恶性肿瘤特异性生长因子在卵巢肿瘤中的临床应用价值

Ibe value of tumor specific growth factor (TSGF) in the diagnosis and monitoring of ovarian carcinoma

目的探讨血清恶性肿瘤特异性生长因子(TSGF)在卵巢恶性肿瘤的诊断及疗效监测中的临床应用价值。方法使用TSGF快速诊断试剂盒,对170例患者的196份血清进行检测,其中69例为卵巢恶性肿瘤,18例卵巢交界性肿瘤,42例卵巢良性肿瘤,41例盆腔良性病变;同时取20例正常妇女血清标本作为对照。所有标本同时检测CA125。结果卵巢恶性肿瘤组血清TSGF阳性率明显高于其他各组(P<0.01)。晚期肿瘤的血清TSGF诊断敏感性高于早期(P<0.05)。卵巢高分化恶性肿瘤及交界性肿瘤血清TSGF敏感性明显低于中、低分化组(P<0.01)。TSGF诊断卵巢恶性肿瘤的敏感性和特异性分别为78.3％和48.2％,CA125为73.9％和55.4％,二者差异无显著性(P>0.05)。TSGF+CA125联合检测诊断卵巢恶性肿瘤的敏感性为87.0％,较TSGF、CA125单项检测敏感性明显提高(P<0.05),治疗前后血清TSGF水平下降不明显(P>0.05)。TSGF对卵巢恶性肿瘤的疗效监测价值似乎不大。结论 TSGF测定诊断卵巢恶性肿瘤的敏感性和特异性分别为78.3％和48.2％,其水平与细胞分化、临床分期有关。TSGF和CA125联合检测可明显提高卵巢恶性肿瘤的检出率,但TSGF对卵巢恶性肿瘤的疗效监测似无明显临床价值。

Objective To estimate the clinical value of tumor specific growth factor (TSGF) in the diagnosis and monitoring of malignant ovarian tumors. Methods One hundred and ninety - six sera samples from 170 patients were collected, including 69 cases of malignant ovarian carcinoma, 18 borderline ovarian tumor, 42 benign ovarian tumor, 41 benign pelvic disease and 20 samples from healthy women as controls. The serum TSGF and CA125 were measured. Results The positive rate of TSGF for malignant ovarian tumor was significantly higher than other groups ( P < 0.01) . The sensitivity of TSGF in advanced stage of ovarian carcinoma was higher than that in early stage ( P < 0.05) .In serum TSGF of well differentiated carcinoma and borderline tumor, the sensitivity were lower than those in poor differentiated ones ( P < 0.01) . The sensitivity and specificity of TSGF for ovarian carcinoma were 78.3% and 48.2% resepectivily, which was similar to those of CA125 (73.9% and 55.4%) . The sensitivity of combining CA12S and TSCF to detect ovarian malignancies was 87.0%, and it was significantly better than CA125 or TSGF alone ( P < 0.01) . No significant decrease of serum TSGF level was found in patients with malignant tumors after effective treatment (P>0.05) . TSGF might have no value in monitoring the malignant ovarian tumors.Conclusions The sensitivity and specificity of serum TSGF for malignant ovarian tumor were 78.3% and 48.2% respectively. The sensitivity of serum TSGF was related with differentiation and clinical - stage. Combining CA125 and TSGF could significantly improve the diagnostic sensitivity of ovarian malignancies. TSGF might have no value in monitoring malignant ovarian tumors.