CA125单项与多项肿瘤指标联合检测在卵巢癌诊断中的价值分析

目的 探讨CA125单项与多项肿瘤指标联合检测在卵巢癌诊断中的价值.方法 选取2014年4月至2016年4月妇科住院部收治的卵巢肿块患者136例,根据手术病理结果将患者分为A组(卵巢癌,78例)与B组(卵巢良性肿瘤,58例),采用化学发光微粒子免疫检测法检测2组血清CA125、CA153、CA199、癌胚抗原(CEA)水平,参照国际参考值标准,对于CA125>35 kU/L,CA153>30 kU/L,CA199>37 kU/L,CEA>5μg/L作为阳性诊断标准.结果 A组血清CA125、CA153、CA199、CEA水平与阳性率明显高于B组,卵巢癌患者血清CA125阳性率明显高于CA153、CA199、CEA阳性率,差异有统计学意义(P<0.05).CA125单项肿瘤指标检测的诊断灵敏度76.92%(60/78),特异度81.03%(47/58),阳性预测值84.51%(60/71),阴性预测值72.31%(47/65),准确度为78.68%(107/136).CA125+CA153+CA199多项肿瘤指标联合检测的诊断灵敏度与准确度明显高于CA125单项肿瘤指标,且特异度、阳性预测值与准确度明显高于CA125+CA153+CEA、CA125+CA199+CEA、CA125+CA153+CA199+CEA,差异有统计学意义(P<0.05).Ⅲ~Ⅳ期卵巢癌血清CA125、CA153、CA199、CEA阳性率明显高于Ⅰ~Ⅱ期,不同FIGO分期较差异有统计学意义(P<0.05).结论 CA125+CA153+CA199多项肿瘤指标联合检测在卵巢癌诊断中的价值更显著,并可作为卵巢癌FIGO分期的评定指标.

The application value of single CA125 detection and combination detection of multi-item tumor indexes in diagnosis of ovarian cancer

Objective To investigate the value of single CA 125 detection and combination detection of multi-item tumor indexes in diagnosis of ovarian cancer .Methods One hundred and thirty-six patients with ovarian tumor who were admitted and treated in department of gynecology of our hospital from April 2014 to April 2016 were enrolled in the study . According to surgical pathological results ,these patients were divided into ovarian cancer group (group A, n =78) and ovarian benign tumor group ( group B, n =58 ). The serum levels of CA125, CA153, CA199, CEA were detected by chemiluminescence particles immunoassay, in accordance with international reference standards:CA125 >35kU/L,CA153>30kU/L,CA199>37kU/L,CEA >5μg/L being regarded as positive diagnostic criteria .Results The serum levels of CA125,CA153,CA199,CEA in group A were significantly higher than those in group B ,moreover, the positive rates of CA125 in group A were significantly higher than those of CA 153,CA199,CEA ( P <0.05).The sensitivity,specificity,positive predictive value,negative predictive value,accuracy of single CA125 detection were 76.92% (60/78),81.03% (47/58), 84.51% (60/71), 72.31% (47/65), 78.68% (107/136),respectively,However,the sensitivity and accuracy by combination detection of CA125+CA153+CA199 were significantly higher than those by single CA 125 detection,moreover the specificity ,positive predictive value ,negative predictive value were significantly higher than those by combination detection of CA125+CA153+CEA, CA125+CA199+CEA, CA125+CA153+CA199+CEA ( P <0.05).The positive rates of CA125,CA153,CA199, CEA in stage Ⅲ ~Ⅳovarian cancer were significantly higher than those in stage Ⅰ ~Ⅱovarian cancer,moreovee, there were significant differences in different FIGO stages ( P <0.05).Conclusion The combination detection of CA125+CA153+CA199 plays an important role in diagnosis of ovarian cancer ,which can be used as evaluation indexes in FIGO staging of ovarian cancer .