血清肿瘤标记物测定在卵巢成熟畸胎瘤及其恶变者的临床应用

Clinical utility of serum tumor markers in mature cystic teratoma of the ovary and its malignant transformation

背景与目的:测定卵巢成熟畸胎瘤以及恶变患者的肿瘤标记物CA125、CA19-9、SCC、CEA及AFP的水平,同时探讨它们与患者临床资料结合在卵巢成熟畸胎瘤恶变诊断方面的价值。方法:分析1997—2004年12月在我院妇产科手术,病理证实为卵巢成熟畸胎瘤的176例患者的临床病理资料,同时测定多种血清肿瘤标记物。结果:170例卵巢成熟畸胎瘤患者,平均年龄35.8岁,肿瘤平均大小为8.8 cm,CA125测定153例,平均值33u/m l,其中37例>35u/m l,CA19-9测定140例,平均值217u/m l,其中77例>37u/m l,SCC测定112例,平均值1.82ng/m l,其中29例>1.5ng/m l;CEA测定115例,平均值1.42ng/m l,其中8例>5ng/m l;恶性变6例,平均年龄47岁,肿瘤平均大小17.6 cm,CA125平均值500u/m l,其中5例>35u/m l,CA19-9平均值609.8u/m l,其中5例>37u/m l,SCC平均值23.4ng/m l,其中5例>1.5ng/m l,CEA平均值22.8ng/m l,其中4例>5ng/m。l成熟畸胎瘤恶变的发病年龄以及肿瘤直径明显大于卵巢成熟囊性畸胎瘤的平均发病年龄和肿瘤直径(P<0.05);成熟畸胎瘤恶变的肿瘤标记SCC、CA125、CA19-9、CEA平均值明显高于卵巢成熟囊性畸胎瘤的平均值(P<0.05)。结论:对于40岁以上,肿瘤直径超过10 cm以上者,术前应注意肿瘤标记联合测定的结果,以鉴定肿瘤有无恶变。

Background and Purpose： The ohjective of this study was to assess the value of tumor markers and clinical characteristics in making a differential diagnosis between mature cystic teratoma（MCT） and its malignant transformation （ MT）. Methods： 176 patients with mature cystic teratoma of the ovary, diagnosed by postoperative pathology were treated in our hospital between 1997 and December 2004, the authors studied their clinicopathologic data and tested several serum tumor markers. Results： 170 were MCT, the mean age was 35.8, the mean tumor size was 8.8cm, 153 were tested for CA125, the mean serum CA125 level was 33u/ml, 37 with serum CA125 level over 35u/ml; 140 for tested CA19-9. the mean serum CA19-9 level was 217u/m], 77 with serum CA19-9 level over 37u/ml; 112 tested for SCC, the mean serum SCC level was 1.82ng/ml, 29 with serum SCC level over 1. 5ng,/ml; 115 tested for CEA, the mean serum CEA level was 1.42ng/ml, 8 with serum CEA level over 5ng/ml; 6 cases were malignant transformation, the mean age was 47, the mean tumor size was 17.6cm, the mean serum CA125 level was 500u/ml, 5 with serum CA125 level over 35u/ml, the mean serum CA19-9 level was 609. 8u/ml, 5 with serum CA19-9 level over 37u/ml, the mean serum SCC level was 23.4ng/ml, 5 with serum SCC level over 1.5ng/ml, the mean serum CEA level was 22.8ng/ml, 4 with serum CEA level over 5ng/mh There were significant differences in age, tumor size and levels of the serum tumor markers between MCT and MT. （ P 〈 0. 05）. Conclusions： Several tumor markers should be tested to determine whether an ovarian tumor is malignant or not preoperatively for patients more than 40 years old who have an MCT-like ovarian tumor larger than 10 cm in its greatest dimension.