肿瘤标志物血清CA-125检测在异位妊娠治疗中的作用

Role of Serum CA-125 in the Management Strategy of Ectopic Pregnancy

背景与目的:探讨检测血清CA_125与β_hCG水平用以鉴别流产型与成活型异位妊娠(Ectopicpregnancy,EP)的作用,为EP治疗方案的选择提供依据。材料与方法:研究对象为86例一般情况稳定的EP患者,入院时作B超、CA_125和β_hCG检测。其中25例行保守治疗列为保守治疗组;61例分别行腹腔镜术或常规剖腹术,其中20例经病理学结果证实为流产型EP列为流产组,41例为成活型EP列为成活组。结果:血清CA_125测值流产组为83.69±36.37IU/ml,成活组为32.23±19.30IU/ml,保守治疗组为64.10±28.33IU/mL。β_HCG测值流产组为3323±2908mIU/ml,成活组为12056±9138mIU/ml,保守治疗组为1878±1043.5mIU/L。流产组CA_125水平显著高于成活组(P<0.01),而流产组β_HCG水平显著低于成活组(P<0.05);保守治疗组CA_125水平显著高于成活组(P<0.01),而β_HCG显著低于成活组(P<0.01),CA_125和β_HCG两项指标的均值在流产组与成活组之间以及在保守治疗组与成活组之间的差异均具有统计学意义。线型回归分析表明血清CA_125与β_hCG水平呈低度负相关;Spearman’s等级相关分析显示CA_125与β_hCG水平与是否手术治疗的相关性具有统计学意义。结论:CA_125联合β_hCG水平测定有可能用作鉴别流产型与成活型EP的一个指标,从而有助于治疗方案的选择。

BACKGROUND ＆ AIM： To determine whether serum CA-125 and serial β-hCG levels could be used to distinguish between tubal miscarriage and viable ectopic pregnancy （EP）. MATERIAL AND METHODS： 86 women with EP who were stable and had B-uhrasound, CA-125 and β-hCG tests at admission were studied. 25 of the 86 patients received conservative treatment and 61 were managed surgically by laparoscopy or laparotomy, of the latter group, 20 had proved tubal miscarrige and 41 had active, viable EPs. RESULTS： The mean CA-125 level was 83.69± 36.37 IU/ml for the patients with aborted EP, 32.23 ± 19.30 IU/ml for the patients with viable EP, and 64.10± 28.33 IU/ml for the patients receiving conservative treatments. The mean β-hCG level was 3 323 ± 2 908 mlU/L for the patients with aborted EP, 12 056 ± 9 138 mIU/L for the patients with viable EP, and 1 878 ± 1 043.5 mIU/L for the patients receiving conservative treatments. Both of the serum CA-125 and β-hCG levels between the aborted and the viable EP groups as well as between the conservative treatment and the viable EP groups showed statistical differences. Linear regression analysis revealed a significant inverse relation between serum CA-125 and β-hCG levels. Spearman nonparametric correlation analysis showed a statistically significant relation between management strategy and both of CA-125 and β-hCG levels. CONCLUSION： The use of CA-125 levels as an adjunct to serial β-hCG levels holds promise as a means for differentiating tubal miscarriage from viable EP.