低功率超声放大卵巢癌肿瘤标志物的实验研究

目的:探讨应用低功率超声放大卵巢癌肿瘤标志物提高卵巢癌早期检出率的可行性。方法:用自制的超声信号发生装置,设定超声信号频率为1 MHz,超声功率为0.1~0.3 W/cm~2,时间为1、2、3、4、5分钟,对人卵巢癌细胞株SKOV3行超声辐射,检测培养基中的肿瘤标志物;以功率0.1~0.3 W/cm~2和超声辐射时间5、10、15分钟对裸鼠卵巢癌瘤体进行声辐射后检测血肿瘤标志物,对标志物的放大效应进行分析。结果:在细胞水平,超声辐射时间一定的条件下,CA125浓度随功率增大而增加,且差异有统计学意义(P0.05)。0.2 W/cm~2和0.3 W/cm~2超声条件下,CA125浓度随照射时间延长而增加,不同时间组间差异均有统计学意义(P0.05)。相同的超声辐射时间条件下,CA199浓度随功率的提高而增加(P0.05)。经超声辐射后,各组裸鼠血清CA_(125)、CA_(199)浓度较对照组均显著上升(P0.05),不同功率组间差异有统计学意义(P0.05)。结论:低功率超声可在细胞和瘤体使卵巢癌肿瘤标志物CA_(125)和CA_(199)浓度增加。     

子宫腺肌病/卵巢异位囊肿炎性压力及其与临床特征相关性研究

目的:系统探讨子宫腺肌病/卵巢异位囊肿患者外周血炎性指标变化及其与临床特征的相关性,为子宫腺肌病/卵巢异位囊肿抗炎治疗提供依据。方法:选取来自同济大学附属杨浦医院收治的子宫腺肌病手术患者58例(子宫腺肌病组)、卵巢异位囊肿手术患者37例(卵巢异位囊肿组),健康女性47例(对照组),于增生期抽取外周血,检测血清炎性细胞因子和肿瘤相关抗原浓度,分析炎性压力与临床特征的相关性。结果:子宫腺肌病组外周血中性粒细胞(Neu)、Neu%、中性粒细胞与淋巴细胞比值(NLR)、白细胞介素6(IL-6)、IL-8、CA199、CA125高于对照组,差异有统计学意义(均P0.05);子宫腺肌病组外周血血红蛋白(HGB)低于对照组,差异有统计学意义(Z=688.50,P=0.00)。卵巢异位囊肿组外周血Neu、Neu%、NLR、IL-6、IL-8、肿瘤坏死因子-α(TNF-α)、CA199和CA125高于对照组,差异有统计学意义(均P0.05)。子宫腺肌病中度痛经组外周血白细胞(WBC)、CA125高于轻度痛经组,差异有统计学意义(均P0.05)。子宫腺肌病重度痛经组外周血WBC、Neu、Neu%、NLR、IL-8和IL-6高于中度痛经组,差异有统计学意义(均P0.05)。子宫腺肌病重度痛经组外周血WBC、Neu、Neu%、NLR、IL-6、IL-8和CA125高于轻度痛经组,差异有统计学意义(均P0.05)。子宫腺肌病中、重度痛经组外周血HGB低于轻度痛经组,差异有统计学意义(均P0.05)。子宫腺肌病经量过多组外周血WBC、Neu、Neu%、NLR、IL-6、IL-8和CA125高于正常月经组,差异有统计学意义(均P0.05)。卵巢异位囊肿重度痛经组外周血IL-6、IL-8高于轻度、中度痛经组,差异有统计学意义(均P0.05)。子宫内膜异位症患者肿瘤指标与外周血炎性指标在统计学上无明显相关性。结论:子宫腺肌病/卵巢异位囊肿处于全身炎症压力状态,并与临床特征相关,为子宫内膜异位症抗炎治疗提供了依据。     

