血清CA125在卵巢癌诊断及预测分期中的应用价值

目的探讨血清CA125在卵巢癌诊断及预测分期中的应用价值。方法我院妇产科2001年1月—2010年10月收治卵巢癌病人520例,测定其血清CA125水平,并分析其与卵巢癌病理组织学类型、临床分期的关系。结果 520例卵巢癌病人中上皮性卵巢癌组血清CA125水平与生殖细胞肿瘤组及性索间质肿瘤组比较明显增高（F=9.466,P〈0.01）;上皮性卵巢癌组中浆液性囊腺癌CA125水平与黏液性腺癌及透明细胞癌相比明显增高（F=7.399,P〈0.01）;Ⅲ～Ⅳ期组CA125的水平明显高于Ⅰ～Ⅱ期组（F=54.720,t=7.852,P〈0.01）;低分化组血清CA125水平明显高于高、中分化组（F=47.031,t=6.880,P〈0.01）;血清CA125含量〉46.36kU/L时,上皮性卵巢癌的诊断价值最高,对应的诊断灵敏度为82.6%,特异度为61.8%;当CA125〉150kU/L时,晚期病人诊断灵敏度、特异度及准确率分别为85.66%、59.22%及75.48%,此时对卵巢癌晚期诊断意义大。结论血清CA125对上皮性卵巢癌的诊断具有较高价值,尤其是上皮性浆液性囊腺癌病人血清CA125水平升高明显;晚期（Ⅲ～Ⅳ期）以及低分化病人CA125水平较高;CA125诊断价值的最佳临界点高于普遍认为的阳性诊断标准,当CA125〉150kU/L时,对晚期病人诊断意义较大。

THE VALUE OF SERUM CA125 IN DIAGNOSIS AND STAGING FORCAST OF OVARIAN CARCINOMA

Objective To study the value of serum CA125 in the diagnosis and staging forcast of ovarian carcinoma. Methods This study consisted of 520 patients with ovarian carcinoma treated in our hospital, from January 2001 to October 2010. Their serum CA125 was detected and its association with histopathology type and clinical staging of this cancer was analyzed. Re- sults Serum CA125 was significantly higher in epithelial ovarian carcinoma （EOC） group than that in the germ cell （GC） tumor and sex cord-stromal （SCS） tumor group （F=9. 466 ,P〈0.01）. CA125 level of serous adenocarcinoma in EOC was higher as com- pared with mucoid adenoearcinoma and clear cell carcinoma （F= 7. 399,P〈0.01）. The CA125 in stage Ⅲ～Ⅳ group was signifi cantly higher than the Ⅰ～Ⅱ group （F：54. 720,t=7. 852,P〈0.01）, and that in poorly-differentiated group was higher than that in well-and moderately differentiated group （F=47. 031 ,t=6. 880,P〈0.01）. When CA125 content was 〉46.36 kU/L, the diag nostic value for EOC was the highest, the corresponding diagnostic sensitivity and specificity being 82.6 % and 61.8 %, respectively; when CA125 was 〉150 kU/L, the diagnostic sensitivity, specificity and accuracy for advanced stage patients were 85.66%, 59.22% and 75.48%, respectively. Conclusion Serum CA125 has a relatively high value in the diagnosis of EOC, especially for epithelial serous adenoearcinoma, in which, serum CA125 elevated dramatically; relatively high serum CA125 was also noted in ad vanced （stageⅢ～Ⅳ） patients. The best critical point of diagnostic value of CA125 is higher than the positive diagnostic criteria that generally accepted. When CA125 was 〉150 kU/L, the value for the diagnosis of advanced cancer is more significant.