卵巢恶性肿瘤风险值在卵巢癌及其FIGO分期中应用与诊断价值

目的 探讨人附睾上皮分泌蛋白4(HF4)、癌抗原(CA) 125单独及基于二者联合检测建立的卵巢癌风险预测模型(ROMA)在卵巢癌诊断中的价值,并且探讨与肿瘤分期的相关性.方法 实验对象根据术后病理检查结果分为4组,卵巢癌患者组108例,其他妇科恶性肿瘤组34例,妇科良性病变组96例,其他系统恶性肿瘤组56例.全自动化学发光仪测定HE4和CA125水平并计算ROMA值.结果 卵巢癌组ROMA值[(61.4±23.2)％]明显高于其他妇科恶性肿瘤组[(19.7±7.5)％],妇科良性病变组[(16.2±6.3)％]及其他系统恶性肿瘤组[(14.9±6.0)％],差异均有统计学意义(P＜0.05),以卵巢良性病变为对照,卵巢癌组中敏感性、阴性预测值和准确性最高,分别为85.19％,83.34％和84.32％,其中敏感性和阴性预测值与CA125、HE4相比较,差异有统计学意义(P＜0.05),准确性与HF4相比较,差异无统计学意义(P＞0.05).在卵巢癌分期中,FIGO I期中ROMA的阳性率为75.87％,与CA125和HF4相比较,有统计学意义(P＜0.05).结论 ROMA指数的计算有助于评估盆腔肿块患者患卵巢癌的风险性,可提高卵巢癌早期诊断效率,进而提高五年生存率.     

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...     

血清人附睾分泌蛋白4在卵巢上皮性癌中的临床价值

目的 研究血清人附睾蛋白4(HE4)在卵巢恶性肿瘤中的诊断价值.方法 用酶联疫吸附试验方法对卵巢上皮性癌组(54例)、盆腔良性疾病组(60例)、正常组(60例)妇女血清中HE4和CA125进行双盲检测,结果以中位数表示,分析比较两者单独检测诊断卵巢恶性肿瘤的价值.血清HE4和CA125的正常值分别为0～ 140pmol/L和0～ 35KU/L,其中任一指标高于正常即为阳性.结果 ①卵巢上皮性癌组血清HE4和CA125水平分别为142.72pmol/L和136.07KU/L,分别与盆腔良性疾病组(分别为63.72pmol/L和72.20KU/L)和正常组(分别为57.82pmol/L和57.42KU/L)比较,差异均有统计学意义(P＜0.01).②以盆腔良性疾病组作参照人群时,HE4和CA125单独检测的受试者工作特征曲线下面积(ROC-AUC)分别为0.958和0.886,两者比较,差异有统计学意义(P＜0.001).③以ROC曲线最左上方的点130 pmol/L、正常组95％参考值80pmol/L和正常值的上限140pmol/L为界值点,比较HE4单项检测对卵巢上皮性恶性肿瘤的诊断能力,结果显示,界值点为80pmol/L的特异度和阳性预测值均为88％,明显低于界值点为130(分别为93％和90％)和140pmol/L(分别为93％和95％)时的特异度和阳性预测值(P＜0.01).结论 HE4单项检测诊断卵巢上皮性恶性肿瘤的特异度优于CA125单项检测.以140pmol/L为界值点,对卵巢上皮性恶性肿瘤的早期诊断准确率更高,而以130pmol/L为界值点有利于卵巢上皮性恶性肿瘤的筛查、降低漏诊率.     

196例妇科盆腔包块患者血清CA125测定

妇科盆腔包块种类繁多 ,区分良恶性的诊断有时十分困难。卵巢肿瘤又是盆腔包块中最常见的。采用血清ＣＡ1 2 5诊断卵巢癌已广泛应用于妇科临床。我们采用免疫放射(ＩＲＭＡ)法检测盆腔包块患者血清ＣＡ1 2 5水平 ,目的在进一步探索血清ＣＡ1 2 5测定对盆腔包块的诊断价值及鉴别诊断的意义。资料和方法一、资料 :本文所有病例为我院妇科收治的妇科盆腔包块患者 1 96例 ,正常健康妇女 40例 ,分以下三组检测 :(一 )盆腔恶性包块组 :79例 ,年龄 1 4～ 77岁 ,平均 47±1 5岁。其中卵巢恶性肿瘤 71例 ,其他妇科恶性肿瘤 8例。(二 )盆腔良性包块组 …     

