血清CA125、SF、CEA及AFP测定在恶性卵巢肿瘤与良性疾病鉴别诊断中的意义

目的评价恶性卵巢肿瘤中CA125、SF、CEA和AFP定量测定的价值,以区分良恶性卵巢肿瘤,发现一种诊断和鉴别诊断恶性卵巢肿瘤的方法。方法回顾性分析陕西省妇幼保健院2001年至2008年间收治的卵巢恶性肿瘤患者159例,卵巢良性肿瘤患者187例。分析各病例术前血清CA125、CEA、AFP及SF水平和术后病理学诊断,计算各指标的敏感性、特异性、阳性预测值、阴性预测值、约登指数。结果（1）SF、CA125和AFP在恶性卵巢肿瘤组平均值和阳性率显著高于良性卵巢肿瘤组,而CEA在恶性卵巢肿瘤组与良性组之间相比,阳性率和平均值均无统计学意义;（2）CA125敏感性为78.32%,而特异性为64.41%,PPV和NPV分别为56.46%和83.45%,YI为0.427。血清铁蛋白的敏感性为58.82%,低于CA125,但特异性较高,为89.66%,PPV和NPV分别是86.96%和65.00%,YI为0.485。结论（1）血清CEA对卵巢恶性肿瘤鉴别诊断的意义不大。（2）血清AFP虽对恶性生殖细胞肿瘤特异,但就整个卵巢恶性肿瘤患者而言,血清AFP敏感性差,对鉴别良恶性卵巢肿瘤意义不大。（3）血清CA125和SF对恶性卵巢肿瘤的鉴别诊断具有一定意义。

Value of the serum CA125,SF,CEA and AFP levels in differential diagnosis of patients with malignant and benign ovarian tumor

Objective To assess the usefulness of quantification of serum CA125,CEA,AFP and SF in malignant ovarian tumor in order to differentiate it with benign ovarian tumor.Methods we collected the records of 159 cases of patients with malignant ovarian tumor,187 cases of patients with benign ovarian tumor hospitalized in shaanxi women and children health hospital from 2001 to 2008 years.The serum CA125,CEA,AFP and SF quantity before laparotomy and their pathology after laparotomy were analyzed retrospectively,sens...