卵巢子宫内膜异位囊肿患者血清CA 125及临床相关因素分析

Clinical evaluation of serum CA-125 concentrations in ovary endometriosis patients

目的:探讨CA125在子宫内膜异位症的诊断意义及影响CA125水平可能存在的临床相关因素。方法:回顾性分析卵巢内异囊肿组76例,卵巢囊肿组58例及子宫腺肌症组32例血清CA125值及相关临床因素。结果:异位囊肿组CA125值(34.1±5.4)IU/ml,腺肌症组血清CA125值(30.7±4.3)IU/ml,均显著高于卵巢囊肿组。血清CA125诊断卵巢巧克力囊肿的敏感性为28.95%,特异性为92.63%。内异患者血清CA125水平随着rAFS分期期别的升高而增加。内异囊肿合并有盆腔粘连患者血清CA125值显著高于无粘连患者(P<0.05),且CA125值与rAFS分期粘连评分分值呈正相关,r=0.253,P<0.05。rAFS分期中,各个期别的痛经以及不孕的发生率没有显著差异(P>0.05)。血清CA125值与月经周期无明显相关性。不同生育和流产次数患者之间以及内异囊肿左侧、右侧或者双侧各组之间CA125水平差异无显著性(P>0.05)。结论:血清CA125在异位症患者中明显升高,尤其是重度者,可作为与卵巢囊肿鉴别诊断的辅助指标,CA125可作为术前评价内异症盆腔粘连严重程度的一个指标。

Objective： To investigate the factors contributing to the evaluated level of CA125 in diagnosis of endometriosis and adenomyosis. Methods： 166 women undergoing surgery for ovarian cysts or adenomyosis were studied. Preoperative serum CA125 levels were compared between various pelvic conditions. Results： The mean serum CA 125 levels （IU/ml） for endometriosis and adenomyosis were 34. 1 ± 5.41 and 30.7 ±4. 3 respectively, significantly higher than that for other cysts. The sensitivity and specificity of CA125 were 28.95% and 92. 63%, respectively. Serum CA 125 levels significantly correlated with the Revised American Fertility Society classification scores. Furthermore, serum CA - 125 levels were significantly higher in patients with more extensive pelvic adhesions （r =0. 253, P 〈0. 05）, and did not show significant correlation with sterility and abortion. Conclusion： CA125 can be used as a diagnostic test for endometriosis, especially for the advanced stage of endometriosis, and CA125 is a useful marker for determining the severity of endometriosis pelvic adhesions.