CA—125和CA—50联检对盆腔包块诊断价值的探讨

卵巢癌的发病率,占妇科恶性肿瘤的第三位,但由于卵巢肿瘤深藏于盆腔,患病初期很少有症状,以致确诊时60～70％的卵巢恶性肿瘤患者已属晚期,卵巢癌患者的死亡率占妇科恶性肿瘤的首位。为此,研究卵巢恶性肿瘤的病因及预防措施,寻找早期诊断方法,是提高卵巢癌的生存率,降低死亡率的关键。本文通过对172例盆腔包块的住院病人血清CA-125和CA-50的联检,探讨其在盆腔疾病的诊断价值。     

血清CA125测定对鉴别盆腔良、恶性包块的意义

卵巢癌是女性生殖器中常见的恶性肿瘤 ,而且死亡率最高 ,其原因在于早期无症状 ,诊断较困难[1,2 ] 。如今肿瘤相关抗原的检测已成为某些肿瘤有效的常规辅助诊断手段。本文通过对正常人及盆腔良恶性包块等患者血清ＣＡ12 5测定结果的分析 ,探讨该项目检测的临床价值 ,尤其对鉴别盆腔良、恶性包块的意义。资料和方法一、临床资料 :(一 )正常对照组 32例 ,年龄 2 5～ 5 3岁 ,为我院妇科体检健康的女性。(二 )盆腔恶性包块组 :1 未治组 :2 1例为我院妇科收治并经病理证实的妇科恶性肿瘤患者 ,年龄 30～ 77岁 ,包括卵巢癌和宫颈癌各 8例、输卵管…     

Clinical Significance of Detecting Serum HE4, CA125 and CA724 Levels in Diagnoses of Ovarian Malignancies

目的 通过检测卵巢恶性肿瘤患者血清人附睾蛋白4(HE4)、CA125和CA724水平,探讨这三项检测在卵巢恶性肿瘤诊断中的临床价值.方法 采用电化学发光免疫法(ECL)检测CA125和CA724水平,以ELISA法检测HE4水平.测定36例卵巢恶性肿瘤组患者、59例卵巢良性疾病患者及70名健康体检人群血清三项水平并进行比较.结果 卵巢恶性肿瘤组患者血清HE4、CA125和CA724水平显著高于良性疾病组和健康体检组(P＜0.05),其中良性疾病组CA125和CA724水平高于健康体检组(P＜0.05),但是良性疾病组HE4水平与健康体检组比较差异无统计学意义(P＞0.05);卵巢恶性肿瘤组患者血清HE4、CA125、CA724单独检测的灵敏度分别为69.4％、83.3％、58.3％,而这三项联合检测的灵敏度为91.7％,明显高于三项单独检测(P＜0.05).当以卵巢良性疾病组作为参照人群时,HE4、CA125、CA724单独检测的特异性分别为96.6％、62.7％、81.4％,而这三项联合检测的特异性为61.0％.结论 HE4在诊断卵巢恶性肿瘤上具有高度特异性的肿瘤标志物,区分良性或恶性肿瘤时应选择HE4检测;卵巢肿瘤疾病的筛查是可选择HE4、CA125、CA724和三项联合检测以提高诊断的敏感性.     

肿瘤标记物CEA、CA125和CA199检测在卵巢癌诊断中的应用

卵巢癌的发病率,占妇科恶性肿瘤的第三位,但由于卵巢肿瘤深藏于盆腔,患病初期很少有症状,以致确诊时60%～70%的卵巢恶性肿瘤患者已属晚期,卵巢癌患者的死亡率占妇科恶性肿瘤的首位.为此,研究卵巢恶性肿瘤的病因及预防措施,寻找早期诊断方法,是提高卵巢癌的生存率、降低死亡率的关键[1].本文通过对112例盆腔包块病人血清CEA、CA125和CA199的联检,探讨在卵巢癌诊断中的意义.     

