血清CA125与EMAb联合经阴彩超对子宫腺肌病诊断的价值

目的探讨CA125与EMAb测定联合经阴彩超对子宫腺肌病诊断的价值。方法经阴彩超诊断为子宫腺肌病或子宫肌瘤的患者136例,测定血清EMAb及CA125,经病理确诊,子宫腺肌病76例,子宫肌瘤60例。对比CA125、EMAb及经阴彩超单独使用以及联合时的敏感性及特异性。结果腺肌病组CA125及EMAb阳性率均明显高于肌瘤组,差异有显著性(<0.01);单独经阴彩色多普勒检查敏感性为76.32%,特异性为90%。结论①经阴彩超对子宫腺肌病的诊断具有一定价值,联合检测血清CA125及EMAb,可提高诊断准确率;②三种方法联合使用有利于子宫腺肌病与子宫肌瘤的鉴别诊断。     

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.     

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.     

CK7和CA125在人卵巢癌的表达及意义

目的研究细胞角蛋白7(CK7)和CA125联合在卵巢恶性肿瘤中的诊断意义及价值。方法采用免疫组化方法,分别检测100例卵巢肿瘤中CK7和CA125的表达,统计学方法比较两种指标在良性、恶性及转移性肿瘤中的阳性表达率。结果 CK7和CA125在卵巢恶性肿瘤中的表达水平均高于转移源性的卵巢癌和卵巢良性瘤,差异均有统计学意义(0.05)。且在晚期癌中的表达高于早期,差异均有意义(0.05)。结论CK7和CA125过表达提示二者可能参与卵巢癌的发病机制。     

HE4、CA125及ROMA在卵巢肿瘤良恶性鉴别的临床应用价值

目的 评估HE4、CA125和ROMA对卵巢癌的术前鉴别诊断价值.方法 电化学发光法检测卵巢癌组(54例)和良性卵巢肿瘤组(103例)女性血清HE4和CA125浓度,根据患者绝经与否计算ROMA值.应用统计分析,对比绝经前后HF4、CA125和ROMA三项血清学指标的诊断性能.结果 卵巢癌组较良性卵巢肿瘤块组患者血清HE4、CA125和ROMA值显著增高,差异有统计学意义(P ＜0.005).所有患者HE4、CA125和ROMA的AUC分别是:0.962、0.899和0.963.三项血清学指标对绝经后妇女较绝经前妇女具有更高的灵敏度(分别为:HE4 91.4％ vs 84.2％,CA125 97.1％ vs 84.0％和ROMA 91.4％ vs 84.6％),血清HE4、CA125及ROMA绝经前后特异性分别为:92.9％ vs 93.6％,87.5％ vs 83.0％,94.6％ vs 95.7％.结论 HE4、ROMA在区分卵巢癌和良性卵巢肿瘤表现出较好的诊断性能.HE4和ROMA在鉴别女性卵巢癌和良性卵巢肿瘤特异性较高,CA125在绝经后卵巢癌患者有高灵敏度.     

CA125、CA72-4与CEA检测在卵巢肿瘤早期诊断中的临床价值

联合检测血清CA125、CA72-4与CEA水平对卵巢癌早期诊断的价值。对112例卵巢癌患者,185例卵巢良性肿瘤患者及对照组100名健康妇女,应用电化学发光免疫法测定血清CA125、CA72-4与CEA水平,然后进行统计分析。结果表明：健康妇女组和卵巢肿瘤组比较,卵巢癌组患者血清CA125、CA72-4与CEA水平及阳性率明显升高（P〈0.01）,三项标志物的阳性率分别为86.61%,67.86%,49.11%,三项联合检测阳性率为91.96%。血清CA125、CA72-4与CEA联检可以提高卵巢癌早期诊断的阳性率,对卵巢肿瘤的良恶性辅助诊断及鉴别诊断具有一定应用价值。     

Transvaginal ultrasonography associated with colour Doppler energy in the diagnosis of hydrosalpinx

