CA125与D-二聚体联合检测在卵巢癌诊断中的应用价值

Practical value of CA125 combined with D-dimer in the diagnosis of ovarian cancer

目的研究联合检测血清糖链抗原125(CA125)和血浆D-二聚体水平在卵巢癌诊断中的应用价值。方法分别采用电化学发光法与定量酶联免疫吸附试验(ELISA)检测经病理学确诊的卵巢癌患者75例和卵巢良性肿瘤患者41例的血清CA125及血浆D-二聚体水平,并选择60例健康体检妇女同样检测该两项指标,进行比较。结果卵巢癌组患者的CA125及D-二聚体水平均显著高于卵巢良性肿瘤组及健康对照组(P均<0.01)。单项检测CA125及D-二聚体对卵巢癌诊断的敏感性分别为81.3%及64.0%,特异性分别为82.9%及87.8%,准确性分别为81.9%及72.4%,而两者联合检测对卵巢癌诊断的敏感性为92.0%,特异性为78.0%,准确性为87.1%。联合检测对卵巢癌诊断的敏感性和准确性明显高于单项检测(P均<0.01),虽然特异性有所降低,但无统计学意义(P均>0.05)。结论联合检测CA125及D-二聚体可提高卵巢癌的早期诊断率,有助于准确判断肿瘤的分期及预后。

Objective To study the clinical value of carbohydrate antigen 125（CA125）combined with D-dimer in the diagnosis of ovarian cancer. Methods Seventy-five patients with ovarian cancer and 41 patients with benign ovarian tumor confirmed by pathology and 60 health women as controls were selected in present study.In all eligible participants,the levels of serum CA125 and plasma D-dimer were respectively determined by electrochemiluminescence assay and enzyme-labeled immunosorbent assay（ELISA）and compared.The sensitivity,specificity and accuracy of individual determination of CA125 or D-dimer and their combining determination were compared. Results The serum CA125 and plasma D-dimer levels were obviously higher in ovarian cancer patients than those in benign ovarian tumor patients and healthy controls（all P〈0.01）.The sensitivity,specificity and accuracy were 81.3%,82.9% and 81.9% in CA125,64.0%,87.8% and 72.4% in D-dimer,92.0%, 78.0% and 87.1% in their combining determination.The sensitivity and accuracy were obviously higher in combining determination of CA125 and D-dimer than those in individual determination of CA125 or D-dimer（all P〈0.01）,and the specificity had no statistical difference among individual determination of CA125 or D-dimer and their combining determination （all P〈0.05）. Conclusions Determination of CA125 combined with D-dimer can raise the early diagnosis rate and be helpful in the judgment of the clinical stage and prognosis for ovarian cancer.