HE4与CA125联合应用ROMA用于上皮性卵巢癌的风险评估

目的 探究HE4与CA125联合应用ROMA指数用于上皮性卵巢癌的风险评估的价值.方法 临床回顾并随访从2013年1月至2016年10月期间在高淳人民医院治疗的患者194例,经石蜡切片病理报告诊断卵巢癌患者84例,卵巢良性疾病110例,同时选取无任何疾病史的健康女性50例.研究并比较各组中人附睾蛋白4以及血清糖类抗原125的指标水平,通过公式计算各组ROMA指数(PP),并根据结果结合绝经状态预测及评价卵巢恶性肿瘤的发病风险.HE4、CA125水平检测采用全自动化学发光微粒子免疫分析方法.结果 卵巢癌组各项指标表达水平均高于健康组(P<0.05),差异具有统计学意义.良性卵巢疾病组CA125及ROMA高于健康组,但两组HE4差异无统计学意义(P>0.05).HE4的灵敏度略高于CA125,但特异性却明显优于CA125.同时,HE4阳性表达率与年龄有一定的相关性,ROMA阳性表达率与年龄和绝经状态均呈相关性.结论 HE4的灵敏度及特异性都较理想,HE4和CA125联合应用ROMA指数用于上皮性卵巢癌风险评估具有重要的临床意义.     

HE4和CA125联合检测对卵巢癌的诊断价值

探讨人附睾上皮分泌蛋白4(HE4)和糖链抗原125(CA125)联合检测对卵巢癌的诊断价值。方法分别检测卵巢癌(n=37例)和妇科良性疾病(n=38例)患者血清HE4和CA125的表达水平,同时选择40例门诊体检妇女作为对照组。结果卵巢癌组血清HE4、CAl25表达水平明显高于良性疾病组和对照组(<0.05),良性疾病组血清CAl25表达水平明显高于对照组(< 0.05);联合检测血清HE4、CA125表达水平的敏感性均高于两种指标单独检测。结论HE4和CA125联合检测可明显提高卵巢癌诊断的敏感性,值得临床推广应用。     

血清HE4、CA125和CA724检测在卵巢恶性肿瘤诊断中的应用

目的通过检测卵巢恶性肿瘤患者血清人附睾蛋白4(HE4)、CA125和CA724水平,探讨这三项检测在卵巢恶性肿瘤诊断中的临床价值。方法采用电化学发光免疫法(ECL)检测CA125和CA724水平,以ELISA法检测HE4水平。测定36例卵巢恶性肿瘤组患者、59例卵巢良性疾病患者及70名健康体检人群血清三项水平并进行比较。结果卵巢恶性肿瘤组患者血清HE4、CA125和CA724水平显著高于良性疾病组和健康体检组(P0.05),其中良性疾病组CA125和CA724水平高于健康体检组(P0.05),但是良性疾病组HE4水平与健康体检组比较差异无统计学意义(P0.05);卵巢恶性肿瘤组患者血清HE4、CA125、CA724单独检测的灵敏度分别为69.4%、83.3%、58.3%,而这三项联合检测的灵敏度为91.7%,明显高于三项单独检测(P0.05)。当以卵巢良性疾病组作为参照人群时,HE4、CA125、CA724单独检测的特异性分别为96.6%、62.7%、81.4%,而这三项联合检测的特异性为61.0%。结论 HE4在诊断卵巢恶性肿瘤上具有高度特异性的肿瘤标志物,区分良性或恶性肿瘤时应选择HE4检测;卵巢肿瘤疾病的筛查是可选择HE4、CA125、CA724和三项联合检测以提高诊断的敏感性。     

ECLIA和CMIA检测HE4对卵巢癌的诊断价值探讨

目的 探讨全自动电化学发光免疫分析法（ECLIA）和化学发光微粒子免疫法（CMIA）检测人血清附睾蛋白4（HE4）对卵巢癌的诊断价值.方法 收集39例卵巢癌、63例卵巢良性疾病和50名体检健康者血清.分别采用ECLIA和CMIA法检测血清HE4,评估两种检测方法对卵巢癌的诊断价值.结果 两种方法测定的HE4值,呈高度正相关（r=0.997,P＜0.01）;卵巢癌组HE4水平均显著高于同种方法检测的卵巢良性疾病组和体检健康人群组,差异具有统计学意义（P＜0.01）;以卵巢良性疾病为对照,ECLIA测定血清HE4用于辅助诊断卵巢癌,ROC曲线下面积为0.813;CMIA测定血清HE4用于辅助诊断卵巢癌,ROC曲线下面积为0.782.两种检测方法均具有较高的特异性和较好的准确性.结论 ECLIA和CMIA测定血清HE4结果较为一致,均可作为临床卵巢癌辅助诊断的良好方法.     

