Serum concentrations of CA 125 and aminoterminal propeptide of type III procollagen (PIIINP) in patients with endometrial carcinoma

Serum CA 125 (a marker of coelomic epithelial cells) and aminoterminal propeptide of type III procollagen (PIIINP; an indicator of collagen metabolism) concentrations were measured in 148 patients with endometrial carcinoma. An initial serum concentration of CA 125 was pathologic in 17% of the patients, the frequency of abnormal values being higher (P = 0.0001) in advanced (63%) than in early disease (10%). The serum PIIINP concentration was increased in 35% of the patients and more often (P less than 0.05) so in advanced (63%) than in early disease (31%). Among all the patients, at least one of the tumor markers was increased in 43% of the cases. In early disease 12 of 108 patients contracted recurrent cancer. The accuracy of the pathologic CA 125 (9%) and PIIINP (18%) concentrations in their prediction was poor. In the total material, pathologic CA 125 and PIIINP concentrations appeared simultaneously in 11 patients, of whom eight had poor prognoses. In monitoring of treatment response of 24 patients, regression was accompanied by normal or decreasing CA 125 and PIIINP values. The persistence of pathologic CA 125 and/or PIIINP concentration predicted relapse of the malignancy. In progressive disease, CA 125 and PIIINP concentrations together or separately remained at a pathologic level or increased continuously. In clinically stable endometrial carcinoma, CA 125 gave false-negative results in 71% of the determinations and PIIINP only in 12%. The current results suggest the use of CA 125 and PIIINP, simultaneously, in monitoring the clinical course of advanced endometrial carcinoma.     

Amino-terminal propeptide of type III procollagen: a new prognosis indicator in human ovarian cancer

To investigate the clinical usefulness of the amino-terminal propeptide of type III procollagen (PIIINP) as an indicator of ovarian cancer behavior, 30 patients with advanced epithelial malignancy were monitored with serial serum PIIINP and CA-125 determinations before and during treatment. Initially, PIIINP and CA-125 concentrations were each separately increased in 87% of the cases and, simultaneously, in 77% of the cases. In monitoring treatment responses, PIIINP and CA-125 were identical in 17 patients (57%), both being good predictors of the clinical behavior of the disease in 16 cases and poor predictors in one case. In 13 patients (43%) they were complementary to each other. In three cases PIIINP alone and in one case CA-125 alone were clinically useful prognosis indicators. During the period of complete clinical response to cytotoxic chemotherapy of 16 patients, the CA-125 concentrations decreased to normal before the clinical disappearance of the tumor in eight cases. PIIINP did so in only two cases, thus correlating more precisely with the presence of malignancy. In second-look laparotomies, PIIINP concentrations correlated with the presence of occult cancer better than those of CA-125. In predicting recurrent malignancy in patients with transient complete response, PIIINP and CA-125 were clinically equal. According to the present data, PIIINP concentrations often give information not obtainable by CA-125, thus being useful in monitoring the clinical behavior of ovarian cancer.     

Measurement of epithelial and stromal changes in vulvar carcinoma - a clinical, biochemical and immunohistochemical study

We evaluated the clinical usefulness of the squamous cell carcinoma antigen (SCC) and CA 125, serum markers of epithelial cancer cells, in comparison with the serum concentration and tissue distribution of the aminoterminal propeptide of type III procollagen (PIIINP), a marker of connective tissue metabolism, in 31 patients with vulvar carcinoma. The SCC concentration was increased in 42%, that of CA 125 in 14% and that of PIIINP in 36% of the cases. The combination of SCC and PIIINP increased the detection rate to 57% and that of all three to 64%. None of the tumor markers correlated with the clinical stage of the disease. The initial values of the serum markers did not discriminate between different patterns of the clinical behavior of the disease. Six patients were followed with serial determinations of the markers. In each case at least one of the markers correlated with the clinical course of the disease. SCC did so in 5 cases, PIIINP in 3 cases and CA 125 in 2 cases. The mean concentrations of SCC and CA 125, but not that of PIIINP, were significantly lower during the periods of response to therapy than during the nonresponsive periods. Immunohistochemistry of PIIINP showed vulvar carcinoma to be associated with a distinct collagenous stroma. In the junctional area of the stroma around the malignant epithelium, the PIIINP positive fibers grew more sparse and irregular with decreasing differentiation of the tumor. The present data suggest that SCC, CA 125 and PIIINP are useful, especially SCC, in monitoring the clinical behaviour of the advanced vulvar cancer, less so in predicting its prognosis.     

