HE4和CA125监测老年卵巢癌转归的价值.

探讨血清人附睾分泌蛋白4(HE4)和CA125在监测老年卵巢癌转归中的价值.选取年龄大于60岁、经手术和病理证实的卵巢癌患者75例、盆腔良性疾病患者73例、其它恶性肿瘤患者53例和健康人103名,采集血清进行HE4和CA125测定,并对其中12例老年卵巢癌患者的血清HE4和CA125水平进行17～32个月的随访研究,研...     

Preoperative CA125 as a prognostic factor in stage I epithelial ovarian cancer

The purpose of the present study was to evaluate preoperative CA125 as a prognostic factor in stage I epithelial ovarian cancer (EOC). Preoperative serum CA125 levels from 118 women with FIGO (International Federation of Gynaecology and Obstetrics) stage I EOC were analysed and the prognostic value was evaluated and compared with other prognostic factors (age, grade, substages, histologic type). By the Kaplan-Meier estimate we demonstrated that patients with stage I EOC and preoperative serum CA125 levels <65 U/mL had a significantly longer survival compared to stage I EOC patients with preoperative serum CA125 > or = 65 U/mL (p=0.01). The results from the present study may be useful for decision making respecting postoperative chemotherapy in stage I EOC patients. Serum CA125 levels might therefore be included as a prognostic factor in future clinical trials of stage I EOC.     

Récurrences du cancer épithélial de l'ovaire : valeur du CA125

CA125 is a glycoprotein found to be increased in ovarian cancer and currently the most applicable tumor marker used in the follow-up of patients with this malignancy. The aim of our study is to evaluate the clinical value of CA125 in the detection of recurrences in patients with epithelial ovarian cancer. A retrospective analysis was done of 78 patients treated for epithelial ovarian cancer. Concentration of CA125 was measured by the immunoenzymatic assay using an AxSYM CA125 kit. During the period of our study 49 patients developed recurrences, 23 cases correspond to biological relapses and 26 cases of histological relapses. Biological relapses are accompanied with histological relapses in 70% of patients. In 94.12% of the patients presenting histological relapses, an increase of serum CA 125 level preceded the diagnosis of recurrence. The evaluation of the CAl25 levels in ovarian cancer could be of powerful value in predicting relapses.     

血清CA125、CA19-9联合监测在盆腔肿物鉴别诊断中的价值

探讨血清CA125、CA19-9水平在盆腔肿物鉴别诊断中的价值.对我院2008年1月至2009年12月因盆腔肿物住院的166例患者的术前血清CA125、CA19-9水平进行回顾性分析;按照病理类型分为4组,分别为卵巢良性肿瘤组、卵巢子宫内膜异位囊肿组、盆腔炎性肿物组、卵巢恶性肿瘤组.结果显示:卵巢恶性肿瘤组血清CA12...     

卵巢癌患者手术前后血清E-CAD,CA125水平变化

目的 :探讨卵巢癌患者手术治疗前后血清可溶性上皮钙粘蛋白 (E -CAD)和CA1 2 5水平的变化。方法 :应用酶联法测定 31例卵巢癌患者血清上皮钙粘蛋白含量 ,放免法测定CA1 2 5含量 ,并与 35名正常健康人作比较。结果 :卵巢癌患者在治疗前血清上皮钙粘蛋白和CA1 2 5含量非常显著地高于正常人水平 (p <0 0 1 ) ,手术治疗后 6个月复发者血清上皮钙粘蛋白、CA1 2 5含量持续异常 ,未复发者上皮钙粘蛋白、CA1 2 5水平恢复正常。结论 :上皮钙粘蛋白含量的变化与卵巢癌患者的病情和预后密切相关 ,可与血清CA1 2 5同时作为卵巢癌诊断及监测的参考指标 ,有一定的临床实用价值     

Is CA72-4 a Useful Biomarker in Differential Diagnosis between Ovarian Endometrioma and Epithelial Ovarian Cancer?

