)。结论超声+CA125+CEA检查能提高卵巢癌诊断的灵敏度和准确性,值得临床推广应用。     

Serum CA125 assay in the early diagnosis of recurrent epithelial ovarian cancer

The present retrospective study included 59 patients who had been treated for epithelial ovarian cancer and who showed an elevation of serum CA125 above 35 U/ml without clinical evidence of disease. Eight patients underwent chemotherapy at the time of serum antigen elevation (group A). The other 51 patients (group B) were periodically checked, and received further chemotherapy only when recurrent disease was detected. Forty-four of the 59 patients relapsed. One patient of group B experienced two different recurrences with two distinct time intervals. The median follow-up of survivors from CA125 elevation was 10 months (range 2-92 months). Of the 8 patients of group A, 3 (37.5%) developed recurrent disease after 14, 17 and 22 months, respectively, from antigen elevation. Of the 51 patients of group B, 41 (80.4%) relapsed. The overall recurrence rate was 82.4% (42/51). The median lead time between CA125 increase and clinical detection of relapse was 3 months (range 2-27 months). The present data confirmed the reliability of serum CA125 assay as predictor of clinical relapse in epithelial ovarian cancer. The recurrence rate seemed to be lower for patients who received chemotherapy at the time of CA125 elevation (37.5% versus 82.4%, p=0.02). However, the small number of patients, the short follow-up, and the non-randomized design of the study do not allow to draw any conclusion on the appropriate timing for second-line chemotherapy.     

CA 125 reliability in predicting ovarian cancer recurrence

The predictive value of CA 125 assay for recurrence in ovarian cancer patients in follow-up was analyzed in a study from April 1984 through June 1987. Forty-two patients with no evidence of disease (NED), with positive antigen levels at diagnosis and negative at the end of active treatment, were considered eligible for the analysis. Median follow-up time was 16 months (range, 5-34). Outcome analysis revealed 19 cases still NED: 16 had normal CA 125 levels (less than 35 U/ml). The 3 patients with positive antigen titers were intensively investigated with no evidence of recurrence. Twenty-three cases had disease recurrence: 13 of them had elevated marker levels prior to relapse diagnosis, with a median lead time of 5 months (range, 2-13). In contrast, 10 patients had positive titers at or soon after the recurrence. Test sensitivity was therefore 56% and specificity 84%. Predictive value for recurrence of elevated CA 125 levels was 0.81.     

Clinical significance of cancer antigen 125 (CA 125) in ovarian cancer

Cancer antigen 125 (CA 125), a new ovarian cancer-associated antigen, was studied by radioimmunological determination of serum concentrations in 58 healthy blood donors, in 31 women with benign tumors, and 100 patients with malignant tumors of the ovary. Elevated CA 125 levels were found in 5% of normal controls, in 13% of women with benign tumors, and in 78% of patients with ovarian cancer. After successful antineoplastic treatment, false positive CA 125 values were observed in 4% of tumor-free patients. The incidence of pathological CA 125 serum levels was found to depend on the histogenetic origin of the ovarian tumors and was highest in patients with epithelial serous cystadenocarcinomas (85%). Sequential determinations of CA 125 in 27 patients with ovarian cancer under therapy showed a concordance in 89% of cases between serum concentrations and clinical courses. Elevations of CA 125 were already observed 1-6 months before objective evidence of recurrence. Therefore, the determination of serum CA 125 is recommended in the surveillance of patients with ovarian cancer.     

正常CA125水平的卵巢癌患者血清和尿液中MMP-2水平变化

目的：探讨在正常和异常CA125水平的卵巢癌患者血清和尿液MMP-2水平的变化。方法：选取83例卵巢癌患者（CA125正常的卵巢癌患者38例,CA125异常的卵巢癌患者45例）,50例健康体检妇女为研究对象。用ELISA方法测定血清和尿液中MMP-2的水平。结果：CA125正常和异常的卵巢癌组血清和尿液中MMP-2水平明显高于对照组（P〈0.01）。血清MMP-2和尿液MMP-2诊断卵巢癌的ROC曲线下面积分别为0.846和0.860（P〈0.01）;血清MMP-2和尿液MMP-2在CA125正常情况下诊断卵巢癌的ROC曲线下面积分别为0.814和0.853（P〈0.01）。尿液MMP-2和CA125的联合诊断达到最高灵敏度96.7%和特异度92.5%。结论：血清与尿液中MMP-2的检测可以用于卵巢癌的辅助诊断。