The aims of this prospective study were to investigate the accuracy of B-mode transvaginal ultrasonography alone, using the typical finding of the presence of an elongated shaped mass with incomplete septa, in the screening of hydrosalpinx in women undergoing surgery for gynaecological diseases, and to determine the predictive value of this method combined with colour Doppler energy (CDE) imaging evaluation and CA125 concentrations in differentiating hydrosalpinx from other adnexal masses. In the first part of the study, 378 consecutive pre-menopausal non-pregnant women were submitted to transvaginal ultrasonography alone before surgery. In the second part of the study, 256 adnexal masses underwent transvaginal ultrasonography combined with CDE imaging evaluation associated with spectral Doppler analysis and plasma concentrations of CA125. Sensitivity and specificity for the ultrasonographic screening were 84.6 and 99.7% respectively, calculated for each adnexum (n = 756) and 93.3 and 99.6% respectively, calculated for each mass, for differentiating hydrosalpinx from other adnexal masses. The CDE imaging and the evaluation of CA125 plasma concentrations do not seem to increase the accuracy of B-mode transvaginal ultrasonography. Inter- and intra-observer agreement, expressed in terms of k-values, was high (0.87 and 0.93 respectively). In conclusion, transvaginal ultrasonography alone is a useful method of detection of hydrosalpinx.     

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。     

Measurement of CA125, carcinoembryonic antigen, and alpha-fetoprotein in ovarian cyst fluid: diagnostic adjunct to cytology.

This study used CA125, carcinoembryonic antigen (CEA), and alpha-fetoprotein (AFP) to classify ovarian cysts by measuring the levels of the three antigens; this information was useful when fluid obtained through laparoscopic puncture of ovarian cysts was submitted for cytologic examination from patients for whom tissue was unavailable for classification. We studied 136 consecutive cyst fluids (108 benign, 28 malignant) and correlated the findings with the tissue diagnosis. All three antigens were very low (CEA, less than 0.5 ng/ml; CA125, 55-2,143 mu/ml; and AFP, less than 4.8 ng/ml) in follicular and lutein cysts. Markedly elevated CA125 (296-1,950,000 mu/ml) and low CEA (0.5-220 ng/ml) and AFP (less than 4.8 ng/ml) levels were seen in patients with serous neoplasms, both benign and malignant. Elevated CEA (greater than 600 ng/ml) and CA125 (56-65,330 mu/ml) levels were seen in primary mucinous cystadenoma and cystadenocarcinoma. Two patients with colonic carcinoma metastatic to the ovary had an elevated CEA (greater than 600 ng/ml) and a normal CA125. Only one patient, with a malignant teratoma, had an elevated AFP. The adjunctive use of CEA and CA125 is recommended for the classification of ovarian cysts.     

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。     

卵巢癌患者调节性T细胞比率和肿瘤标志物CA125、CA19-9测定及临床意义

目的 探讨卵巢癌患者、卵巢良性疾病及健康成人女性调节性T细胞（Tregs）和肿瘤标志物CA125、CA19-9水平的差异,并将其与临床病理因素及预后进行相关分析。 方法 选择2016年10月~2017年10月承德医学院附属医院妇科收治的经病理确诊的卵巢癌患者43例,设为恶性组,另选择同期医院收治的卵巢良性疾病患者55例作为良性组,健康体检妇女50例作为对照组。比较3组患者Tregs和肿瘤标志物CA125、CA19 9在卵巢癌患者中的表达水平,分析其与临床病理因素及预后的关系。 结果 恶性组和良性组Tregs比例、CA125和CA19-9水平均高于对照组,恶性组Tregs比例、CA125和CA19-9水平高于良性组（P<0.05）。CA125、CA19-9、Tregs水平与患者的年龄差异无显著性（P>0.05）;CA125水平与卵巢癌患者的淋巴结是否转移、肿瘤分期和组织学类型均有关;Tregs表达水平与卵巢癌患者的淋巴结是否转移和肿瘤分期均相关,CA19-9水平只与肿瘤分期相关（P<0.05）。随访12个月后,Tregs-low组中位生存时间高于Tregs-high组（P<0.05）。卵巢癌中Tregs数与CA125存在显著正相关性（P<0.05）,而与CA19-9不具有相关性（P>0.05）。 结论 Tregs、CA125和CA19-9均可有望成为卵巢癌临床诊断、治疗和预后的指标。     