Background. Surgical excision of ovarian endometriomas in patients desiring pregnancy has recently been criticized because of the risk of damage to healthy ovarian tissue and consequent reduction of ovarian reserve. A correct diagnosis in cases not scheduled for surgery is therefore mandatory in order to avoid unexpected ovarian cancer misdiagnosis. Endometriosis is often associated with high levels of CA125. This marker is therefore not useful for discriminating ovarian endometrioma from ovarian malignancy. The aim of this study was to establish if the serum marker CA72-4 could be helpful in the differential diagnosis between ovarian endometriosis and epithelial ovarian cancer. Methods. Serums CA125 and CA72-4 were measured in 72 patients with ovarian endometriomas and 55 patients with ovarian cancer. Results. High CA125 concentrations were observed in patients with ovarian endometriosis and in those with ovarian cancer. A marked difference in CA72-4 values was observed between women with ovarian cancer (71.0%) and patients with endometriosis (13.8%) (P < 0.0001). Conclusions. This study suggests that CA72-4 determination can be useful to confirm the benign nature of ovarian endometriomas in women with high CA125 levels.     

人附睾分泌蛋白4对卵巢恶性肿瘤的诊断价值

为探讨血清人附睾分泌蛋白4在卵巢癌及妇科盆腔良性疾病中的诊断价值,应用ELISA方法检测了31例卵巢癌患者、44例子宫肌腺症、32例卵巢囊肿、30例内膜异位症患者及65名正常健康人血清人附睾分泌蛋白4水平;化学发光微粒子免疫分析法检测以上各疾病组及正常对照组血清CA125水平。结果显示,卵巢癌患者血清人附睾分泌蛋白4水平较其他良性疾病组患者及正常健康人均显著升高,其差异均具有非常显著的统计学意义（P〈0.01）。结果还显示,血清CA125水平升高的妇科盆腔良性疾病组患者血清人附睾分泌蛋白4水平与正常对照组比较,其差异均无统计学意义（P〉0.05）。结果提示,人附睾分泌蛋白4是一种能区分卵巢癌与妇科盆腔良性疾病的新型标记物,可以弥补CA125作为卵巢癌诊断特异性不强的弱点,结合CA125水平,影像学检查,人附睾分泌蛋白4有可能成为卵巢癌诊断的重要标记物。     

血清HE4、 CA125及CEA联合检测对卵巢癌诊断价值的评价

目的 评价血清人附睾分泌蛋白4(HE4)、CA125以及CEA联合检测对卵巢癌的诊断价值.方法 收集94例卵巢癌患者,112例卵巢盆腔肿块患者及106例健康对照人群的血清.酶联免疫吸附双抗体夹心法检测HE4的水平,电化学发光法检测CA125和CEA水平.使用二元Logistic回归分析CA125和CEA的联合价值,然后使用受试者工作特征曲线评价其单独和联合诊断的价值.结果 E4、CA125及CEA三项联合评价时,区分健康对照和卵巢癌的灵敏度和特异性分别为93.6％和82.1％,区分良性盆腔肿块和卵巢癌的灵敏度和特异性分别为91.5％和90.2％.与单项指标相比,诊断价值均显著提高,且差异具有统计学意义.结论 HE4、CA125及CEA联合检测可提高卵巢癌的诊断价值,可作为一种潜在的卵巢癌辅助诊断方法.     

Tumor markers in gynecological and breast cancer

Serum tumor markers are useful in diagnosis and follow-up for patients with gynecological malignancy or breast cancer. In epithelial ovarian cancer, CA125 has been identified as the most sensitive marker. Unfortunately, CA125 detection in the serum of patients with minimal malignant tumor has not been possible. Many nonmalignant conditions including endometriosis, menstruation and massive ascites may elevate the CA125, and almost 50% of patients with clear cell adenocarcinoma do not show CA125 elevated above 100 U/ml. To improve sensitivity and specificity in the diagnosis of ovarian cancer, the use of multiple tumor markers and the simultaneous use of image diagnosis should be employed. The value of tumor markers in the screening for cervical cancer and endometrial cancer has received little attention. However, the utility of serum SCC as a marker for monitoring cervical squamous cell carcinoma has been established. Since hCG is produced by gestational trophoblastic neoplasia and is a sensitive marker of trophoblastic cells in the body, patients with choriocarcinoma or invasive mole must be followed closely for this parameter. The improvement of the hCG detection technique has reduced the mortality rate from trophoblastic neoplasia. In breast cancer, many markers including CEA and CA15-3 are used, and they are reported to be useful as markers for monitoring.     

