血清CA199、CA125和YKL40联合检测对卵巢癌的诊断价值

目的探讨血清CA199、CA125和YKL-40联合检测在卵巢癌诊断中的应用价值。方法分别用酶免分析法（EIA）和电化学发光法测定36例卵巢癌、38例卵巢良性肿瘤及40例健康对照妇女血清YKL-40和CA125、CA199水平，YKL-40以健康对照组95％可信区间的上限值为阳性，比较YKL-40和CA125、CA199在三组间、卵巢癌病人不同临床分期阳性率的差异。结果正常对照组血清YKL-40水平的95％可信区间的上限值为76．2ng/mL；卵巢癌患者血清YKL-60水平及阳性率显著高于卵巢良性肿瘤组和对照组（t=3．45，P〈0．01），而卵巢良性肿瘤组和对照组之间差异无统计学意义（t=1．62，P〉0．05）。Ⅲ／Ⅳ期卵巢癌患者血清YKL-40水平显著高于Ⅰ／Ⅱ期患者（t：2．81，P〈0．01）。CA125和CA199联检的阳性率为77．8％，YKL-40与CA125、CA199联合检测的阳性率可达到88．9％。结论YKL-40是一种新的诊断卵巢癌的肿瘤标志物，联合YKL-40，CA199、CA125三项检测可提高对早期卵巢癌诊断的灵敏度，对卵巢癌的诊断有重要临床价值。

Serum CA199 ,CA125 and YKL40 combined detecting for ovarian cancer diagnose value

Objective To study the application of combined detection of serum CA199, CA125, and YKL-40 to ovarian cancer diagno sis. Method Enzyme immtmoassay analysis （EIA） and were used to detect serum YKL - 40 and CA125, and CA199 values in 36 cases of ovarian cancer patients, 38 cases of benign ovarian tumor patients and 40 healthy women as the control group. In healthy group YKL-40 at 95% confidence interval upper limit is positive; and YKL-40 and CA125, CA199 values are compared among the three groups and in different clinical stages of ovarian cancer patients, their positive rates are also compared. Results The serum YKL - 40 at 95 % confidence interval upper limit is 71 .gng/mL; the serum YKL- 40 in ovarian cancer patients and its positive rate are significantly higher than the benign ovarian tumor group and the control group （t = 3.45, P 〈 0.01 ）, and there is no significant difference between the benign ovarian tumors and the control group （t = 1.62,P 〉 0.05）. Serum YKL-40 values in phase Ⅲ/Ⅳ ovarian cancer patients are significantly higher than that in phrase Ⅰ/Ⅱ patients（t = 2.81, P 〈 0.01 ）. With combined detection of CA125 and CA199, the positive rate is 77.8 %, while with combined detection of YKL - 40 and CA125, CA199 the positive rate can reach 88.9 %. Conclusion YKL- 40 is a new tumor marker in ovarian cancer diagnosis, and combined detection of YKL- 40, CA199, CA125 can improve the sensitivity of early ovarian cancer diagnosis, so it has important clinical value in the ovarian cancer diagnosis.