子宫腺肌病与卵巢子宫内膜异位症患者血清中抗子宫内膜抗体及CA125的测定比较

目的:探讨不同部位的子宫内膜异位病灶的血清中抗子宫内膜抗体及CA125的测定,对临床上的不同部位的子宫内膜异位症患者的诊断方法的选择和评估。方法:术后病理确诊的子宫腺肌病的患者45例,单纯卵巢子宫内膜异位症41例,并临床排除两者并发的患者,术前测定血清中抗子宫内膜抗体及CA125。结果:子宫腺肌病组血清CA125水平为100.21±20.56u/ml,卵巢子宫内膜异位症组80.46±10·12u/mL;子宫腺肌病组阳性率为64·44%,卵巢子宫内膜异位症组阳性率为39·02%,两组阳性率比较有显著性差异(P<0·05)。抗子宫内膜抗体(EMAb)子宫腺肌病组阳性例数32例,敏感性为71·11%,特异性为83·21%。卵巢子宫内膜异位症组阳性例数25例,敏感性为60·79%,特异性为79·11%。两组阳性率比较无显著性差异(P>0·05)。结论:血清中CA125的测定对不同部位的子宫内膜异位症均有很好的特异性,但不同部位的敏感性有明显区别;血清中抗子宫内膜抗体的测定对不同部位的子宫内膜异位症的敏感性无区别。两者联合测定对不同部位的病灶检测有相互协同的作用,特别在单纯卵巢子宫内膜异位症的诊断上,大大提高了敏感性和特异性。

Determinating Comparison Between CA-125 and the Anti-endometrial Antibodies in the Serum of the Patients Who have Adenomyosis Disease and Ovarian Endometriosis Disease

Objective:To study the clinical value of serum CA125 and EMAb in different area of endometriosos.Methods:Eighty-six cases were divided into adenomyosis group(45 cases)and endometrial cyst group(41 cases)according to the postoperative pathological examination.The serum CA125 and EMAb were determined in all cases before operation.Results:The average CA125 level and positive rate in adenomyosis group were higher than those in endometrial cyst group.The difference between the two groups was significant(P<0.05);If combining the use of EMAb for diagnostic criteria of endometrosis,the sensitivity and specificity were 71.11% and 83.21%,respectively in adenomyosis group,the sensitivity and specificity were 60.97% and 79.11%,respectively in endometrial cyst group.The difference between the two groups was not significant(P>0.05).Conclusion:The determination of serum CA125 had the same specificity in different area of endometriosis,but the sensitivity was different.The determination of serum EMAb had the same specificity and sensitivity in different area of endometriosis.Both of the serum CA125 and EMAb will enhance the specificity and sensitivity in the diagnostic of endometrial cyst.