CA 125 in peritoneal fluid from patients with endometriosis.

This study was performed to evaluate CA 125 in peritoneal fluid as an indicator of endometriosis. Peritoneal fluid from patients with mostly minimal and mild endometriosis (n = 43) and normal controls (n = 17) was collected at laparoscopy or laparotomy. The median concentration of CA 125 in peritoneal fluid did not differ significantly between patients and controls (79 IU/ml versus 76 IU/ml). In patients with endometriosis, a significantly increasing concentration of CA 125 in peritoneal fluid was seen from the early follicular to the late luteal phase; a similar change was not observed in the controls. In 14 patients, peritoneal fluid was sampled again after treatment with danazol and a significant reduction in median CA 125 concentration (76.5 IU/ml versus 57 IU/ml), peritoneal fluid volume (17.5 ml versus 10.5 ml) as well as reduced endometriosis scores (4 versus 2) were found. In controls, the concentration of CA 125 was about 10 times higher in peritoneal fluid than in serum. As the peritoneal levels of CA 125 did not differ significantly between patients with endometriosis and controls and as the reduction seen after danazol treatment did not correlate with the decrease of endometriotic implants, it is concluded that the monitoring of CA 125 in peritoneal fluid will not be useful in the diagnosis or control of endometriosis.     

血清AFP、CEA、CA19-9、CA125、TSGF联检对卵巢癌的诊断价值

目的：探讨血清AFP、CEA、CA19-9、CA125、TSGF联检对卵巢癌的诊断价值。方法：卵巢病变患者共109例（卵巢癌45例,卵巢良性病变64例）,采用分光光度法测定TSGF,采用全自动化学发光法测定AFP、CEA、CA19-9和CA125。结果：卵巢癌组单项阳性率依次为：TSGF 73.33%（33/45）、CA125 60.00%（27/45）、CA19-9 35.56%（16/45）、CEA8.89%（4/45）、AFP 2.22%（1/45）。去除AFP、CEA后,CA19-9、CA125、TSGF三项联检阳性率为91.11（41/45）。结论：CA19-9、CA125、TSGF联检有助于提高卵巢癌的检出率。     

盆腔良性病变血清CA125水平测定的临床意义

评价血清CA125水平检测在妇科良性病变患者的临床意义.回顾分析了71例妇科良性病变患者,65例卵巢癌患者和53名正常对照者的临床资料,发现卵巢癌和妇科良性病变组血清CA125水平均明显高于对照组,卵巢癌组CA125水平明显高于妇科良性病变组和盆腔结核组血清CA125水平明显高于其他妇科良性病变.结合临床其他资料,血清CA125水平检测有助于卵巢癌和盆腔结核病的诊断.     

Usefulness and limits of CA-125 in diagnosis of endometriosis without associated ovarian endometriomas

BACKGROUND: The aim of this study was to evaluate the diagnostic significance of CA-125 for endometriosis without ovarian endometriomas. METHODS: Preoperative serum CA-125 levels were measured in 775 consecutive women diagnosed by laparoscopy or laparotomy with endometriosis, adenomyosis, leiomyomas, or normal pelvis. RESULTS: Receiver operating characteristic curve analysis revealed that the area under the curve for endometriosis without endometriomas was 0.788, significantly smaller than that for endometriosis with endometriomas (0.935, P < 0.05). In diagnosis of endometriosis without endometriomas, both the maximal accuracy of 78.8% and the maximal diagnostic value of 61.2% were obtained at the cutoff value of 20 U/mL. Negative predictive value was 78.0% at the cutoff value of 20 U/mL, whereas positive predictive value was 92.9% at the cutoff value of 30 U/mL. This range is clearly superior to the empirical single cutoff of 35 U/mL. CONCLUSIONS: In the diagnosis of endometriosis without endometriomas, combined use of two cutoff values for CA-125, 20 and 30 U/mL, provides improved diagnostic performance. However, the accuracy of using only CA-125 testing for diagnosis is still limited. Serum CA-125 testing can be done during initial screenings of women with possible endometriosis.     

