血清CA125联合子宫内膜芳香化酶检测诊断子宫内膜异位症

Diagnostic value of serum CA125 level and endometrial aromatase detection to endometriosis

目的：探讨血清CA125、子宫内膜芳香化酶检测诊断子宫内膜异位症（endometriosis,EMs）的价值。方法：经腹腔镜或开腹手术确诊的EMs患者40例（EMs组）,因盆腔炎行腹腔镜手术且排除EMs的患者20例（对照组）,术前均抽血检测血清CA125水平,术中取其子宫内膜,采用免疫组织化学法检测芳香化酶的表达情况,并进行比较。结果：EMs组血清CA125水平高于对照组（P〈0.05）,Ⅲ~Ⅳ期EMs患者血清CA125水平较Ⅰ~Ⅱ期患者高（P〈0.05）,EMs组在位内膜芳香化酶阳性表达率高于对照组（P〈0.05）,Ⅲ~Ⅳ期EMs患者在位内膜芳香化酶阳性表达率与Ⅰ~Ⅱ期患者比较差异无统计学意义（P〉0.05）。以血清CA125≥35 u/mL为临界值,诊断EMs的敏感性为55.0%,特异性为80.0%;免疫组织化学检测子宫内膜芳香化酶诊断EMs的敏感性为92.5%,特异性为90.0%;2种方法联合检测诊断EMs的敏感性95.0%,特异性70.5%。结论：血清CA125联合子宫内膜芳香化酶检测可提高EMs的早期诊断率和诊断准确性。

Objective To explore the value of serum CA125 level and endometrial aromatase detection to the diagnosis of endometriosis.Methods Forty patients with endometriosis diagnosed by laparoscopy or laparotomy（endometriosis group） and 20 patients receiving laparoscopy due to pelvic inflammatory disease（control group） were detected the serum CA125 level before operation.The expression of aromatase protein was detected with immunohistochemistry.The results were compared between two groups.Results Serum CA125 level was higher in endometriosis group than that in control group（P0.05）,and was higher in Ⅲ to Ⅳ stage of endometriosis than that in Ⅰ to Ⅱstage（P0.05）.Aromatase expression of eutopic endometrium was higher in endometriosis group than that in control group（P0.05）,and showed no significant difference between Ⅲ to Ⅳ stage and Ⅰ to Ⅱ stages（P0.05）.As the cut-off of serum CA125≥35 u/mL,the sensitivity for endometriosis was 55.0% and the specificity was 80.0%.The diagnostic sensitivity of endometrial aromatase expression detected with immunohistochemistry was 92.5% and the specificity was 90.0%.The sensitivity of the combined methods for endometriosis was 95.0%,and the specificity was 70.5%.Conclusion The combination of serum CA125 and endometrial aromatase assay may enhance the early diagnosis rate and diagnostic accuracy of endometriosis.