联合检测HE4、CA125和CEA在卵巢上皮癌中的诊断意义

目的:探讨单独及联合检测HE4、CA125及CEA对卵巢上皮癌的诊断意义。方法:电化学发光法检测79例卵巢上皮癌、83例卵巢良性肿瘤患者及82例健康查体女性血清中HE4、CA125及CEA水平。分析HE4、CA125及CEA水平与卵巢上皮癌临床病理特征的关系。受试者工作曲线(ROC曲线)分析单独与联合检测卵巢上皮癌的灵敏度和特异度。结果:卵巢上皮癌组的血清HE4、CA125、CEA水平明显高于卵巢良性肿瘤组及健康查体组,差异均有统计学意义(P均0.05),后两组比较则无明显差异(P0.05)。卵巢上皮癌组患者中,临床病理期别越晚,血清HE4水平越高(P0.05),肿瘤分化程度越低,CA125水平越高(P0.05)。联合检测HEA、CA125和CEA ROC曲线下面积大于单独检测(P0.05)。结论:联合检测HE4、CA125、CEA比单独检测对卵巢上皮癌有更好的诊断价值。     

血清CA125及LDH对子宫肉瘤术前诊断的临床意义

目的:研究血清CA125及LDH检测水平对术前诊断子宫肉瘤的临床意义。方法:回顾分析2016年10月至2017年6月于安徽医科大学附属省立医院就诊并经病理学检查确诊的子宫肉瘤患者25例、子宫平滑肌瘤患者150例、恶性潜能未定平滑肌肿瘤患者5例。检测并比较各组患者的血清CA125和LDH水平。结果:子宫肉瘤组与子宫平滑肌瘤组、恶性潜能未定平滑肌肿瘤组中的血清CA125表达比较,差异无统计学意义(P0.05)。子宫肉瘤组的血清LDH水平[201.00(150.50,238.00)U/L]明显高于子宫平滑肌瘤组[149.00(135.00,160.00)U/L],差异有统计学意义(P0.001)。子宫肉瘤组的血清LDH检测水平与恶性潜能未定平滑肌肿瘤组[172.00(147.00,175.00)U/L]比较,差异无统计学意义(P=0.229)。子宫肉瘤组患者血清CA125、LDH的ROC-AUC分别为0.546、0.757。血清LDH诊断子宫肉瘤的cut-off值为199U/L,取临界值时的灵敏度、特异度分别为61.90%、96.4%。结论:血清CA125对子宫肉瘤的术前诊断尚未发现指导意义。血清LDH检测水平可用于协助子宫肉瘤的术前诊断、对临床治疗方式的选择有一定的指导意义。     

