宫颈腺癌治疗前血清CA125水平的临床应用价值

The clinical value of pretreatment serum CA125 in cervical adenocarcinoma

目的:探讨治疗前血清CA125水平在宫颈腺癌中的临床应用价值。方法:检测2002年5月至2010年6月天津市中心妇产科医院72例宫颈腺癌患者治疗前血清CA125的水平,并回顾分析临床病理资料,采用秩和检验和Logistic回归分析CA125与临床病理参数的关系,绘制受试者工作特征(ROC)曲线,确定对宫颈腺癌有评估意义的CA125最佳阳性域值。结果:单因素分析显示,血清CA125水平与宫颈癌分期,肿瘤直径,肌层浸润深度和淋巴结转移有关,与分化程度,脉管内瘤栓无关;ROC曲线显示CA125为30U/ml为筛选宫颈腺癌的最佳界值,30～38U/ml是宫颈腺癌的高危界值。Lo-gistic回归分析进一步提示肿瘤直径和淋巴结转移是影响血清CA125≥38U/ml的独立影响因素。结论:血清CA125水平在30～38U/ml是宫颈腺癌的高危界值,结合血清CA125水平,可指导临床分期的诊断和个体化治疗。

Objective：To investigate the clinical value of CA125 before treatment in cervical adenocarcinoma.Methods：Pretreatment serum CA125 detection was conducted in 72 patients with cervical adenocarcinoma who were admitted to the Tianjin Central Hospital of Obstetrics and Gynecology during a period from May 2002 to June 2010,and a retrospective study of the cases in combination with the related clinic-pathologic data was carried out.The correlation between the clinico-pathologic finding and CA125 outcomes was statistically analyzed using rank-sum test and multiple logistic regression analysis.The receptor performance curve（ROC） of the cases was drawn to decide and evaluate the threshold value of CA125 in adenocarcinoma.Result：Univariate analysis showed that serum CA125 titer correlates significantly with the FIGO staging,tumor size,depth of muscular infiltration and lymphatic metastasis,but not with the degree of differentiation and intravascular tumor embolus.The ROC showed that the best cut-off value of CA125 for screening the adenocarcinoma was 30U/ml,the high-risk threshold is 30~38U/ml.The logistic regression analysis further confirmed that the tumor size,depth of muscular infiltration and lymphatic metastasis were the independent risk factors affecting serum CA125 levels（CA125≥38U/ml）.Conclusion：The high-risk threshold of serum CA125 is 30~38U/ml,CA125 may be a useful clinical tool for diagnosing the clinical-stage and treatment individually.