CA125、CA199和 CEA 联合检测在卵巢癌诊断中的临床意义

目的：探讨糖类抗原125（CA125）、糖类抗原199（CA199）和癌胚抗原（CEA）联合检测在卵巢癌诊断中的临床意义。方法选择我院收治的卵巢癌患者80例为研究组，卵巢良性疾病患者80例为对照 A 组，来院检查的健康者80例为对照 B 组，采用化学发光法对3组血清中 CA125、CA199和 CEA 含量进行测定。比较3种肿瘤标志物联合检测与单项检测 CA125的诊断意义。结果研究组3种肿瘤标志物水平及阳性率均显著高于对照组，且有显著性差异（P ＜0．05）。两对照组比较无显著性差异（P ＞0．05）。研究组单项检测及联合检测卵巢癌的阳性率均显著高于两对照组（P ＜0．05）。研究组联合检测阳性率为88．75％，明显高于单项检测的73．75％、43．75％和21．25％（P ＜0．05）。CA125、CA199和 CEA 单项检测比较，CA125的敏感性、特异性最佳。CA125的敏感性为73．75％，特异性为90．00％，阳性预测值为78．67％，阴性预测值为87．27％。除特异性外，联合检测的敏感性为88．75％、阳性预测值为79．78％、阴性预测值为94．04％，均较单项检测得以提高，且各指标更加趋于平衡。另外，联合检测对卵巢癌Ⅰ期、Ⅱ期的诊断有效率明显高于单项检测，且有显著性差异（P ＜0．05）。结论CA125、CA199和 CEA 3种肿瘤标志物联合检测能够早期有效地实现对卵巢癌的检测，对于卵巢癌病情的判断、治疗和转归有着重要的意义。

Clinical Significance of the Combined Detection of CA125,CA199 and CEA in Diagnosis of Ovarian Cancer

Objective To investigate clinical significance of the combined detection of carbohydrate antigen 125 （CA125）,carbohydrate antigen 199 （CA199）and carcinoembryonic antigen （CEA）in the diagnosis of ovarian cancer. Methods 80 ovarian cancer patients in our hospital were collected as study group,80 cases of benign ovarian diseases （control group A）,80 healthy women（control group B）.Content of CA125,CA199,CEA were measured by chemilumi-nescence method.Results Levels and positive rates of three kinds of tumor marker of the study group were significantly higher than two control groups（P 〈0.05）.There was no significant difference between two control groups （P 〉0.05）.The positive rate of ovarian cancer of study group was significantly higher than two control groups（P 〈0.05）. The positive rate of combined detection was 88.75% was significantly higher than that of single detection,73.75%, 43.75%,21.25% （P 〈0.05）.Comparison of CA125,CA199,CEA single detection,results showed that the sensitivity and specificity of CA125 is the best.The sensitivity of CA125 was 73.75%,the specificity was 90%,the positive predictive value was 78.67%,the negative predictive value was 87.27%.In addition to the specificity,sensitivity of combined detection was 88.75%,the positive predictive value was 94.04%,negative predictive value was 79.78%.Compared with single detection all index of combined detection can be improved,and each index tends to be more balanced. And the combined detection in the diagnosis of ovarian cancer stage Ⅰ,Ⅱ were significantly higher than single detection （P 〈0.05）.Conclusion Combined detection of CA125,CA199,CEA can effectively realize the detection of early ovarian cancer,has important implications for ovarian cancer,treatment,prognosis judgement.