血清中肿瘤相关抗原自身抗体谱与CA125联合检测在卵巢恶性肿瘤诊断及病情监测中的价值

目的 评价血清中肿瘤相关抗原自身抗体谱与CA125联合检测在卵巢恶性肿瘤诊断及病情监测中的价值.方法 选择2003年8月23日至2006年3月28日间广西医科大学附属肿瘤医院收治的卵巢恶性肿瘤患者126例(均为治疗前)、卵巢良性肿瘤患者42例,以及2003年至2006年在本院进行健康体检证实无肿瘤及免疫性和炎症性疾病的健康妇女142例,用间接ELISA法检测其血清中肿瘤相关抗原(即TM4SF1、C1D、TIZ、OV-142、FXR1、OV-189)的IgG、IgM型自身抗体,用二分类logistic回归法分析由上述自身抗体组成的自身抗体谱与CA125联合检测在卵巢恶性肿瘤诊断中的价值.另选择同期收治的24例卵巢恶性肿瘤患者,检测其治疗前、后肿瘤相关抗原自身抗体谱的变化,验证并分析自身抗体谱在卵巢恶性肿瘤病情监测中的价值.结果 卵巢恶性肿瘤患者(126例)血清中肿瘤相关抗原IgG型自身抗体的阳性率为34.1%～47.6%,非卵巢恶性肿瘤患者(184例,包括卵巢良性肿瘤患者42例和健康妇女142例)为13.0%～19.0%,两者比较,差异有统计学意义(P＜0.05);卵巢恶性肿瘤患者血清中肿瘤相关抗原IgM型自身抗体的阳性率为39.7%～53.2%,非卵巢恶性肿瘤患者为12.0%～33.2%,两者比较,差异有统计学意义(P＜0.05).FXR1抗原IgG型自身抗体及TIZ、FXR1、OV-189抗原IgM型自身抗体在早期(Ⅰ～Ⅱ期)卵巢恶性肿瘤患者血清中的阳性率(分别为55.3%、63.8%、61.7%、66.0%)明显高于晚期(Ⅲ～Ⅳ期)患者(分别为34.2%、39.2%、26.6%、45.6%),差异有统计学意义(P＜0.05).由TM4SF1、C1D、FXR1抗原IgG型自身抗体及TM4SF1、TIZ抗原IgM型自身抗体组成的自身抗体谱,该抗体谱检测的敏感度为75.4%、特异度为78.3%、准确率为77.1%,与CA125单独检测(分别为61.1%、88.0%、77.1%)比较,其敏感度明显增高(P＜0.05)、特异度明显降低(P＜0.05)、准确率相当,但自身抗体谱单独检测诊断早期卵巢恶性肿瘤患者的敏感度(76.6%)明显高于CA125单独检测者(51.1%,P＜0.05);自身抗体谱与CA125联合检测诊断卵巢恶性肿瘤的敏感度为85.7%、特异度为90.8%、准确率为88.7%,均明显高于自身抗体谱单独检测(P＜0.05);而与CA125单独检测比较,其敏感度和准确率明显升高(P＜0.05),特异度稍升高(P＞0.05).24例卵巢恶性肿瘤患者治疗后血清自身抗体谱与CA125联合检测的阳性率为42%(10/24),明显低于治疗前的88%(21/24,P＜0.05).结论 自身抗体谱与CA125联合检测可提高卵巢恶性肿瘤的早期诊断率,并可用于病情监测.

Abstract：

Objective To evaluate the clinical value of autoantibody spectrum against ovarian cancer associated antigens combine CA125 in detecting and monitoring ovarian cancer. Methods Circulating IgG, IgM autoantibodies against ovarian cancer associated antigens which included TM4SF1, C1D,TIZ, OV-142,FXR1 and OV-189 were measured by indirect ELISA in serum from 126 patients with ovarian cancer (prior treatment), 42 patients with benign ovarian masses, 142 healthy women. Cut off value of IgG, IgM autoantibodies were determined by receive operating characteristic (ROC) curve. CA125 was measured in serum by immunoradiometric assay (IRMA). We evaluated the clinical value of combining multiple autoantibodies (autoantibody spectrum ), combining autoantibody spectrum with CA125 by binary logistic regresion. The positive ratio of autoantibody spectrum in serum (prior and post treatment ) of 24 synchronization patients with ovarian cancer was analyzed to evaluate the value in monitoring state of illness.Results Our data indicated that serum contains IgG, IgM autoantibodies against ovarian cancer associated antigens. The positive ratio of IgG autoantibodies in serum from ovarian cancer patients and cancer-free patients were 34. 1% - 47. 6% and 13.0% - 19. 0%, respectively ( P ＜ 0. 05 ). The positive ratio of IgM autoantibodies in serum from ovarian cancer patients and cancer-free patients were 39. 7% - 53.2% and 12. 0% -33.2%, respectively (P ＜0. 05). The positive ratio of IgG autoantibodies against FXR1 and IgM autoantibodies against TIZ,FXR1 and OV-189 in early stage ( Ⅰ - Ⅱ ) ovarian cancer(55.3% ,63.8%,61.7% and 66. 0% ) were significantly higher than those in advanced ( Ⅲ - Ⅳ )ovarian cancer( 34. 2%,39. 2% ,26. 6% ,45.6%; all P ＜ 0. 05 ). Combining five autoantibodies ( TM4SF1 IgG, TM4SF1 IgM, C1D IgG, FXR1 IgG and TIZ IgM ) showed significantly improved sensitivity (75.4%, P ＜ 0. 05 ), lower specificity (78. 3% ,P ＜ 0. 05 ) and similar accuracy (77. 1%, P ＞ 0. 05 ) in detecting ovarian cancer compared to those of CA125 (61.1% ,88.0% ,77. 1% ). But the autoantibody spectrum showed significantly improved sensitivity in classifying early stage (76. 6% ), compared to those of CA125 (51.1% ,P ＜ 0. 05 ).Combining autoantibody spectrum with CA125 showed significantly improved sensitivity ( 85.7% ), specificity (90. 8% )and accuracy (88.7%) in detecting ovarian cancer compared to those of autoantibody spectrum alone ( all P ＜ 0. 05 ), while CA125 ( 61.1%, P ＜ 0. 05; 88. 0%, P ＞ 0. 05; 77. 1%, P ＜ 0. 05 ). The positive ratio of combine the autoantibody spectrum with CA125 was significantly lower in 24 post-treatment serum (42%) compared to the pairing prior treatment serum ( 88%, P ＜ 0. 05 ). Conclusion Combining the autoantibody spectrum against ovarian cancer associated antigens with CA125 can improve sensitivity,specificity and accuracy in detecting early ovarian cancer and may be used to monitoring state of illness.     

