腹腔镜下病灶切除、^(125)I粒子植入的复发妇科恶性肿瘤患者血清CA125水平变化及意义

Change and significance of serum CA125 level after implantation of ^(125)I seeds guided by laparoscopy in patients with recurrent gynecologic malignancies

目的观察腹腔镜下病灶切除及125I粒子植入复发妇科恶性肿瘤患者血清CA125水平的变化,并探讨其意义。方法复发妇科恶性肿瘤患者30例,15例行腹腔镜下病灶切除并植入125I粒子(植入组),15例行开腹手术病灶切除(对照组)。放免法检测30例患者的血清CA125。结果术后1个月植入组血清CA125水平升高、对照组降低(P<0.05);术后3个月植入组中有9例血清CA125水平正常,而对照组中只有3例正常(P<0.05);术后3个月两组血清CA125下降至正常的患者其2 a无瘤生存率为83.3%(10/12),高于术后3个月CA125未降至正常者的50.0%(9/18),两者相比,P<0.05。结论腹腔镜下切除病灶并植入125I粒子的复发妇科恶性肿瘤患者术后血清CA125水平有短暂升高,术后3个月降至正常,可作为疗效及预后判断的有效指标。

Objective To study the CA125 level and its significance after laparoscopic resection and ^125I seeds inplantation in patients with recurrent gynecologic malignancies.Methods 30 cases with recurrent gynecologic malignancies were divided for average into two groups,15 cases of ^125I implantation group were deal with laparoscopic resection and 125I seeds inplantation,15 cases of control group were deal with laparotomy.Serum CA125 levels of 30 cases were measured by RIA.Results Serum CA125 level of ^125I implantation group were all increased in the first month after operation with which in control group dropped obviously（P〈0.05）.CA125 level of 9 cases in ^125I implantation group and only 3 cases in control group dropped to normal in the third month after operation（P〈0.05）.The 2 year tumor-free survival rate（83.3%） of the patients with normal CA125 level in the third month after operation was higher than those（50.0%） with abnormal CA125 level（P〈0.05）.Conclusion There is temporary increased CA125 elevation after laparoscopic resection and 125I seeds implantation.CA125 level in the third month after operation is an effective marker for prognosis.