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.     

Synthesis and breakdown of fibrillar collagens: concomitant phenomena in ovarian cancer.

The synthesis and degradation of type I and type III interstitial collagens releases several antigenic metabolites, whose measurement allows the metabolism of connective tissue to be evaluated under a variety of different conditions. In this study we investigated the influence of benign and malignant ovarian neoplasms on the metabolism of these collagens. The study population comprised patients with benign (n = 53), borderline (n = 6) or malignant (n = 36) ovarian neoplasms. We quantified the serum, cyst fluid and peritoneal/ascitic fluid concentrations of the amino-terminal propeptide of type I (PINP) and III (PIIINP) procollagens, indicators of the synthesis of type I and III collagen, respectively and the cross-linked carboxy-terminal telopeptide of type I collagen (ICTP), an indicator of type I collagen degradation. Macrophage colony-stimulating factor 1 (CSF-1) concentration was also assayed as its serum level is increased in ovarian cancer and CSF-1 may be involved in the regulation of collagen metabolism. The concentration of each antigen was significantly higher in patients with malignant tumour than with benign neoplasm in each comparison, except for ICTP in peritoneal fluid and for CSF-1 in cyst fluid. The high ascitic fluid concentration of PINP, PIIINP or CSF-1 correlated with malignancy, and the low cyst fluid concentration of any of the four markers was indicative of benign tumour. Levels of CSF-1 did not correlate with the levels of any of the markers of collagen turnover. The concentration of PINP in ascites was about 50 times higher and in cyst fluid about eight times higher than that in the serum from patients with malignant tumour, whereas the respective ratios for ICTP were only 2.5 and 1.3. In such patients, the ratio of ascitic fluid to serum concentration was also about 80-fold higher for PIIINP and about 20-fold higher for PINP than for ICTP. The different distributions of PIIINP, PINP and ICTP suggests dominance of synthetic processes or retarded elimination of PIIINP and PINP in ovarian cancer. In advanced malignancies, the accumulation of PINP and PIIINP in abdominal space, possibly due to increased synthesis and/or failed resorption, may promote ascites formation. This study shows that both accelerated synthesis and breakdown of fibrillar collagens are characteristic of ovarian malignancy, and suggests that measurements of cyst fluid or ascitic fluid concentrations of collagen metabolites or CSF-1 could be used in the differential diagnosis of benign and malignant ovarian neoplasms.     

A prospective study of tumor markers CA 125 and CA 19.9 in patients with epithelial ovarian carcinomas.

In a prospective study, CA 125 and CA 19.9 serum levels were measured in 229 patients with ovarian cancer [121 with active disease, 108 in complete remission (CR)], and in 20 patients with other malignancies. Abnormal levels of CA 125 were found in 90% of patients with active ovarian cancer, in 1.8% of those in CR and in 38% of cases with other malignancies. Abnormal CA 19.9 serum levels were found in 36, 9 and 48% of these groups, respectively. Serum levels of both tumor markers were related to tumor stage and histological type. The highest levels of CA 125 were found in serous adenocarcinoma and the lowest in the mucinous type (p < 0.0001). In contrast, significantly higher CA 19.9 values were found in mucinous carcinoma than in other histologies (p < 0.0001). CA 125 and CA 19.9 were useful for monitoring disease activity in 88.3 and 32%, respectively, while one or other tumor marker was useful in 92% of patients. At the time of the second-look operation, abnormal CA 125 serum levels were found in 32% (6/19) of patients with active disease and in none of those with CR (0/38). CA 125 sensitivity was 83% (5/6) in those patients with residual tumor > 2 cm and in 8% (1/13) in those with tumor < 2 cm. CA 19.9 values were abnormally high in 16% of cases with persistent disease and in 11% of CR patients. In conclusion, our results confirm that CA 125 is a useful marker in ovarian carcinoma. CA 19.9 improves the results obtained with CA 125 alone only in mucinous adenocarcinomas.     

