CA-125、CA19-9在卵巢子宫内膜异位囊肿并发自发性破裂中的临床意义

目的：评价血清CA-125、CA19-9在自发性卵巢子宫内膜异位囊肿并发自发性破裂患者中的临床意义。方法：回顾性分析2006年1月-2015年10月于温州医科大学附属第一医院妇科确诊的50例卵巢子宫内膜异位囊肿并发自发性破裂患者（破裂组）及同期70例未破裂卵巢子宫内膜异位囊肿患者（对照组）的临床病例资料及血清CA-125、CA19-9水平。结果：①破裂组患者血清CA-125与CA19-9水平均较对照组明显升高（P＜0.05），且CA-125与CA19-9联合检测水平均明显升高（P＜0.05）；②CA-125的受试者工作特征曲线下面积（AUC）值为0.966（95%CI：0.937～0.995），敏感性和特异性分别为86.8%和95.4%；CA19-9的AUC值为0.939（95%CI：0.884～0.994），敏感性和特异性分别为93.5%、89.4%，而CA-125、CA19-9联合检测的AUC值为0.992（95%CI：0.981～1.000），具有更高的敏感性和特异性，分别为99.9%和93.6%；③破裂组囊肿直径为（7.78±3.12）cm，大于对照组的（5.80±1.63）cm（P＜0.05）。结论：自发性卵巢子宫内膜异位囊肿破裂患者CA-125以及CA19-9水平均明显升高，联合检测CA-125及CA19-9有助于自发性卵巢子宫内膜异位囊肿破裂的早期诊断。

Clinical significance of CA-125 and CA19-9 levels in spontaneous ruptured ovarian endometrioma

Objective: To explore the clinical roles of serum CA-125 and CA19-9 in women with spontaneous ruptured ovarian endometriomas. Methods: Retrospective data were collected from 50 women who were diagnosed as spontaneous ruptures ovarian endometriomas from January 2006 to October 2015. In addition, 70 women diagnosed with unruptured ovarian endometriomas were chosen to serve as control subjects. Serum CA-125 and CA19-9 levels, together with the clinical materials, were collected. Results: Serum CA-125, CA19-9, and the combined biomarkers were shown to be obviously elevated in the spontaneous ruptured ovarian endometrioma group (P<0.05). The AUC value of CA-125 was 0.966 (95%CI: 0.937-0.995), the sensitivity and specificity were 86.8%, 95.4%, and AUC value of CA19-9 was 0.939 (95%CI: 0.884-0.994), the sensitivity and specificity were 93.5% and 89.4%, respectively. The AUC value for the combined biomarkers was 0.992 (95%CI: 0.981-1.000), with a high sensitivity and specificity of 99.9% and 93.6%, respectively. Moreover, The diameter of the tumor in the rupture group (7.78±3.12) cm was greater than that in the non rupture group (5.80±1.63) cm (P<0.05). Conclusion: Serum CA-125 and CA19-9 are significantly increased in the patients with spontaneous ruptured ovarian endometriomas. Moreover, the combined CA-125 with CA19-9 is better than alone in the diagnosis of a spontaneous ruptured ovarian endometrioma.