白细胞介素-15治疗3AO裸鼠移植瘤的实验研究

目的:探讨白细胞介素-15(IL-15)治疗3AO裸鼠皮下移植瘤的效果及其机制。方法:建立3AO裸鼠皮下移植瘤模型,随机分为5组,每组12只。I组为顺铂(cD-DP)3mg/kg;Ⅱ组、Ⅲ组分别为IL-1550μg/kg,100μg/kg;Ⅳ组为cDDP1.5mg/kg加IL-1550μg/kg;Ⅴ组为对照组,注射生理盐水(各组药物均腹腔注射,按每只裸鼠0.2ml配制),1次/d,连用1周。观察移植瘤成瘤率、裸鼠生存期、生存延长率及肿瘤生长曲线。停药1天,1周,2周后,观察移植瘤细胞凋亡率及细胞周期,NK细胞群计数;测定裸鼠脾脏重量;对移植瘤及裸鼠肝、脾、肾行常规病理学检查。结果:实验组与对照组相比荷瘤裸鼠生存延长率,脾脏重量,移植瘤细胞凋亡率,NK细胞群计数均有明显差异。病理学检查示各治疗组均见肿瘤坏死,肿瘤细胞周围及肿瘤内淋巴细胞明显浸润。IL-15治疗组脾脏有充血增生表现,肝脏肝细胞嗜酸性变性,肝细胞水肿,周围有浊肿;cDDP治疗组肾脏近曲小管和远曲小管细胞水肿,管腔变小;对照组裸鼠肝、脾、肾未见明显病理改变。结论:IL-15对人卵巢癌裸鼠皮下移植瘤有明显的抑制作用,其机制可能与IL-15增强NK细胞的细胞毒活性,诱导NK细胞及细胞因子产生有关。     