卵巢浆液性囊腺癌中PD-L1的表达和血清CA125对评价恶性程度的意义

目的:研究PD-L1在卵巢浆液性囊腺癌中的表达,结合患者术前CA125值,探讨二者对评价肿瘤生物学恶性程度的意义。方法:应用免疫组织化学法检测36例卵巢浆液性囊腺癌和20例正常卵巢组织蜡块中PD-L1的表达情况,收集36例卵巢癌患者术前血清CA125值,分析卵巢癌组织PD-L1表达与卵巢癌临床病理特征的关系及术前血清CA125的相关性。结果:卵巢浆液性囊腺癌组织中PD-L1的阳性表达率为88.9%（32/36）,显著高于其在正常卵巢组织中的表达40.0%（8/20）,差异有统计学意义（P＜0.01）。分化程度G2-3级组中PD-L1的阳性率显著高于G1级组,PD-L1与 FIGO分期无明显相关性,与患者术前CA125值呈正相关（r=0.739,P＜0.01）。结论:PD-L1的表达与术前血清CA125的增高程度结合分析对判断卵巢浆液性囊腺癌的生物学恶性程度有重要意义。     

血清HE-4和CA125检测在卵巢癌术后转归中的特点

目的 探讨血清人附睾蛋白4(human epididymis protein 4,HE-4)结合糖类抗原125(carbohydrate anti-gen 125,CA125)检测在卵巢癌术后转归中的特点.方法 收集卵巢癌患者84例,于入院时、术后3 d和第1、3、6次化疗前以及术后6、9、12、18、24个月检测血清CA125和HE-4,分析HE-4和CA125水平的变化.结果 术前HE-4总阳性率高于CA125总阳性率(78.6%vs 66.7%,P<0.05).在早期卵巢癌、黏液性卵巢癌及其他病理分型患者中HE-4阳性率高于CA125阳性率(均P<0.05).HE-4水平随病情缓解而降低,下降速度较CA125快(P<0.05).随访至术后24个月,36例卵巢癌复发患者中,HE-4升高早于CA125(P<0.05).结论 HE-4和CA125检测对卵巢癌诊断(尤其是早期卵巢癌)、术后预后和转归有较好的价值.     

Diagnostic accuracy of CA125 and HE4 in ovarian carcinoma patients and the effect of confounders on their serum levels

ObjectivesTo evaluate the diagnostic accuracy of serum cancer antigen 125 (CA125) and human epididymis protein 4 (HE4) in the prediction of malignant ovarian masses then to analyze the effect of personal criteria and medical diseases on this accuracy.Study DesignThis prospective study was performed in Zagazig University Hospital. The eligibility criteria for inclusion were; consecutive women, at any age ≥18 years, with established diagnosis of ovarian mass based on symptoms, signs, and imaging techniques. All patients underwent personal and medical history taking, preoperative serum CA125 and HE4 (cutoff 35 IU/mL and 150 pmol/L, respectively) assessment then postoperative histopathologic examination of lesions as a reference standard.ResultsAmong the included 140 patients, 62 were confirmed to have ovarian malignancy and 78 had benign lesions. Serum CA125 ≥35 IU/mL was associated with ovarian malignancy at sensitivity 91.9%, specificity 53.8%, and accuracy 70.7%. Raising its cutoff to 67.5 IU/mL decreased the sensitivity 83.9%, increased the specificity 80.7% with accuracy 82.1%. The combination of HE4 and CA125 showed sensitivity 75.8%, specificity 93.5%, and accuracy 85.7%. Women suffering from both diabetes mellitus and hypertension showed a significant decrease in CA125 concentration P = 0.02 with false negative results in (5/11) of them, making its sensitivity 54.5% in this condition.ConclusionsThe performance of CA125 in cancer ovary prediction can be improved by increasing its cutoff or by combining CA125 with HE4. Diabetes mellitus and hypertension can influence CA125 performance while HE4 is independent on these factors. This can be an additional value of the introduction of HE4 in cancer ovary prediction protocols.     

