血清CA125检测对子宫内膜癌的临床价值

The clinical value of serum CA125 detection in endometrial carcinoma patients

目的:探讨肿瘤标志物CA125检测对子宫内膜癌患者的临床意义。方法:选取近10年来广西医科大学第一附属医院妇科收治的166例术前有血清CA125检测结果的子宫内膜癌患者的临床病理资料进行回顾性分析。结果:166例患者术前血清CA125阳性率为26.5%(44/166),Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者的血清CA125阳性率分别是15.7%(16/102)、22.2%(4/18)、51.1%(23/45)、100.0%(1/1),CA125阳性率随子宫内膜癌的分期增加而升高(P=0.001)。有深肌层浸润或附件转移或腹腔细胞学阳性的患者血清CA125阳性率增加(P=0.020,P=0.000,P=0.000)。通过Logistic回归进行多因素分析,结果显示,CA125阳性率与附件转移、腹腔细胞学阳性密切相关(P=0.000,P=0.005)。病理类型、组织学分级、盆腔淋巴结转移与血清CA125水平无相关性(P=0.095,P=0.664,P=0.538)。结论:术前血清CA125检测对早期子宫内膜癌的诊断没有意义,但对子宫内膜癌患者术前判断临床分期、附件转移、腹腔细胞学阳性与否有一定的参考价值。

Objective：To explore the clinical significance of tumor marker CA125 in endometrial carcinoma patients.Methods：A retrospective study was carried out on 166 cases of endometrial carcinoma with preoperative serum CA125 who were admitted to the Department of Gynecology of the First Affiliated Hospital of Guangxi Medical University in the past ten years.Results：The positive rate of preoperatire serum CA125 of 166 patients was 26.5%（44/166）,those of stage Ⅰ,Ⅱ,Ⅲand Ⅳ were 15.7%（16/102）,22.2%（4/18）,51.1%（23/45） and 100.0%（1/1） respectively.Univariate analysis showed that elevated CA125 positive rate was significantly correlated with the advanced stage,increasing depth of the my ometrial invasion,adnexal metastasis and positive peritoneal cytology（P=0.001,P=0.020,P=0.000,P=0.000）.Multivariate analysis using a Logistic regression model showed adnexal metastasis and positive peritoneal cytology had the most significant effect on the elevation of CA125 positive rate.CA125 positive rate was not correlated with histology,cell differentia tion,pelvic lymph node metastasis（P=0.095,P=0.664,P=0.538）.Conclusion：Preoperative serum CA125 level is valuable in estimating the tumor stage,adnexal metastasis and positive peritoneal cytology of the patients with endometrial carcino ma,but not in diagnosing the early stage of endometrial carcinoma.