不同促排卵方案对子宫内膜异位症妊娠结局的影响因素分析

目的:了解不同促排卵方案对行体外受精-胚胎移植( IVF-ET)子宫内膜异位症(EMT)患者妊娠结局的影响.方法:回顾性分析安徽医科大学第一附属医院生殖医学中心2008年1月至2010年3月因EMT行IVF-ET共262周期的临床资料,根据超促排卵方案不同分为超长方案组、短方案组和长方案组,比较3组间年龄、不孕类型、不孕年限、降调前CA125值、基础FSH、LH、E2水平、基础窦卵泡数、Gn启动量、Gn天数、Gn总量、取卵日E2、P、LH水平、子宫内膜厚度、获卵率、优质胚胎率和临床妊娠率,以及超长方案组降调后血清CA125水平与临床妊娠率的关系.结果:①短方案组年龄大于超长方案组和长方案组(P＜0.05),而3组患者不孕类型和不孕年限比较,差异无统计学意义(P＞0.05);②短方案组基础FSH水平、Gn启动量、取卵日LH值均较超长方案组及长方案组高(P＜0.05);短方案组基础窦卵泡数、Gn天数、Gn用量、取卵日子宫内膜厚度及获卵数均少于其他两组(P＜0.05);超长方案组降调前CA125值大于短方案组及长方案组(P＜0.05).③超长方案组降调后CA125值≤10 KU/L的妊娠率(40.91％)与10～20 KU/L和＞20 KU/L水平的妊娠率(18.31％和17.65％)比较,差异有统计学意义(P＜0.05).结论:对于轻度EMT患者早期发现、早期选择辅助生殖技术治疗可以有效增加临床妊娠率,中重度患者采用超长方案同时检测血清CA125水平,对判断妊娠结局有辅助指导意义.     

髓样分化因子88在妊娠期糖尿病发病机制中的作用研究

目的:通过调控孕妇单核细胞中髓样分化因子88(My D88)的表达水平,研究My D88在妊娠期糖尿病(GDM)发病机制中的作用。方法:30例正常妊娠孕妇为正常组,30例GDM患者为GDM组,两组每个样本处理均相同,每个样本各分为4个组,分别为未处理组、LPS组、ST2825组、LPS+ST2825组。采用Western blot法检测并比较各组单核细胞中My D88及核转录因子-κB(NF-κB)/p65的表达量,分析各组中My D88与NF-κB/p65的相关性;采用ELISA法检测并比较各组培养液中肿瘤坏死因子-α(TNF-α)、白介素-1(IL-1)、白介素-10(IL-10)水平。结果:①正常组和GDM组组内的比较:LPS组、ST2825组的My D88及NF-κB/p65的表达水平与同组未处理组相比,差异有统计学意义(P0.05);LPS+ST2825组的My D88及NF-κB/p65的表达水平明显低于同组的LPS组(P0.05)。正常组与GDM组组间比较:GDM组各处理组My D88及NF-κB/p65的表达水平均较正常组相同处理组明显升高(P0.05)。②两组中除未处理组外,其他处理组的My D88与NF-κB/p65的表达水平均呈正相关关系(P0.05)。③GDM组中未处理组和LPS组中的细胞因子(TNF-α、IL-1、IL-10)的表达水平均高于正常组中未处理组及LPS组(P0.05);GDM组中LPS组3个细胞因子的表达水平高于其未处理组(P0.05),ST2825组3个细胞因子的表达水平低于其未处理组(P0.05)。GDM组中LPS+ST2825组3个细胞因子的表达水平低于其LPS组(P0.05)。结论:调控GDM孕妇单核细胞中上游My D88的表达水平,下游NF-κB/p65及细胞因子(TNF-α、IL-1、IL-10)水平发生相应变化,提示My D88可能参与了GDM的发生并在其发病机制中起着重要作用。     

血清和腹腔液CA125测定与子宫内膜异位症诊断的相关分析

目的:探讨不孕症患者术前血清及术中腹腔液CA125浓度与诊断子宫内膜异位症(EM)的关系。方法:对129例因疑输卵管性不孕而行腹腔镜或宫腹腔镜联合手术的患者,于术前抽取血清,术中抽取腹腔液测CA125浓度。根据血清CA125值分为<10U/ml、10-15U/ml、16-34U/ml和≥35U/ml4组,分析各组血清和腹腔液中CA125浓度与EM诊断的相关性。结果:血清CA125水平<10U/ml和≥16U/ml时,EM的诊断符合率分别为9.09%和89.55%,两组比较有显著差异(P<0.01)。腹腔液<800U/ml和≥800U/ml的EM诊断符合率分别为19.23%和94.80%,两组比较有显著差异(P<0.01)。血清CA125≥10U/ml结合腹腔液CA125≥800U/ml的诊断符合率为93.42%。结论:血清CA125≥10U/ml结合腹腔液CA125≥800U/ml对EM的诊断有重要参考价值。     