血清人附睾蛋白4在辅助诊断卵巢癌中的临床价值

目的探讨血清人附睾蛋白4（human epididymis protein4,HE4）在辅助诊断卵巢癌中的临床意义。方法应用酶联免疫吸附试验法测定82例卵巢癌患者血清HE4水平,并同步检测糖类抗原125（CA125）水平,与143例卵巢良性疾病患者和40例健康体检者进行对照比较。计算敏感性、特异性等诊断性指标,绘制ROC曲线,计算ROC曲线下面积。结果卵巢癌组血清HE4、CA125水平均显著高于健康对照组（P〈0．01）;其卵巢良性疾病组与健康对照组之间均无显著性差异。HFA以≥45．10pmol／L为阳性时,HE4对卵巢癌的诊断敏感性为85．37％（70／82）,特异性为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。结论HE4对诊断卵巢癌有较高的敏感性和特异性,是一个新的卵巢癌辅助诊断标记物。     

Comparison of HE4, CA125, and Risk of Ovarian Malignancy Algorithm in the Prediction of Ovarian Cancer in Korean Women

This study is a multi-center clinical study, which aimed to compare CA125, HE4, and risk of ovarian malignancy algorithm (ROMA) in predicting epithelial ovarian cancer of Korean women with a pelvic mass. Prospectively, serum from 90 Korean women with ovarian mass was obtained prior to surgery. For control group, serum from 79 normal populations without ovarian mass was also obtained. The HE4 and CA125 data were registered and evaluated separately and ROMA was calculated for each sample. Total 67 benign tumors and 23 ovarian cancers were evaluated. Median serum levels of HE4 and CA125, and ROMA score were significantly higher in patients with ovarian cancer than those with benign ovarian tumor and normal population (P < 0.001). In ROC curve analysis for women with a pelvic mass, area under the curve (AUC) for HE4 and ROMA was higher than CA125. Statistical differences in each study compared to CA125 were marginal (P compared to CA125; 0.082 for HE4 and 0.069 for ROMA). Sub-analysis revealed that AUC for HE4 and ROMA was higher than AUC for CA125 in post-menopausal women with a pelvic mass, but there were no statistically significant differences (P compared to CA125; 0.160 for HE4 and 0.127 for ROMA). Our data suggested that both HE4 and ROMA score showed better performance than CA125 for the detection of ovarian cancer in women with a pelvic mass. HE4 and ROMA can be a useful independent diagnostic marker for epithelial ovarian cancer in Korean women.     

血清HE4和CA125联合检测在卵巢癌诊断中的应用分析

目的探讨血清人附睾蛋白4(HE4)和糖类抗原125(CA125)水平联合检测在卵巢癌诊断中的应用价值。方法对85例卵巢癌组患者、55例盆腔良性疾病组患者和120名对照组用ELISA测定血清HE4水平,用ECLIA测定CA125水平。结果卵巢癌组血清HE4水平与对照组比较明显升高,差异有明显统计学意义(P0.001),而盆腔良性疾病组血清HE4水平与对照组比较,差异无统计学意义(P0.05)。在卵巢癌组及盆腔良性疾病组血清CA125水平均升高,与对照组比较,差异有统计学意义(P0.001)。结论结果表明,HE4和CAl25是较理想的卵巢癌肿瘤标志物,其血清水平对卵巢肿瘤的良恶性辅助诊断及鉴别诊断有一定的临床价值,可提高对卵巢癌的诊断能力。     

Multiple peritoneal cytologies collected during laparotomy for gynecologic malignancy

Review of an 18-mo experience with peritoneal cytology specimens showed that 760 peritoneal washings and 177 diaphragmatic smears were collected during 300 laparotomies on patients known to have or suspected of having gynecologic malignancy. One hundred three patients were eventually shown to have benign gynecologic disease. The remaining 197 procedures were done on patients undergoing primary operations for gynecologic malignancy or laparotomies for previously treated gynecologic malignancy. Of the 197 laparotomies for gynecologic malignancies, 168 had washings separately collected from multiple intra-abdominal sites, and these fluids were interpreted as either all positive or all negative in all but seven (4%) patients. The location and extent of the gross or microscopic disease did not correlate with the site of positive washings. Only three of the 177 diaphragmatic smears were positive for malignant cells; these were collected from three patients undergoing primary treatment of ovarian carcinoma, two of whom had extensive peritoneal involvement by carcinoma. Only 35 of the 197 patients with gynecologic malignancy had positive peritoneal cytologies; 32 of these patients had gross or microscopic peritoneal involvement by malignancy, and one additional patient had metastatic carcinoma in pelvic lymph nodes. The analysis of multiple peritoneal washings separately collected from various intra-abdominal sites and the analysis of diaphragmatic smears collected in the absence of gross diaphragmatic disease appear to be of benefit in few cases.     

