肝硬化病人血清CA125水平的变化分析

Cancer antigen CA125 in patients with cirrhosis

目的探讨肝硬化病人血清肿瘤抗原CA125水平与肝损害的关系。方法观察肝硬化病人66例，男36例；女30例，年龄52±12岁。Child—Pugh A级22例，B级22例，C级22例；设立健康对照组66例。用ELISA法检测血清CA125水平，并与病因、腹水、Child分级等指标作相关分析。同时检测AFP、CEA和CA19—9等肿瘤标记物。结果肝硬化病人血清CA125水平显著高于对照组（r=0．543，P〈0.01），并随肝硬化程度加重而增高。在肝硬化Child—Pugh分级中CA125水平在Child C级明显高于B级，B级明显高于A级（P〈0．01）。而血清CA125显著低于腹水CA125（233．79±212．25u／L vs 447．23±253．48u／L），二者呈线性相关（r=0．592，P〈0．01）。CA125水平与总胆红素呈显著正相关（r=0．647，P〈0．01），与白蛋白及凝血酶原活动度Pa水平呈显著负相关（r=0．713，P〈0．01）。AFP水平有少数升高，但无统计学意义，而CEA和CA19—9均正常。结论肝硬化病人血清CA125水平均有不同程度地升高，血清CA125水平可作为反映慢性肝病病人肝损害程度的指标之一。血清CA125可能来源干腹水，但与疾病良恶性无关，且血清CA125有可能成为监测肝硬化病人腹水消长的一项有用指标，并为临床诊断及预后评估提供参考。

AIM To study the relationship between serum CA125 and the stages of cirrhosis. METHODS Serum 0A125, as well as AFP,CEA and CA19 - 9,was analysed in patients with cirrhosis （n= 66） and healthy controls （n= 66）. RESULT Serum CA125 was significantly higher in patients with cirrhosis than in controls, in Class C than in Class B,and in Class B than in Class A patients （ P 〈 0.01 ）, while CEA, AFP and CA19 - 9 were not significantly elevated. CONCLUSION Serum CA125 level may be used as an index of hepatic impairment.