联合应用多项肿瘤标志诊断卵巢恶性肿瘤的价值

Transcriptional expression and promoter hypermethylation of Vasohibin gene in ovarian cancer

目的探讨CA125等7种肿瘤标志联合应用对卵巢恶性肿瘤的诊断价值。方法对430例卵巢包块手术前患者(卵巢恶性肿瘤110例,卵巢良性肿瘤320例)及50例正常妇女血清应用ELISA法进行检测。检测项目包括糖类抗原CA125(CA125)、肿瘤相关物质(TSGF)、唾液酸(SA)、癌胚抗原(CEA)、甲胎蛋白(AFP)、促性腺激素(hCG)和铁蛋白(Fer)。结果卵巢恶性肿瘤患者血清中CA125、TSGF、SA、CEA、AFP及Fer水平明显高于卵巢良性肿瘤或对照组,F=177.24,P<0.0001;F=52.49,P<0.0001;F=3.38,P=0.0347;F=6.88,P=0.0011;F=34.94,P<0.0001;F=8.23,P=0.0003;F=124.37,P<0.0001。在7项肿瘤标志中,CA125单独诊断价值最大。单独应用CA125诊断卵巢恶性肿瘤的敏感性、特异性及准确性分别为86.4%、82.8%及83.7%。联合应用7项肿瘤标志时,以任意一项及一项以上异常指标为诊断标准时,诊断卵巢恶性肿瘤的敏感性、特异性及准确性分别为95.5%、45.6%和58.4%;以任意两项及两项以上异常指标为诊断标准时,分别为93.6%、80.6%和84.0%;以任意3项及3项以上异常指标为诊断标准时,分别为87.3%、90.3%和89.5%。结论7项肿瘤标志联合检测对提高卵巢恶性肿瘤诊断的敏感性、特异性及准确性有一定意义,其中CA125、TSGF及SA3项肿瘤标志阳性诊断价值最大。

OBJECTIVE：To study the diagnostic value of application of muti-tumor markers in malignant ovarian neoplasms. METHODS： The sera were obtained from 430 patients with ovarian masses （110 cases were malignant ovarian tumors, 320 cases were benign ovarian tumors） at preoperative time, and the sera from 50 healthy women were as control. Serologic examination of tumor markers included CA125, TSGF, SA, CEA, AFP, hCG and Fer. RESULTS： The serum levels of CA125, TSGF, SA, CEA, AFP and Fer in patients with ovarian cancer were higher than those in patients with benign ovarian tumors or those in control group, F=177.24, P〈0.000 1; F=52.49, P〈0.000 1; F=3.38, P=0.034 7; F=6.88, P=0.001 1; F=34.94, P〈0.000 1; F=8.23, P=0.000 3; F= 124.37, P〈 0. 000 1. In the diagnoctic value of application for malignant ovarian neoplasms, CA125 was better than the others. The sensitivity, specificity and accuracy in diagnosis of ovarian cancer were 86. 4%, 82. 8% and 83.7% respectively for CA125 alone, whereas 95.5%, 45.6% and 58.4% for muti-tumor markers combined examination in which 1 or more indices showing positive, 93.6%, 80.6% and 84.0% for that in which 2 or more indices show positive, and 87. 3%, 90.3% and 89. 5 % for that in which 3 or more indices showing positive. CONCLUSIONS： Muti-tumor markers examination could improve the diagnosis of ovarian cancer, and the combined examination of CA125, TSGF and SA is the most ideal method.