阴道彩色多普勒探测不孕症妇女卵巢动脉血流变化与卵泡成熟度的关系

目的　探测卵巢因素引起的不孕症妇女的卵巢动脉血流变化与卵泡成熟度的关系。方法　经阴道探头探测卵巢动脉血流指标和卵泡生长情况。结果　正常健康组随着卵泡的生长 ,卵巢动脉的搏动指数 (PI)、阻力指数 (RI)值逐渐减低 ;不孕症未经治疗组 ,卵泡无明显增大 ,卵巢动脉的PI、RI值未见逐渐降低 ;两者相比 (P <0 .0 1)。不孕症经治疗组随着卵泡的生长 ,卵巢动脉的PI、RI值出逐渐降低 ,与正常健康组相比 (P >0 .0 5 )。结论　不孕症患者卵巢动脉血流变化与卵泡成熟度密切相关 ,二者呈负相关。测量卵巢动脉的PI、RI值可作为不孕症监测的重要指标之一。     

卵巢癌标志物CA125酶联免疫吸附分析法的建立

目的：建立一种血清ＣＡ１２５的临床检测方法。方法：一株ＣＡ１２５单抗用于固相包被，另一株与辣根过氧化物酶偶联制备ＣＡ１２５的酶标记物，以四甲基联苯胺为底物，采用一步法，建立了ＣＡ１２５的酶联免疫吸附分析法。结果；灵敏度为２．００Ｕ／ｍｌ。批内ＣＶ值低于５．３２％，批间ＣＶ值低于７．３９％。     

彩色多普勒超声对痛风性关节炎和骨性关节炎的鉴别价值

目的:探讨彩色多普勒超声对痛风性关节炎（GA）和骨性关节炎（OA）的鉴别价值。 方法:选取2014年12月~2017年12月收治的GA患者50例作为GA组,同期选取OA患者50例作为OA组,两组均给予彩色多普勒超声检查双侧第一跖趾关节,分析两组超声表现。 结果:GA组和OA组关节积液、滑膜增厚、滑膜血流分级比较,差异无统计学意义（P>0.05）;GA组和OA组多点状高回声、双轨征、痛风石比较,差异有统计学意义（P<0.05）;GA组急性期患者滑膜血流分级明显高于慢性期,差异有统计学意义（P<0.05）。 结论:彩色多普勒超声检查第一跖趾关节可对GA和OA作出有效的鉴别,其中GA滑膜血流分级可为GA病情评估提供重要的参考依据,值得临床进一步推广。     

血清CA125、CA15．3、CA242联合检测对乳腺癌诊断的价值

目的评价血清标志物糖类抗原125（CA125）、15．3（CA15．3）、242（CA242）联合检测对乳腺癌诊断的价值。方法对长海医院肿瘤科2003年9月至2005年9月期间收治的73例乳腺癌患者及60例健康人血清进行CA125、CA15．3、CA242检测。结果乳腺癌组三种肿瘤标志物检测的阳性率显著高于对照组（Х^2检验,P〈0．01）。乳腺癌组CA125、CA15．3、CA242及联合检测的阳性率由高到低依次为联合检测（68．49％）、CA15．3（49．32％）、CA125（34．25％）、CA242（28．77％）,CA15．3阳性率与三种标志物联合检测的阳性率差异有统计学意义（Х^2=5．546,P〈0．05）,即联合检测的阳性率高于CA15．3单独检测的阳性率。结论CA125、CA15．3、CA242联合检测能明显提高乳腺癌的检出率。     

血清CA125、经阴道B超检查及CT检查在子宫内膜癌术前评估方面的价值

目的 研究血清CA125、经阴道B超检查及CT检查在子宫内膜癌（EC）术前评估方面的价值。方法 选取2017年2月~2018年2月在我院确诊的46例EC行分期手术患者为研究对象,术前分别进行阴道B超、CT检查以及血清CA125检测,对比术前与术后检测结果,并根据术后病理结果分析术前各种检测方法特异性、敏感性等。结果 术前血清CA125水平、阳性率在I期（40.0±23.20）U/ml、26.92%,低于Ⅱ~Ⅳ期（131.7±85.10）U/ml、75.00%,差异有统计学意义（P＜0.05）;肿瘤深肌层浸润诊断中血清CA125联合CT与血清CA125联合阴道B超、血清CA125联合CT与阴道B超特异性、敏感性、准确性对比,差异无统计学意义（P＞0.05）;在诊断累及宫颈中血清CA125联合CT与CA125联合阴道B超、CA125联合CT与阴道B超特异性、敏感性、准确性对比,差异无统计学意义（P＞0.05）;在诊断盆腔淋巴转移方面,CA125联合CT检查与CA125单纯检查对比,特异性、敏感性、准确性升高,敏感性升高,差异无统计学意义（P＞0.05）,特异性、准确性升高,差异有统计学意义（P＜0.05）。结论 血清CA125、经阴道B超检查在EC术前分期、病理分级、诊断肿瘤深肌层浸润、宫颈受累方面具有较大的价值,但在盆腔淋巴癌转移方面CT检查更具有优势。     

