肿瘤标志物检测对卵巢成熟、未成熟畸胎瘤的诊断价值

背景与目的:卵巢成熟、未成熟畸胎瘤术前鉴别诊断较困难,本研究期望通过血清肿瘤标志物联合检测的方法,为其诊断及鉴别诊断提供有价值依据。方法:收集1995年1月至2005年12月在中山大学肿瘤防治中心初治并经病理确诊为单纯型卵巢畸胎瘤的272例患者的临床资料,统计分析血清糖链抗原125(carbohydrate antigen125,CA125)、糖链抗原153(CA153)、糖链抗原199(CA199)、神经元特异性烯醇化酶(neuron specific enolase,NSE)、甲胎蛋白(alpha-fetoprotein,AFP)、癌胚抗原(carcinoembryonic antigen,CEA)的检测水平在卵巢成熟及未成熟畸胎瘤中的差异。结果:254例卵巢成熟畸胎瘤患者,中位年龄30岁,血清CA125、CA153、CA199、NSE、AFP、CEA平均值分别为25.5×103u/L,11.8×103u/L,106.6×103u/L,12.6μg/L,2.7μg/L和2.5μg/L。18例卵巢未成熟畸胎瘤患者,中位年龄23岁,上述6项指标的平均值分别为140.3×103u/L,16.8×103u/L,112.0×103u/L,18.0μg/L,369.5μg/L和3.2μg/L。未成熟畸胎瘤患者血清中CA125、CA153、AFP平均水平及表达阳性率均高于成熟畸胎瘤患者,差异有统计学意义(P<0.05)。单独应用一项指标,CA125、CA153、AFP对未成熟畸胎瘤诊断性能的特异度均较高,而CA125的灵敏度最高(50.0%)。使用CA125、CA153、AFP三项指标联合检测明显提高了灵敏度(71.4%)。结论:术前肿瘤标志物,尤其是CA125、CA153、AFP联合检测对卵巢未成熟型与成熟型畸胎瘤的鉴别诊断有一定参考价值。

Diagnostic value of multiple tumor marker detection for mature and immature teratoma of the ovary

BACKGROUND & OBJECTIVE: It is difficult to differentially diagnose mature cystic teratoma (MCT) and immature teratoma (IT) of the ovary before operation. This study was to evaluate the value of multiple tumor marker detection in differential diagnosis of ovarian MCT and IT. METHODS: Clinical data of 272 patients with ovarian teratoma, diagnosed pathologically and treated at Cancer Center of Sun Yat-Sen University from Jan. 1995 to Dec. 2005, were reviewed. Of the 272 patients, 254 had MCT and 18 had IT. The serum levels of carbohydrate antigen 125 (CA125), CA153, CA199, neuron-specific enolase (NSE), alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA) in MCT and IT were compared. RESULTS: Of the 254 patients with MCT, the median age was 30, the mean serum levels of CA125, CA153, CA199, NSE, AFP and CEA were 25.5 x 103 u/L, 11.8 x 103 u/L, 106.6 x 103 u/L, 12.6 microg/L, 2.7 microg/L and 2.5 microg/L. Of the 18 patients with IT, the median age was 23, the mean serum levels of these tumor markers were 140.3 x 103 u/L, 16.8 x 103 u/L, 112.0 x 103 u/L, 18.0 microg/L, 369.5 microg/L and 3.2 microg/L. Both the serum levels and positive rates of CA125, CA153 and AFP were significantly higher in IT than in MCT (P<0.05). When detected alone to differentially diagnose MCT and IT, the specificity of CA125, CA153, AFP were high, and the sensitivity of CA125 was the best (50.0%). The sensitivity was elevated to 71.4% by combined detection of CA125, CA153 and AFP. CONCLUSION: Combined detection of tumor markers, especially CA125, CA153 and AFP, may be helpful for differential diagnosis of ovarian MCT and IT.