LPA、CA125与经阴道彩色多普勒超声联合诊断卵巢上皮癌的临床价值

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。     

Experiments with tissue cultures from a human ovarian serous cystadenocarcinoma producing cancer antigen 125 (CA125), tissue polypeptide antigen (TPA) and carcinoembryonic antigen (CEA)

Summary The patient was a 57-year-old woman with ovarian serous cystadenocarcinoma in FIGO clinical stage IV. Cancer antigen 125 (CA 125), tissue polypeptide antigen (TPA) and carcinoembryonic antigen (CEA) were immunohistochemically demonstrated in tumor cells, and the variations of serum CA125 and TPA levels reflected the clinical course. The tumor tissue obtained at exploratory laparotomy was minced with scissors, and transplanted subcutaneously into female nude mice for in vivo maintenance. The tumor cells from 5th generation nude mice were dispersed in Eagle's minimal essential medium supplemented with 10% fetal calf serum, and incubated in Falcon tissue culture dishes at 37°C in 5% CO₂ in air for in vitro maintenance. The results were as follows: Histopathologically the tumor transplanted into nude mice showed a cystadenocarcinoma, which closely resembled the original human tumor. Immunohistochemically CA125, TPA and CEA were demonstrated in the tumor transplanted into nude mice as well as in the original human tumor. From the growth curve in nude mice, the doubling time was estimated to be about 3.5 days. Serum TPA levels in nude mice were increased in proportion to the tumor growth after transplantation, but serum levels CA125 and CEA were normal. The concentrations of CA125 and TPA were increased in the conditioned media compared with the control media, although the elevated values were decreased with subsequent passages. CEA concentrations in the conditioned media were unchanged.     

CA19-9、CA125和CP2在卵巢黏液性肿瘤诊断和监测中的价值

目的探讨血清肿瘤标志物CA19-9、CA125及CP2在卵巢黏液性肿瘤诊断和监测中的价值。方法对北京大学人民医院1999年1月至2007年6月间收治的273例卵巢肿瘤患者的临床资料进行回顾性分析,探讨血清肿瘤标志物CA19-9、CA125及CP2在50例卵巢黏液性肿瘤诊断和监测中的价值,并与223例卵巢非黏液性肿瘤进行比较。结果（1）卵巢黏液性肿瘤中,CA19-9的曲线下面积最大（为0．95）,其次是CA125（为0．90）;而卵巢非黏液肿瘤中,CA125和CP2的曲线下面积最大（均为0．90）。（2）卵巢黏液性肿瘤患者联合检测CA19-9和CA125时,其敏感度（93．8％）较单项检测（CA19-9和CA125分别为75．0％和66．7％）明显提高（P〈0．05）,而特异度（分别为86．1％、86．6％和90．2％）无明显变化（P〉0．05）。卵巢非黏液性肿瘤患者联合检测CA125和CP2时的敏感度（85．0％）,较CP2（70．6％）单项检测明显提高,差异有统计学意义（P〈0．05）;较CA125（80．7％）单项检测虽有提高,但差异无统计学意义（P〉0．05）;3者的特异度（分别为90．2％、88．5％和93．9％）比较,差异无统计学意义（P〉0．05）。（3）82例卵巢恶性肿瘤术前血清肿瘤标志物阳性患者中。可行满意的肿瘤细胞减灭术患者[70％（57／82）]的血清肿瘤标志物于术后2个月内降为正常的百分率高于未能行满意肿瘤细胞减灭术者（分别为75％和28％）,差异有统计学意义（P〈0．05）;且其术后血清肿瘤标志物再次上升的平均时间延长（分别为18．2和16．4个月）,但差异无统计学意义（P〉0．05）;复发率（分别为35％和56％）及死亡率（分别为14％和32％）降低,差异有统计学意义（P〈0．05）。20例术前血清肿瘤标志物阴性患者均可行满意的肿瘤细胞减灭术,其中复发患者仅2例（10％）。（4）卵巢黏液性肿瘤患者术后复发时多为血清CA19-9水平上升,而卵巢非黏液性肿瘤术后复发时主要为血清CA125水平上升,部分患者血清CP2水平也上升。（5）术前血清肿瘤标志物阳性患者较阴性患者生存率明显下降,其中CA125（＋）与CA125（-）、CP2（＋）与CP2（-）患者间生存率比较,差异有统计学意义（P〈0．05）;而CA19-9（＋）与CA19-9（-）患者间生存率比较,差异则无统计学意义（P〉0．05）。结论CA19-9是诊断卵巢黏液性肿瘤的敏感指标,与CA125联合检测可提高对卵巢黏液性肿瘤诊断的敏感度,并对术后监测有重要临床意义。CA125和CP2联合检测则对诊断卵巢非黏液肿瘤更敏感。     