HE4和CA125联检在卵巢癌中的应用价值

目的：探讨联检血清人附睾蛋白4（HE4）和CA125水平在卵巢癌诊断中的应用价值。方法：用ELISA测定47例卵巢癌患者、65例卵巢良性疾病患者和109例健康对照者血清HE4水平,同时测定CA125,并对结果进行比较分析。结果：卵巢癌组血清HE4、CA125水平均显著高于健康对照组,差异有统计学意义（P〈0.01）,HE4在早期卵巢癌（Ⅰ～Ⅱ期）阳性率高于CA125,两者联检可提高诊断卵巢癌的敏感性。结论：HE4是一种良好的预测早期卵巢癌的肿瘤标志物,其联合CA125的测定有助于卵巢癌的诊断。     

人附睾蛋白4在诊断卵巢癌中的临床意义

目的：探讨卵巢癌患者人附睾蛋白4（human epididymis protein4,HE4）的临床意义。方法：用ELISA测定82例卵巢癌患者血清HE4水平,同时应用RIA检测CA125水平,与143例卵巢良性病变患者和40例健康人进行对照比较,评估诊断试验的敏感性、特异性,绘制ROC曲线。结果：HE4对卵巢癌的诊断敏感性82.9%（68/82）,特异性94.54%（173/183）,均高于CA125;HE4的ROC曲线下面积最大（面积：0.949;95%可信区间0.915-0.982）,临床诊断效能优于CA125;HE4与CA125联检针对卵巢癌诊断的敏感性和特异性之和最大。结论：HE4针对卵巢癌诊断显示了较高的敏感性和特异性,可望成为一个新的卵巢癌辅助诊断指标。     

Serum interleukin-6 levels are elevated in women with minimal-mild endometriosis

BACKGROUND: There is a need for a reliable marker of endometriosis, especially in early stages of peritoneal disease during which imaging is not effective. The use of serum interleukin (IL)-6 as a marker is controversial. To readdress the matter, patients undergoing laparoscopy were prospectively evaluated for serum IL-6 levels. MATERIALS AND METHODS: A total of 119 women 31 years old who underwent laparoscopy were divided into groups: control patients (n = 38) with no pathologic findings; endometriosis sufferers (n = 47) with minimal-mild (MM, n = 11) or moderate-severe (MS, n = 36) endometriosis; uterine myomas (n = 13) and benign ovarian pathologies (n = 21). Blood was drawn on cycles days 5-12 and stored for subsequent analysis of IL-6 and carbohydrate antigen (CA)-125 levels. RESULTS: Serum IL-6 levels were significantly (P = 0.002) higher in women with MM endometriosis (29.4 9.0 pg/ml) than in controls (15.7 9.3 pg/ml). When all the non-endometriosis patients were grouped together (n = 72) and serum IL-6 (17.8 12.1 pg/ml) compared with MS (n = 36; 17.6 10.3 pg/ml) and MM (n = 11; 29.4 9.0 pg/ml) endometriosis significantly (P < 0.01) higher levels in MM endometriosis were observed as compared to the other two groups. Serum Ca-125 levels were significantly (P < 0.01) elevated in MS endometriosis. A serum IL-6 threshold of 25.75 pg/ml afforded a sensitivity of 75% and specificity of 83% in the diagnosis of MM endometriosis. Sensitivity and specificity for CA-125 in the diagnosis of MS endometriosis, using 35 IU/ml as the cut-off value, were 47% and 97%, respectively. CONCLUSIONS: IL-6 is a reliable non-invasive marker of MM endometriosis, whereas Ca-125 is of use as a marker of severe cases.     

