OPN、CA125和CA199检测对卵巢上皮癌诊断和预后的价值

Diagnosis and Prognosis Value of the Serum OPN,CA125 and CA199 Detection in Patients with Epithelial Ovarian Cancer

目的:探讨血清癌抗原125(CA125)、癌抗原199(CA199)和骨桥蛋白(OPN)检测对卵巢上皮癌诊断和预后的临床价值。方法:用酶联免疫法和微粒子化学发光法测定OPN、CA125和CA199水平;并对卵巢上皮癌患者术后3个月内连续测定,观察不同疗效者治疗前后OPN、CA125、CA199的变化。结果:卵巢上皮癌患者血清OPN、CA125、CA199水平明显高于卵巢上皮类良性肿瘤患者,Ⅲ期和Ⅳ期卵巢上皮癌患者OPN、CA125、CA199水平明显高于I期和Ⅱ期患者。OPN、CA125、CA199检测的敏感度分别为84.4%、71.9%、42.2%;三者联合检测的敏感度为95.3%。OPN+CA125对浆液性卵巢癌的敏感度93.5%;OPN+CA199对粘液性卵巢癌的敏感度88.9%。原发性卵巢上皮癌患者术后OPN、CA125、CA199水平与术前比较,疗效为完全缓解者明显下降;部分缓解者下降;进展者升高;无改变者差异无统计学意义。结论:血清OPN、CA125、CA199是卵巢上皮癌诊断和判断预后的敏感性指标,三者联合检测可提高卵巢上皮癌诊断的敏感性。OPN+CA125联合检测增加浆液性卵巢癌诊断的敏感性;OPN+CA199联合检测增加黏液性卵巢癌诊断的敏感性。

Objective： To probe into the clinical value of detecting osteopontin（OPN）, CA125 and CA199 in diagnosis and prognosis of epithelial ovarian cancer. Methods：Serum levels of OPN, CA125 and CA199 were measured by ELISA and microparticle chemiluminescence method. Series of OPN, CA125 and CA199 determination for patients with epithelial ovarian cancer in three months were carried out to observe the relationship between OPN, CA125 and CA199 value and therapeutic efficacy. Results：The levels of OPN, CA125 and CA199 in ovarian cancer were significantly higher than those in benign ovarian tumor. In ovarian cancer, the expression of OPN, CA125 and CA199 increased significantly in stage Ⅲ＋Ⅳ than in stageⅠ＋Ⅱ. The sensitivity of OPN, CA125 and CA199 were 84.4%, 71.9% and 42.2%. The sensitivity of combined detection of three markers was 95.3%. The sensitivity of OPN ＋CA125 in patients with serous adenocarcinoma was 93.5% and OPN ＋CA199 in patients with mucous adenocarcinoma was 88.9%. The levels of serum OPN, CA125 and CA199 decreased significantly after surgery in patients with complete response （CR）, decreased in patients with partial response （PR）, increased significantly in patients with progressive disease （PD） and showed no changes in patients with stable disease （SD）. Conclusion：The measurement of serum OPN, CA125 and CA199 is an effective method in the diagnosis and prognosis for patients with epithelial ovarian cancer and the clinical value can be increased by the combined use of three markers. The positive rate can be increased by the combined use of OPN＋CA125 for patients with serous adenocarcinoma and the combined use of OPN＋CA199 for patients with mucous adenocarcinoma.