Significance of CA 125 antigen levels in patients with ovarian cancer

CA 125 antigen levels were measured in patients with ovarian cancer (54 cases) by the RIA method using a monoclonal antibody OC 125 and were examined as a marker for ovarian cancer. The upper normal limit of CA 125 of 35 U/ml was derived from the mean value (15.7 U/ml) + 2 SD (9.3 U/ml) of CA 125 in healthy controls. The mean value of CA 125 in patients with ovarian cancer (1160 +/- 1850 U/ml) was statistically (p less than 0.001) higher than those of healthy controls, benign ovarian tumors (28 +/- 20 U/ml) and cervical cancers (226 +/- 526 U/ml). Elevated CA 125 levels were also found in the early stages pregnancy and endometriosis, but these cases did not show such high CA 125 values as those of ovarian cancers. In addition, CA 125 levels were not affected by the menstrual cycle. Among ovarian malignancies, elevated CA 125 values were specifically demonstrated in serous cystadenocarcinoma (positivity 89%) and markedly low in mucinous cystadenocarcinoma (positivity 16%). No positive correlation of CA 125 values with clinical stage (FIGO) were found in any ovarian cancer patients. The rise or fall of CA 125 level was well correlated with the progression or regression observed in cancer patients with positive CA 125 levels. In conclusion, serum CA 125 determinations may be useful in patients with ovarian cancer (except for mucinous type) for diagnosis and for monitoring the results of treatment.     

上皮性卵巢癌患者手术及化疗前后血清中人附睾蛋白4和糖类抗原125的变化

目的探讨上皮性卵巢癌患者手术及化疗前后血清中人附睾蛋白4(HE4)和糖类抗原125(CA125)的变化。方法选取2012年3月至2013年3月间收治的50例上皮性卵巢癌患者,采用酶联免疫吸附试验(ELISA)检测50例上皮性卵巢癌患者(研究组)手术及化疗前后、正常健康人群(健康组)及卵巢良性肿瘤患者(对照组)血清中HE4和CA125水平,探讨其在疾病预后的的价值。结果对照组患者CA125和HE4水平显著高于健康组,差异有统计学意义(P<0.05)。研究组患者术前CA125和HE4水平明显高于对照组和健康组,其中化疗3个疗程后血清CA125水平降至正常水平,化疗2个疗程后血清HE4水平降至正常水平。CA125阴转符合率为41.5%,HE4阴转符合率为75.6%,CA125+HE4联合检测阴转符合率则增至85.4%;联合检测阳转符合率高达100%。结论血清CA125和HE4联合检测对卵巢癌预后判断有重要指导意义,可作为卵巢癌病情检测指标之一。     

Serum copper in ovarian carcinoma

The serum copper and CA 125 levels of 31 patients with epithelial ovarian carcinoma were determined. Serum copper was elevated in seven patients and CA 125 was elevated in 22 patients. A rise in serum CA 125 always was associated with disease progression. In comparison, serum copper fluctuation did not correlate with the natural history of the malignancy. We concluded that serum copper determination has no use in epithelial ovarian carcinoma management.     

HE4 and Mesothelin: Novel Biomarkers of Ovarian Carcinoma in Patients with Pelvic Masses

Objectives: To evaluate the utility of novel serum tumor markers, HE4 and mesothelin either alone or incombination with CA125 in diagnosis and early detection of ovarian carcinoma in patients with pelvic masses.Subjects and methods: Sera were obtained preoperatively from 65 women underwent surgery for a pelvic massand 25 age- and menopausal status-matched healthy women. All samples were analyzed for levels of CA125,HE4, and mesothelin by serum based immunoassays and patients results were compared to final pathologyfindings. Results: Of 65 patients with pelvic masses; 41 had histologically diagnosed ovarian cancer, and 24 hadbenign ovarian diseases. The studied tumor markers were significantly increased in malignant compared tobenign cases and healthy subjects, and in benign cases compared to healthy subjects (p<0.001). Based uponReceiver operator characteristic (ROC) curves analysis, HE4 had the highest sensitivity as a single marker indetecting ovarian malignancy (82.9%) and early stage malignancy (76.9%), followed by CA125, then mesothelin.The combination of HE4 and CA125 gave the highest sensitivity in detecting ovarian carcinoma and early stagedisease (90.2%, 84.6% respectively). Addition of mesothelin to this combination did not show any improvementin the sensitivity. Conclusions: As a single marker, HE4 had the highest sensitivity for detecting ovarian carcinomaspecially early stage disease. Combined CA125 and HE4 was a more accurate predictor of ovarian malignancythan either alone.     