Color Doppler imaging and angiogenesis in ovarian tumors

The detection and assessment of ovarian lesions are an important part of gynecological practice. Advance knowledge of whether an overt ovarian mass is malignant may be useful for improving the effectiveness of surgical treatment. Pelvic ultrasonography has been developed continuously, and (in conjunction with biochemical and genetic markers) is being used to achieve these objectives with increasing accuracy. At the same time, knowledge is being accrued about the relationship between ultrasound-derived indices of ovarian tumor vascularity and the molecular aspects of angiogenesis. There is now the exciting prospect that color Doppler imaging with pulsed Doppler spectral analysis could also be used to monitor the development and intermediate effectiveness of novel anticancer treatment.     

卵巢癌和胰腺癌患者血清CA125、CA199的水平相关分析

目的:研究血清CA125和CA199的测定对卵巢疾病和胰腺疾病诊断的临床意义.方法:发光免疫分析测定了50例正常对照组,95例卵巢疾病和67例胰腺疾病患者血清中CA125和CA199的水平.结果:卵巢癌与胰腺癌患者的血清CA125和CA199水平较对照组显著升高(P＜0.001).结论:血清CA125和CA199联合测定对诊断和鉴别卵巢癌和胰腺癌有一定的临床价值.     

A comparison of CA125, HE4, risk ovarian malignancy algorithm (ROMA), and risk malignancy index (RMI) for the classification of ovarian masses

OBJECTIVE:

Differentiation between benign and malignant ovarian neoplasms is essential for creating a system for patient referrals. Therefore, the contributions of the tumor markers CA125 and human epididymis protein 4 (HE4) as well as the risk ovarian malignancy algorithm (ROMA) and risk malignancy index (RMI) values were considered individually and in combination to evaluate their utility for establishing this type of patient referral system.

METHODS:

Patients who had been diagnosed with ovarian masses through imaging analyses (n = 128) were assessed for their expression of the tumor markers CA125 and HE4. The ROMA and RMI values were also determined. The sensitivity and specificity of each parameter were calculated using receiver operating characteristic curves according to the area under the curve (AUC) for each method.

RESULTS:

The sensitivities associated with the ability of CA125, HE4, ROMA, or RMI to distinguish between malignant versus benign ovarian masses were 70.4%, 79.6%, 74.1%, and 63%, respectively. Among carcinomas, the sensitivities of CA125, HE4, ROMA (pre- and post-menopausal), and RMI were 93.5%, 87.1%, 80%, 95.2%, and 87.1%, respectively. The most accurate numerical values were obtained with RMI, although the four parameters were shown to be statistically equivalent.

CONCLUSION:

There were no differences in accuracy between CA125, HE4, ROMA, and RMI for differentiating between types of ovarian masses. RMI had the lowest sensitivity but was the most numerically accurate method. HE4 demonstrated the best overall sensitivity for the evaluation of malignant ovarian tumors and the differential diagnosis of endometriosis. All of the parameters demonstrated increased sensitivity when tumors with low malignancy potential were considered low-risk, which may be used as an acceptable assessment method for referring patients to reference centers.     

血清CEA、CA125、CA199联合检测在肺癌诊断中的应用价值

目的 研究CEA、CA125、CA199联合检测在肺癌诊断中的应用价值,旨在为临床肺癌的早期发现及诊断提供一种快捷而又简单的方法.方法 收集2013年1月至2014年10月邢台市人民医院呼吸内科、肿瘤内科和肿瘤外科收治的住院患者338例,其中肺癌患者236例,肺部良性疾病患者102例,50例门诊健康体检者作为健康对照,检测其血清中CEA、CA125、CA199的水平.结果 血清CEA、CA199和CA125水平,肺癌组显著高于肺部良性疾病组和健康体检组.CA125诊断肺癌的灵敏度最高,特异度最低,三项联检的灵敏度显著高于任何各单项.结论 CEA,CA125和CA199可作为肺部良、恶性疾病的鉴别指标.单项肿瘤标志物诊断肺癌的灵敏度较低,三项联合检查能有效提高肺癌诊断的灵敏度,但特异度会相应降低.