血清CA125监测卵巢上皮性癌术后复发界值探讨

Cut-off value of serum CA125 for monitoring the recurrence of epithelial ovarian carcinoma

目的探讨CA125在监测卵巢上皮性癌术后复发的界值。方法回顾性总结分析四川大学华西二院2005年1月至2009年12月收治的卵巢上皮性癌170例手术后患者,未复发组135例,复发组35例,以绝经后体格检查正常的105例妇女及除卵巢恶性肿瘤之外的65例术后无复发的妇科恶性肿瘤患者作为对照组。以CA125值为5kU/L、10kU/L、15kU/L、20kU/L、25kU/L、30kU/L、35kU/L分别作为界值,比较各界值对判断卵巢上皮性癌术后复发的敏感度、特异度。结果卵巢上皮性癌术后无复发患者、绝经后妇女及妇科恶性肿瘤术后患者CA125中位数值分别为7.5kU/L、8.4kU/L、6.9kU/L;均数±标准差分别为(8.3±3.6)kU/L、(9.1±4.2)kU/L、(7.3±2.6)kU/L。以15kU/L为界值判断复发,敏感度、特异度分别为74.3%、97.0%。结论以15kU/L为CA125界值配合影像学检查监测卵巢上皮性癌术后病情变化,敏感度提高,能够早期发现微小癌灶存在,早期治疗,延长患者生存期。

Objective To explore the relationship between the cut-off value of CA 125and the recurrence of epithelial o- varian carcinoma. Methods Analyze 170 postoperative patients of epithelial ovarian carcinoma retrospectively, consisting of 135 non-recurrent and 35 securrent cases, while !05 cases of menopausal women and 65 cases of postoperative patients of gynecological malignancies except ovarian carcinoma served as control group. Cut-off values of 5, 10, 15, 20, 25, 30, and 35 kU/L were used to compare sensitivity, and specificity. Results The median value of CA125 for non- recurrent patients was 7.5 kU/L; 8.4 kU/L for menopausal women ; 6.9 kU/L for postoperative patients of other gyneco- logical malignancies, whereas the x ＋ s was （ 8.3 ±3.6） kU/L, （9. 1±4. 2 ） kU/L, and （ 7.3 ±2. 6） kU/L, respectively. The cut-off value of 15 kU/L produced the following results： 74. 3% sensitivity, 97.0% specificity. Conclusions When 15 kU/L was used as the cut-off value combined with image examination, the sensitivity increased. This result may improve the prognosis for recurrent patients because of the early detection of recurrent lesions and early retreatment.