子宫内膜芳香化酶与血清CA125联合检测对卵巢子宫内膜异位症的诊断价值

Diagnostic value of the detection of aromatase cytochrome P450 in endometrium combine with serum CA-125 for endometriosis

目的探讨子宫内膜芳香化酶联合血清CA125检测对卵巢子宫内膜异位症(EMs)的诊断价值。方法经腹腔镜或开腹手术证实为卵巢子宫内膜异位囊肿的患者42例为实验组,同期因宫颈上皮内瘤变(CIN)行子宫全切术的卵巢正常患者30例为对照组。术前检测两组血清CA125水平,术后检测实验组在位及异位子宫内膜和对照组子宫内膜芳香化酶的表达。结果实验组血清CA125水平高于对照组,差异有统计学意义(P<0.05);芳香化酶在实验组异位及在位内膜均有强表达,对照组子宫内膜无表达或弱表达,差异有统计学意义(P<0.05)。单独检测在位子宫内膜芳香化酶诊断EMs的敏感性为73.8%,特异性为90.0%,诊断正确率为80.6%;单独血清CA125测定诊断EMs的敏感性为66.7%,特异性为90.0%,诊断正确率为76.4%。在位内膜芳香化酶联合血清CA125检测诊断EMs的敏感性为92.9%,特异性为83.3%,诊断正确率为88.9%。结论在位子宫内膜芳香化酶检测对EMs诊断具有一定价值,与血清CA125联合检测对EMs更具早期诊断价值。

Objective To evaluate the diagnostic value of examing serum CA125combining with aromatase cytochrome P450 in eutopic and ectopic endometrial biopsy specimens as a diagnostic test for endometriosis.Methods Forty two women of reproductive age with normal menstrual cycles underwent endometrial biopsy laparotomy or laparoscopy,and pathologic examination of their tissue revealed ovarian endometriosis,they were classified to experimental group.Thirty patients who had Cervical Intraepithelial Neoplasia（CIN） but no other estrogen dependent gynecologic disease were considered to be disease-free and were classified to control group.The serum CA125 level was tested by chemical radiation method before operation,and the expression of aromatase cytochrome P450 in endometrium of control group and experimental group was tested by immunohistochemical analysis method after operation.Results The level of serum CA125 in experimental group was high than control group and there was statistical significance between the two group（P〈0.05）.There was strong expression of aromatase cytochrome P450 both in eutopic and ectopic endometrium of endometriosis.There was no or weak expression of aromatase cytochrome P450 in endometrium of controls and there was statistical significance between experimental group and control group.The sensitivity to diagnose endometriosis by testing aromatase cytochrome P450 in eutopic endometrium was 73.8%,the specificity was 90.0%,and the diagnostic accuracy was 80.6%.The sensitivity to diagnose endometriosis by testing serum CA125 was 66.7%,the specificity was 90.0%,and the diagnostic accuracy was 76.4%.The sensitivity of serum CA125 combining with aromatase cytochrome P450 in eutopic endometrium was 92.9%,the specificity was 83.3%,and the diagnostic accuracy was 88.9%.Conclusion Test of aromatase cytochrome P450 in eutopic endometrium is valuable to diagnosis of endometriosis.Test of serum CA125 combining with aromatase cytochrome P450 in eutopic endometrium is more valuable to the early diagnosis of endometriosis.