Comparison of Two Ovarian Malignancy Prediction Models Based on Age Sonographic Findings and Serum Ca125 Measurement

Objective: The aim of our study is to compare an ovarian malignancy prediction model based on age andfour sonographic findings (OMPS1) with a new model called OMPS2 which differs just by adding serum CA125measurement to (OMPS1). Methods: In a cross sectional comparative study OMPS1 was validated in 830 operatedovarian masses within a 3 years period (2006-2009). Logistic regression analysis was used to construct OMPS2based on OMPS1 adding serum CA125 findings. The area under the curve for two models was compared in411 patients. Results: OMPS2 was calculated as follows: OMPS1 + 1.444 (if serum CA125= 36-200) or 3.842 (ifserum CA125 is more than 200). AUC of OMPS2 was increased to 84.3% (CI 95% 78.1- 89.8) in comparison toOMPS1 with AUC of 78.1% (CI 95% 71.8-84.5). Conclusion: Our second model is more accurate in predictionof ovarian malignancy, compared with our first model.     

The value of the human milk fat globule membrane antigen HMFG2 in epithelial ovarian cancer monitoring: comparison with CA125.

We assayed serum HMFG2 in serial samples from 215 primary epithelial ovarian cancer patients using an ''in-house'' single determinant ELISA, 45% of patients with stage I, 54% with stage II, 61% with stage III and 75% with stage IV disease had elevated serum HMFG2. Post-operative levels were significantly related with residual tumour volume (P < 0.005), and fell in the majority of responders, although the association with response to first-line chemotherapy was not significant. HMFG2 had a sensitivity of 50% specificity of 83%, accuracy of 61%, PVP of 86% and PVN of 45% for disease at second-look laparotomy. Serial levels gave a lead time to clinical relapse in 47% of patients who responded to therapy, including one patient with negative CA125 levels. HMFG, paralleled CA125 in many respects, although it was elevated in fewer patients. In a stepwise discriminant analysis, HMFG2 added to the discrimination of CA125 (r = 0.183, P < 0.005), although additional accurate information was only given in patients with advanced poorly differentiated serous cystadenocarcinoma. Given that HMFG2 is expressed in few patients who are CA125 negative it is unlikely that it will have a significant clinical impact upon patient management.     

彩色多普勒超声联合肿瘤标志物CA125、CA724对卵巢良恶性肿瘤的鉴别诊断价值

目的:探讨彩色多普勒超声检查联合肿瘤标志物血清CA125、CA724对卵巢良恶性肿瘤的鉴别诊断价值.方法:收集绵阳市第三人民医院2014年1月至2016年3月手术治疗的卵巢肿瘤患者212例,分析患者的彩色多普勒超声各项指标及血清CA125、CA724水平.以病理诊断作为金标准,计算超声诊断及三项指标联合诊断的准确率、灵敏度及特异度等.结果:超声诊断结果显示,在卵巢恶性肿瘤组中,超声诊断与病理诊断符合率为56.5%(26/46),卵巢良性肿瘤组诊断符合率为88.0%(146/166),良性卵巢肿瘤组超声病理诊断符合率高于恶性肿瘤组,差别有统计学意义(P<0.001).卵巢恶性肿瘤组患者的血清CA125和CA724水平均高于良性肿瘤组,差别有统计学意义(P<0.05).卵巢恶性肿瘤组三项指标联合检测诊断阳性率明显高于良性组(78.3% vs 37.3%,P<0.001).三个单项检测指标中,CA125的灵敏度最高,CA724的特异度最高,超声检查的准确度、阳性预测值、阴性预测价值最高.联合检测中,彩色多普勒超声检查联合CA125诊断卵巢癌的准确度、灵敏度、特异性、阳性预测值、阴性预测价值高于三项指标的联合诊断,亦高于两项肿瘤标志物的联合诊断.结论:超声联合血清肿瘤标志物一定程度上可以提高卵巢良恶性肿瘤的鉴别诊断率.     

Markers of type I collagen degradation and synthesis in the monitoring of treatment response in bone metastases from breast carcinoma.

