不同部位子宫内膜异位症与血清CA125水平的关系

目的:探讨血清CA125水平与不同部位的子宫内膜异位症之间的相关性。方法:选择经手术或腹腔镜确诊的内异症患者63例和排除内异症的对照组30例,按内异症发生部位的不同分为3组:Ⅰ组(卵巢内异组)34例;Ⅱ组(阴道直肠隔内异组)15例;Ⅲ组(腹壁切口内异组)14例。Ⅳ组为对照组,系临床和病理检查排除了内异症的健康者。术前采取空腹静脉血,用化学发光法测定各组血清中CA125水平。结果:(1)卵巢内异组、阴道直肠内异组的血清CA125水平均显著高于对照组(P<0·05);腹壁切口内异组CA125水平显著低于卵巢内异组(P<0·05),而与阴道直肠隔内异症组、对照组比较无统计学差异(P>0·05);(2)以血清CA125≥35U/ml为临界值,CA125诊断各组内异症的敏感性分别为:卵巢内异症52·94%,阴道直肠内异症40·00%,腹壁切口内异症21·43%。诊断特异性为96·67%。结论:CA125在诊断子宫内膜异位症发生方面具有一定的价值,但并不是敏感指标。单凭血清CA125不能鉴别不同部位的子宫内异症。

Evaluation of the relationship between serum CA125 and endometriosis in different locations

Objective: To evaluate the relationship between serum CA125 levels and endometriosis in different locations.Methods: Sixty-three patients who had been diagnosed by laparoscopy or laparotomy with endometriosis and 30 control women were collected.Three groups were divided according to the different locations of endometriosis:GroupⅠ:ovarian endometriosis,34 cases;GroupⅡ: vagina-rectum endometriosis,15cases;Group Ⅲ:Scar endometriosis,14 cases.Group Ⅳ was the control group.The serum CA125 levels were measured by chemiluminescence analysis before operation.Results: (1)The serum CA125 levels in ovarian endometriosis and vagina-rectum endometriosis were higher than those in control women (P<0.05).The serum CA125 levels in scar endometriosis were lower than those in ovarian endometriosis (P<0.05).(2)If the diagnosis standard of endometriosis by CA125 was above 35U/ml,the sensitivity was 52.94% of ovarian endometriosis,40.00% of vagina-rectum endometriosis,21.43% of scar endometriosis respectively,and the specificity was 96.67%.Conclusion: The serum CA125 testing for diagnosis of endometriosis may have considerable value,but it is not a sensitive marker.The accuracy of using only CA125 testing for diagnosis of endometriosis in different locations is limited.