血清CA125在子宫内膜异位症和子宫腺肌病中的临床应用价值探讨

The exploration of diagnostic value for serum CA125 in endometriosis and adenomyosis

目的:探讨血清CA125在子宫内膜异位症和子宫腺肌病中的临床应用价值。方法:用化学发光免疫法测定336例患者的血清CA125水平,分为两组,病例组包括子宫内膜异位症98例,子宫腺肌病58例;对照组包括子宫肌瘤60例,卵巢良性肿瘤70例,正常育龄女性50例。对子宫内膜异位症患者分期测定血清CA125水平,复测手术后子宫内膜异位症及子宫腺肌病患者血清CA125水平并对其手术标本进行病理免疫组化CA125标记。结果:病例组血清CA125水平较对照组显著增高,差异均有统计学意义(P<0.01),子宫内膜异位症分Ⅰ、Ⅱ期组与Ⅲ、Ⅳ期组比较,差异有统计学意义(P<0.05),手术后子宫内膜异位症、子宫腺肌病患者血清CA125水平均明显下降,差异有统计学意义(P<0.01),子宫内膜异位症、子宫腺肌病患者手术后标本均行免疫组化CA125标记,术前化验检查血清CA125增高者,其手术后病理标本免疫组化CA125标记亦为阳性。结论:结合患者体征及影像学检查,血清CA125可作为子宫内膜异位症和卵巢良性肿瘤、子宫腺肌病和子宫肌瘤鉴别诊断以及疗效评价的指标。

Objective： To explore the value of serum CA125 in diagnosis of endometriosis and adenomyosis. Methods： Chemical luminescence immunoassay method was employed to measure the serum CA125 values in 336 cases who were divided into two groups. The case group included 98 cases of endometriosis and 58 cases of adenomyosis. The control group included 60 cases of uterine fibroids, 70 cases of benign ovarian tumors and 50 cases of normal women of child - bearing age. Meanwhile, staging determination was employed to measure serum CA125 value for the endometriosis patients, repeated measure was used in serum CA125 value of the endometriosis patients after sur- gery and adenomyosis patients. And its surgical specimens were marked with pathological immunohistochemical CA125. Results： The level of serum CA125 of the case group was significantly higher than the control group, and differences were statistically significant （ all P 〈 0. 01 ） . Endometriosis was divided into Ⅰ , Ⅱ period group and Ⅲ, IV period group, and difference was statistically significant （P 〈 0. 05 ） . Serum CA125 level were obviously decreased in endometriosis patients after surgery and patients wilh adenomyosis, and differences were statistically significant （P 〈 0. 01 ） . Endometriosis, adenomyosis specimens of patients undergo post - operative CA125 immunohistochemical markers. The patients, whose serum CA125 were increased by testing before surgery, were also positive in pathology immunohistochemical marker CA125 after surgery. Conclusion： Combined patients body features and imaging examination, serum CA125 can be used as the indicator for differential diagnosis and efficacy evaluation about endometriosis and benign ovarian tumors, adenomyosis and uterine fibroids.