Thirty-six patients with bone metastases included in a trial of supportive calcitonin on the treatment response to systemic therapy were monitored by conventional radiography, conventional indicators of bone metabolism [alkaline phosphatase (AP), osteocalcin (gla), urinary hydroxyproline excretion (OHP), urinary calcium (uCa), serum calcium (sCa)] and collagen metabolites (ICTP, the pyridinoline cross-linked carboxy-terminal telopeptide of type I collagen; PICP, the carboxy-terminal propeptide of type I procollagen; and PIIINP the amino-terminal propeptide of type III procollagen). All patients had been on the same systemic treatment for at least 3 months at the start of the trial. There was a positive correlation between the concentrations of ICTP and PICP at baseline (Spearman''s rank-order correlation coefficient rs = 0.62). Both ICTP and PICP showed statistically significant correlations to the other markers of bone metabolism (except sCa and uCa) as well as to the number of bone metastases on bone scans. Reduction in ICTP correlated significantly with the treatment response at three months (rs = - 0.57). while PICP showed a borderline negative correlation to therapy response (rs = - 0.37). Of all the biochemical parameters studied the changes in ICTP showed the best correlation with the treatment response. PICP and ICTP changes in patients with progressive disease differed significantly from those in patients with responding and stable metastases, whereas no difference was found between responders and stable patients.     

Ovarian cancer antigen CA125: a prospective clinical assessment of its role as a tumour marker.

Serum CA 125, quantified by an immunoradiometric assay employing the monoclonal antibody 0C125 was found to be elevated in 48/58 (83%) of patients with established ovarian cancer. All histological types of carcinoma were antigen positive and there was a positive correlation between the frequency and level of serum CA125 and body burden of tumour. Twenty patients undergoing chemotherapy had serial CA125 estimations following a prospective protocol. Variation in CA125 level reflected disease progression or regression in 21/23 instances. Three of 9 patients tested showed an acute elevation of CA125 in the first week following chemotherapy and this effect predicted a good response to treatment. The natural half-life of CA125 in serum was estimated at approximately 4.8 days, sufficiently short to allow changes in tumour volume to be rapidly reflected by a change in circulating antigen level. Although none of 15 patients with non-Hodgkin lymphoma demonstrated antigen levels outside the normal range, 11/27 patients with non-ovarian adenocarcinoma showed elevated CA125 levels, a specificity of 58% for this latter group. The value of CA125 in the management of ovarian malignancy is discussed.     

超声检查与血清CA125检测在卵巢恶性肿瘤诊断中的价值

目的 探讨超声检查与血清肿瘤标志物CA125检测在卵巢恶性肿瘤诊断中的价值。方法 收集我院2012年10月至2013年12月收治的卵巢肿瘤患者113例,其中恶性53例,良性60例,于术前1周内均行超声检查及血清CA125检测。采用倾向得分匹配法（propensity score matching,PSM）均衡组间协变量,获得34对匹配成功的患者并对其诊断结果与病理检查进行比较。结果 CA125检测在卵巢恶性肿瘤诊断中的灵敏性、特异性、阳性预测值（positive predictive value,PPV）、阴性预测值（negative predictive value,NPV）、准确性分别为88.2%、61.8%、69.8%、84.0%、75.0%;超声检查在卵巢恶性肿瘤诊断中的灵敏性、特异性、PPV、NPV、准确性分别为85.3%、88.2%、87.9%、85.7%、86.8%;超声检查联合CA125检测在卵巢恶性肿瘤诊断中的灵敏性、特异性、PPV、NPV、准确性分别为94.1%、64.7%、72.7%、91.7%、79.4%。超声检查单独应用的特异性明显高于CA125检测及二者联合检查的特异性,差异有统计学意义（P均〈0.05）;而灵敏性、PPV、NPV及准确性在两两检查比较中的差异均无统计学意义（P均〉0.05）。结论 CA125检测联合超声检查并不能提高卵巢恶性肿瘤的诊断符合率。     

Elevated serum CA 125 levels in patients with benign ascitic or pleural effusions

The tumor-associated antigen CA 125 is widely used in monitoring of ovarian carcinomas. As this determinant is also expressed in proliferating mesothelia, we studied CA 125 levels in serum and effusion fluid of patients with ascitic and pleural effusions. Patients with benign and malignant disease were included. There was no statistically significant or diagnostically useful difference between 26 benign and 44 malignant cases in the CA 125 levels in effusions or sera. In 77% of benign cases, serum levels exceeding 105 U/ml (3 times the recommended upper limit of normal values) were found. Thus, in patients with serous effusions, elevated serum CA 125 values alone do not provide evidence for the presence of an (ovarian) malignancy, but may also indicate a proliferation of mesothelium due to benign disease.