血清AFP、CEA、CA50、CAl9．9、CAl25联合检测对卵巢恶性肿瘤的诊断及复发的价值

目的 探讨血液中AFP、CEA、CA50、CA19.9、CA125含量的联合检测对恶性卵巢肿瘤的诊断及预后的临床价值.方法 采用放免法(RIA)测定138例患者治疗前后的血清5项指标含量(恶性卵巢肿瘤48例、卵巢良性肿瘤55例及良性包块35例).结果 联合检测恶性卵巢肿瘤性率95.8％(46/48),明显高于卵巢良性肿瘤、良性包块及CA125单项检测阳性率(p<0.05).卵巢良性肿瘤及良性包块的联合检测阳性率分别为12.7％(7/55)和77.1％(27/35),与CA125单项检测率无差异(P>0.05).非上皮性肿瘤联合检测阳性率明显高于CA125阳性率(p<0.05).恶性卵巢肿瘤I期-Ⅱ期联合检测阳性率明显高于CA125阳性率无差异(p<0.05).Ⅲ期-Ⅳ期CA125阳性率与联合检测阳性率无差异(p>0.05).48例恶性卵巢肿瘤经化疗或手术治疗后,证实复发有10例.联合检测阳性9例,CA125阳性5例(p(0.05).结论 上述五项指标联合检测对恶性卵巢肿瘤的诊断及预后有较高的临床价值.

The Value of Serum AFP, CEA, CA50, CA19.9, CA50 and CA125 Determination in the Diagnosis and Follow up Studies of Ovary Malignant Neoplasm

Objective To evaluate the diagnostic and prognostic validity of determination serum AFP,CEA,CA50,CA19.9 and CA125 in patients with ovary malignant neoplasm. Methods The serum levels of AFP,CEA,CA19.9,CA50,CA125 in 138 patients with gynecologic diseases (including 48 cases of ovary malignant neoplasm, 55 cases of benign neoplasm, 35 cases of benign mass. ) , before and after treatment were examined by the method of radioimmunoassay (RIA) . Results Positive rates of combined measurement of AFP, CEA.CA19.9, CA50 and CA125 in patients with ovary malignant neoplasm were 95 .8 %(46/48) significantly higher than those in patients with benign neoplasm and benign mass and those of CA125 measurement (p < 0.05) . Positive rates of combined measurement in cases of benign neoplasm and benign mass were 12.7% (7/55) and 77 .1% (27/35)respectively .There was no significant difference comparing with those of CA125 measurement (p > 0.05) . Positive rates of combined measurement in patients with ovary non - epithelial neoplasm were significantly higher than those of CA125 measurement (p < 0.05) . Positive rates of combined measurement in patients with ovary malignant neoplasm in stage I ~ II were significantly higher than those of CA125 measurement (p < 0.05 ) . There was no significant difference between two methods in cases of stage III-IV ( p > 0.05 ) . Ten recurrence in 48 cases of ovary malignant neoplasm were verified after chemical and surgical therapy. Nine of 10 cases with combined measurement and 5 with CA125 measurement were positive. There was significant difference between two methods (p< 0.05) . Conclusions Serum AFP. CEA,CA50.CA19.9 and CA125 assay is reliable in the diagnosis, treatment evaluation and prognosis of ovary malignant neoplasm .