常规肿瘤标记物在卵巢成熟囊性畸胎瘤中的诊断意义

The diagnostic value of routine tumor markers in mature cystic teratomas of the ovary

目的:评估常规血清肿瘤标记检测卵巢成熟囊性畸胎瘤的意义,指导临床正确选用肿瘤标记物。方法:回顾性分析125例卵巢成熟囊性畸胎瘤患者的临床资料。结果:患者平均年龄为34.1岁;肿瘤平均直径(49.6±19.8)mm,中位数为46 mm;4种血清肿瘤标记物水平CA199为(74.1±135.8)U/L,CA125为(17.2±15.3)U/ml,AFP为(2.3±1.6)μg/L,CEA为(1.4±0.9)μg/L,升高率分别为35.2%(44/125)、4.9%(6/122)、0%、0%,肿瘤双侧率为40.0%(50/125)。CEA、AFP在检测卵巢成熟囊性畸胎瘤中无意义,CA125与CA199有一定意义;血清CA199水平高的患者瘤体较大,且较低水平者其肿瘤为双侧的可能性显著升高(72.7%vs 22.2%,P<0.05)。双侧的似然比CA199为1.8,CA125为3.2。结论:CEA、AFP对于检测卵巢成熟囊性畸胎瘤无意义,CA199有一定意义,可指导手术医生对于双侧性肿瘤的探查以及治疗。

Objective： To evaluate the value of routine tumor markers in serum in the diagnosis of mature cystic teratomas （MCTs） of the ovary, direct proper selection of tumor markers. Methods： Clinical data of 125 cases with MCTs were analysed retrospectively. Results： The mean age of 125 cases was 34. 1 years. The mean diameter of MCTs was （49.6 ± 19. 8） mm （median 46 mm） . The mean levels of cancer antigen 199 （CA199） , cancer antigen 125 （CA125） , careinoembryogenic antigen （CEA） and alpha -fetoprotein （AFP） in serum were （74. 1 ± 135.8） U/L, （17.2 ± 15. 3 ） U/ml, （ 1.4 ±0. 9） μg/L and （2.3 ± 1.6） μg/L, respectively. The elevated rate of CA199, CAl25, CEA and AFP was 35.2% （44/125）, 4. 9% （6/122）, 0% and 0%, respectively. The bilaterality rate was ziO% （50/125） . Cases with high level CA199 had significantly larger tumors and higher bilaterality rate （72.7% vs 22.2% , P 〈 0. 05 ） than the cases with low level. Likelihood ratio for bilaterality was 1.8 for CA199 and 3.2 for CA125. Conclusion： CEA and AFP are insignificant in the detection of MCTs. Elevated level of CA199 may be an indicator of bilaterality which plays an important role in the exploration of surgery.