卵巢癌患者血清CA125检测的临床价值

目的：探讨血清CA125在卵巢癌诊断和疗效观察中的临床价值。方法：血清CA125检测采用放射免疫分析法，研究对象包括56例卵巢癌患者，妇科良性肿瘤患者52例和正常对照组38例，结果：卵巢癌患者血CA125明显高于妇科良性肿瘤和正常对照组；卵巢上皮细胞癌明显高于非上皮细胞癌；妇科良性肿瘤和正常对照组比较无明显差异；卵巢癌患者治疗有效者血清CA125明显下降。结论：血清CA125检测对卵巢癌的诊断具有较高的诊断价值。尤其是上皮型细胞癌，同时有助于病情的观察和疗效的监测。     

CA125测定对卵巢癌诊断和预后的评价

本文用酶联免疫吸附分析（ELISA）,测定各种妇科疾病患者100例治疗前后血清CA125水平,CA125大于35kU/L为诊断卵巢癌的阳性阈值,结果显示卵巢癌阳性率为95%（19/20）;子宫肌瘤为16.7%(6/36）;卵巢良性畸胎瘤20%（3/15）;其他妇科疾病为13.8%(4/29）。以CA125大于65kU/L为诊断卵巢癌阳性阈值,除卵巢癌组外则不存在假阳性。20例卵巢癌患者经手术或放化疗治疗后,其中16例CA125小于35kU/L,其余良性妇科疾病患者经治疗后,虽然CA125有不同程度的降低,但降低幅度不大。提示测定妇科疾病患者血清CA125对卵巢癌诊断、疗效评价及预后有较高的价值。     

Chemokine expression in patients with ovarian cancer or benign ovarian tumors

IntroductionChemokines play a crucial role in tumor growth and progression according to proangiogenic and immunosuppressive action. The aim of this study was to investigate the serum levels of selected chemokines in patients with ovarian cancer or benign ovarian tumors to assess their role in tumorigenesis and their potential use in preoperative diagnosis of an adnexal mass.Material and methodsThe study group consisted of 59 women with ovarian cancer: 17 epithelial ovarian cancer (EOC) patients and 42 women with benign ovarian tumors. We measured in sera obtained preoperatively the level of CA125 and a panel of 5 chemokines – CX3CL1/fractalkine, CXCL1/GRO-α, CXCL12/SDF-1, CCL20/MIP-3α and IL-17F – using the chemiluminescence method with multiplexed bead based immunoassay.ResultsCX3CL1 was significantly elevated in sera of advanced ovarian cancer patients compared to women with benign ovarian tumors. The significant elevation of CXCL1 was also observed (both early and advanced stages). A similar pattern was present with the standard ovarian cancer marker CA125. In our patients with endometriotic cysts CA125 levels were significantly higher than in women with other benign tumors, whereas all analyzed chemokines had similar serum titers in patients with endometriotic vs. other benign ovarian cysts.ConclusionsCX3CL1 and CXCL1 are elevated in sera of EOC patients, which indicates their role in cancer development. Moreover, they might be useful in preoperative differential diagnosis of ovarian tumors, especially as they were not elevated in cases of endometriosis.     

CA125 and endometriosis

This review covers the literature on CA125 and endometriosis; data on CA125 and oncology are not discussed. In normal women, plasma concentrations of CA125 are increased slightly at ovulation and significantly during menstruation. Marked increases are observed during pregnancy and following peritoneal irritation by infection or surgery. These data are consistent with the concept that CA125 in normal women is mainly derived from the endometrium and the irritated peritoneum. Plasma concentrations of CA125 are markedly elevated in women with cystic ovarian endometriosis and/or deeply infiltrating endometriosis, but not, or only slightly, in the luteal phase of women with minimal or mild endometriosis. This is consistent with the recent concept which considers minimal endometriosis as a normal condition occurring intermittently in many women, in contrast with deep endometriosis and cystic ovarian endometriosis which are called 'endometriotic disease'. Serum CA125 is not a good marker for endometriosis but it is a helpful additional parameter to diagnose endometriotic disease in patients with chronic pelvic pain. Following treatment of endometriosis, elevated plasma concentrations of CA125 could be used as an argument that treatment has been incomplete, or that the condition has recurred. Assaying CA125 in peritoneal fluid requires high sample dilutions or a modified immunoradiometric assay, and until now, its clinical value has been questionable.