The diagnostic value of multiple tumor markers in malignant ovarian neoplasms

Ovariancanceristhemostfrequentcauseofdeath fromgynecologicalcancer.Almost90%ofpatientsare diagnosedwithmetastaticdiseaseinthepelvisorabdo menandforthesepatients5yearsurvivalratesareless than30%.Incontrast,thesmallproportionofpatients diagnosedwithstageIovariancancerconfinedtotheo varieshavea5yearsurvivalrateinexcessof90%[1].Tumormarkerisakindofsubstancecorrelatedwiththe occurrenceoftumor.Itarisesfromthetumortissue,ex istsinthetumor,orexcretesintobloodorotherbody fluid[2].Nowadaysmorethan100ki…     

Is there a correlation between tumor marker panel and tumor size and histopathology in well staged patients with borderline ovarian tumors?

AIMS: To investigate whether there is a correlation between serum tumor markers panel (CA 125, CA 19-9, CA 15-3, and carcinoembryonic antigen (CEA)) and tumor size and histopathology in well staged patients with borderline ovarian tumors (BOTs). METHODS: Four tumor markers (CA 125, CA 19-9, CA 15-3, and CEA) were analysed clinically in 60 well staged patients with borderline ovarian tumor, for this retrospective observational study. RESULTS: Most patients had serous histology and early stage disease, and the mean age at the time of diagnosis was 40.70 years (range: 19-73). Twenty-nine patients (48.3%) had high CA 125 levels (>35 U/l), 15 patients (25%) had high levels of CEA (>4 ng/ml), 12 patients (20%) had high levels of CA 19-9 (>37 U/ml), and 9 patients (15%) had high levels of CA 15-3 (>30 ng/ml) at the time of initial surgery. The positive rate of CA 125, CA 19-9, CA 15-3, and CEA in serous tumor were 57.9, 7.9, 7.9 and 15.8%, respectively. These figures were 31.8, 40.9, 27.3 and 40.9% in mucinous tumor. The positive rate of CA 125 in the serous group was statistically significantly higher than that in the mucinous group, while the positive rates for CA 19-9 and CEA in mucinous histology was significantly higher than those in serous tumors. In case of grouping the tumor size as <4, 4.1-10 and >10 cm, the mean serum levels of tumor markers had significantly increased by increasing tumor size (p<0.05 for CA 125, and CA 19-9, p>0.05 for CA 15-3, and CEA). CONCLUSION: The high levels of tumor markers, especially for CA 125 and CA 19-9, may indicate the larger tumor size. The elevation of serum CA 125 may suggest serous tumors, while the high level of serum CA 19-9 and CEA may indicate mucinous BOTs.     

