CA_(125)、CA_(724)、CA_(199)、BFP检测对判定卵巢浆液性囊腺癌疗效的意义

The significance of combined measurement of CA125, CA724, CA199 and BFP for assessing therapeutic effect in patients with ovarian serous cystic tumors.

目的:探讨检测CA_(125)、CA_(724)、CA_(199)及BFP对卵巢浆液性囊腺癌患者诊断及疗效监测的意义。方法:用RIA或EIA测定卵巢浆液性囊腺癌患者术前及术后24个月内血CA_(125)、CA_(724)、CA_(199)及BFP,以腹腔镜检查及剖腹探查术为对照,监测上述4项标记物。结果:(1)术前各项标记物的阳性率为57.1%～79.1%,以CA_(125)最高;3项标记物组合阳性率为79.1%～85.7%。(2)Ⅰ期患者组合阳性率达80%,而且3项组合测定(CA_(125)+CA_(724)+BFP)即可达此水平。(3)3例复发病例均有2项以上标记物超过界值,即3项标记物组合阳性率可达100%。(4)每项单独测定均有假阴性。(5)CA_(125)单独测定有1例假阳性。结论:标记物的组合测定可覆盖复发病例,也能有效地提示绝大部分早期病例,但应注意单独检测有假阴性和假阳性的问题。

Objective To investigate the significance of combined measurement of CA125, CA724, CA199 and BFP for monitoring the diagnosis and the effectiveness of treatment in patients with ovarian serous cystic tumors(OSCT). Methods The CA125, CA724, CA199 and BFP in sera of 21 patients with OSCT evidenced by laparotomy and gynecological laparoscopic surgery were measured by RIA or EIA before and 24 months after surgery. Results (1)The positive rates of everymarker ranged between 57.1% to 79.1% with CA125 highest. The positive rates of the combination of three different markers were 79. 1% to 85. 7%. (2)The positive rate of the combination was nearly 80% in patients with stage Ⅰ and so far that of the combination measurements of CA125, CA724 and BFP. (3)The value of more than two markers was over borderline on every 3 recurrent patients, namely the positive rate of the combination of three different markers approached to 3/3. (4) False negativity measured by every single marker was found. (5)False positivity in 1 case was found in terms of CA125 alone. Conclusions The combined measurement of different markers may detect tumor recurrences and suggests a overwhelming majority of early patients. However, false positivity or negativity measured using a single marker should be cautioned.