复发妇科恶性肿瘤患者HIF-1α、EGFR的表达及其与放射敏感性的关系

目的探讨复发妇科恶性肿瘤患者HIF-1α、EGFR的表达及其与放射敏感性的关系。方法采用免疫组化的方法检测了32例复发妇科恶性肿瘤患者初次手术后及二次复发灶切除术后肿瘤组织的HIF-1α及EGFR表达水平。所有患者二次手术前均经放疗。32例二次手术中有15例行腹腔镜下病灶切除及125I粒子植入,17例行开腹手术切除。结果第二次手术后肿瘤组织的HIF-1α及EGFR的阳性表达率略高于初次手术组,但无统计学意义(P0.05)。第二次手术后肿瘤组织的HIF-1α及EGFR的强阳性表达率明显高于初次手术组(P0.05)。10例HIF-1α及EGFR呈强阳性表达的患者预后很差。结论 HIF-1α及EGFR表达增加可降低肿瘤放射敏感性,HIF-1α及EGFR强阳性表达可作为预测放疗或125I粒子植入的疗效的指标。     

Neovaginal cytology after total pelvic exenteration for gynecological malignancies

Vaginal reconstruction has become an established method to re-store sexual function in women who have undergone ultraradical surgery and/or irradiation for the treatment of gynecologic malignancies. Cytologic evaluation of the neovagina serves a major role in the detection of recurrent disease. The purpose of this retrospective 6-yr study (January 1987–December 1993) was to evaluate the cytologic features of vaginal smear specimens from neovaginas constructed utilizing split-thickness skin grafts. Thirty-four vaginal smears were obtained at regular intervals from nine women (mean age: 51 yr) who underwent total pelvic exenteration with vaginal reconstruction for recurrent malignancies of the vagina and the cervix. Anucleated, keratinizing squames were a constant finding in each smear. Over a 4-mo-6-yr postoperative period, superficial and intermediate squamous cells were present in the majority of the smears and the maturation index showed a shift to the right. In two cases, a squamous cell carcinoma of the cervix recurred within the neovagina. Knowledge of the cytologic features associated with neovaginas is important in order to distinguish normal changes from neoplastic lesions. © 1995 Wiley-Liss, Inc.     

尼莫地平对癫痫太鼠海马P75NTR和P513蛋白表达的影响

目的：探讨尼莫地平（NM）对戊四氮（PTZ）点燃癫痫持续状态（SE）大鼠海马P75NTR和P53蛋白表达的影响,以期为临床应用尼莫地平治疗癫痫提供充分的理论依据。方法：动物分为正常对照组,PTZ组和NM组,模型诱导成功后,观察大鼠行为学改变,并取脑常规HE染色,并用免疫组化方法分别检测各组大鼠海马神经元凋亡相关基因P75NTR和P53的表达。结果：PTZ组大鼠有典型的SE发作,其海马P75NTR和P53表达较对照组明显增加（P〈0．05）,与PTZ组比较,NM组大鼠海马P75NTR和P53表达均减少（P〈0．05）。结论：NM有神经保护作用,其机理可能与抑制癫痫大鼠海马凋亡相关基因的发生有关。     

腹腔镜诊治不孕症患者盆腔病变临床分析

目的探讨应用腹腔镜手术诊治不孕症的临床价值。方法对126例女性不孕症患者行腹腔镜诊断和治疗,观察术后妊娠率。结果 126例中发现盆腔病变117例,占92.86%;慢性盆腔炎是不孕症的第1位病因;其次为子宫内膜异位症、多囊卵巢综合征。腹腔镜手术术后妊娠率为47.50%,1例发生异位妊娠。结论腹腔镜手术对女性不孕症盆腔病变的诊治具有重要的价值。