地诺孕素治疗子宫内膜异位症对患者生殖激素及血清CA125水平的影响

目的 探讨地诺孕素治疗子宫内膜异位症对患者生殖激素、血清糖类抗原125(CA125)水平的影响.方法 选取90例子宫内膜异位症患者,按照随机数字表法分成甲组、乙组、丙组,每组30例.患者均实施腹腔镜下保留生育功能手术治疗,术后甲组给予口服地诺孕素6个月,乙组给予注射促性腺激素释放激素类似物(GnRHa)6个月,丙组给予...     

IL-6、CRP、CA_(125)在卵巢肿瘤定性诊断中的价值及临床意义

目的 :探讨测定血清IL 6、CRP、CA12 5水平在卵巢肿瘤定性诊断中的价值及临床意义。方法 :取卵巢肿瘤 61例患者的血浆及 17例合并腹水患者的腹水 ,用ELISA法及胶乳凝集法测定IL 6、CA12 5、CRP。结果 :IL 6诊断卵巢癌敏感性为 80 .9% ,特异性为77.3%。CA12 5诊断卵巢癌敏感性为 85 .7% ,特异性为 80 .9%。这二项指标联合检测 ,敏感性为 92 .5 % ,特异性 73.9%。CRP诊断卵巢癌敏感性达 76.2 % ,特异性 60 .0 %。临床分期晚、组织分化低者血清及腹水IL 6、CA12 5水平明显升高。结论 :IL 6、CA12 5是卵巢肿瘤定性诊断的良好指标 ,联合检测可提高定性诊断的敏感性及特异性。腹水或血中IL 6、CA12 5水平可为卵巢癌早期诊断、分期及判断预后提供有效的参考指标。     

IOTA SR 与 CA125、HE4、ROMA、RMI1、GI-RADS对卵巢良恶性肿瘤的诊断价值比较

目的 探讨糖链多肽抗原125(CA125)、人附睾蛋白4(HE4)、恶性肿瘤风险算法(ROMA)、恶性风险指数1(RMI1)、国际卵巢肿瘤分析简单规则(IOTA SR)、妇科影像报告与数据系统(GI-RADS)在卵巢良恶性肿瘤鉴别诊断中的价值.方法 选取2019年7 月至2020年7 月于锦州医科大学附属第一医院83例...     

人附睾蛋白4在子宫内膜非典型增生患者中筛查子宫内膜癌的临床价值

目的：探讨人附睾蛋白4（human epididymis protein 4,HE4）检测在诊断性刮宫（诊刮）病理为子宫内膜非典型增生（atypical endometrial hyperplasia,AEH）患者中筛查子宫内膜癌（endometrial carcinoma,EC）的临床价值。方法：选取2011年1月—2014年12月在天津市中心妇产科医院诊刮病理为AEH进而行手术治疗的患者,术前采用电化学发光免疫分析法检测患者血清HE4、CA125和CA199水平,根据术后病理分为EC组和AEH组,分析2组患者肿瘤标记物的水平差异。制作受试者工作特征曲线（ROC）,以曲线下面积（AUC）反映肿瘤标记物的诊断价值。结果：入选的118例诊刮病理为AEH的患者中,31例术后被诊断为EC（EC组）,其血清HE4、CA125和CA199水平分别为73.4 pmol/L、31.4 kU/L和23.3 kU/L;87例术后诊断仍为AEH（AEH组）,上述3种肿瘤标记物的水平分别为44.3 pmol/L、17.0 kU/L和19.0 kU/L;EC组HE4和CA125水平高于AEH组,差异有统计学意义（P＜0.05）,而CA199水平差异无统计学意义（P＞0.05）。EC组以AEH组为参照时,HE4和CA125单独检测的AUC分别为0.785和0.706,两者联合检测的AUC为0.867,敏感度为76.6%。结论：EC患者血清HE4和CA125水平明显高于AEH患者,两者联合检测有助于筛查出诊刮病理为AEH人群中漏诊的EC患者。