评价血清CA125在附件包块中的鉴别诊断价值

Study of the value of serum CA125 in differential diagnosis for adnexal mass

目的评价血清CA125在附件包块中的鉴别诊断价值。方法对2006年1月至2008年12月中山大学附属第三医院妇科收治的375例附件包块进行回顾性分析。结果375例附件包块中，血清CA125〉35U／ml的有198例，其中卵巢恶性肿瘤92例，附件良性包块106例，分别占46．5％和53．5％，但卵巢恶性肿瘤的血清CA125值高于附件良性包块（P〈0．05），而且CA125取值不断升高时，附件包块的患者中诊断为卵巢恶性肿瘤的比例就越来越高。当血清CA125〉65U／ml时，检出卵巢恶性肿瘤的敏感性、特异性和诊断准确性都较高，分别为84．5％、80．1％和81．3％。当血清CA125〉150U／ml时，提示晚期卵巢恶性肿瘤的敏感性、特异性和诊断准确性都较好，分别为84．4％、76．3％和78．4％。结论血清CA125取65U／ml是临床鉴别诊断附件良恶性肿瘤的较佳临界值；当血清CA125〉150U／ml时，提示晚期卵巢恶性肿瘤的意义较大。

Objective To Study of the value of serum CA125 in differential diagnosis for adnexal mass. Methods Retrospective analysis was utilized to analyze the clinical materials of 375 cases of adnexal mass in the 3th Affiliated Hospital of SUN Yat-sen University from January 2006 to December 2008. Results 198 cases, serum CA125 were 〉 35 U/ml, including 92 eases of malignant ovarian tumor and 106 cases of benigh adnexal mass, hut CA125 value of malignant ovarian tumor was higher significantly than that of benigh adnexal mass （P 〈 0. 05 ）. When serum CA125 was 〉 65 U/ml, the sensitivity, specificity and accuracy were better for diagnosis of malignant ovarian tumor,which were 84. 5% ,80. 1% and 81.3% respectively. When serum CA125 was 〉 150 U/ml,the sensitivity, specificity and accuracy were better for the diagnosis of advanced malignant ovarian tumor,which were 84.4% ,76. 3% and 78.4% respectively. Conclusion 65 U/ml of serious CA125was the more suitable cut-off for differential diagnosis of malignant or benigh adnexal mass, and 150 U/ml for advanced or early stage of malignant ovarian tumor.