子宫内膜异位症腹腔镜保守性手术前后CA_(125)值的探讨

Study on the CA _(125) level before and after conservative operative laparoscopy of endometriosis

目的 了解子宫内膜异位症 (内异症 )患者血清和腹腔液CA12 5水平以及在腹腔镜保守性手术治疗后的变化。方法 收集内异症 3 0例的腹腔镜保守性手术的血清和腹腔液 ,并以经腹腔镜检查确诊为与内异症无关病例 1 0例为对照 ,应用免疫酶标反应测定CA12 5水平。结果 内异症患者血清和腹腔液CA12 5水平高于对照组 ,并随病情的加重而升高 ,但在腹腔镜保守性手术后显著下降 ;在R AFSⅠ Ⅱ期内异症患者检测高倍稀释( 1∶1 0 0 )腹腔液CA12 5水平比检测血清CA12 5更敏感。结论 血清和腹腔液CA12 5值在术后随访、监测及估价手术方法的彻底性和有效性方面有重要价值 ;检测高倍稀释 ( 1∶1 0 0 )腹腔液CA12 5水平 ,可避免与对照组之间可能存在的血清CA12 5“交叉” ,及检测未稀释腹腔液标本时存在的“HOOK效应”。

Objective To evaluate the serum and peritoneal fluid levels of CA 125 before and after conservative operative laparoscopy of endometriosis. Methods The CA 125 level of serum and peritoneal fluid in 30 cases of endometriosis patients and in 10 controls were determined by immunoenzymatic assay.Results The CA 125 level determined was higher in emdometriosis group than in that in control group, which increased during progressed mild to severe, after conservative laparoscopic surgery, the CA 125 level decreased significantly. In R AFS Ⅰ Ⅱ stage patients, peritoneal fluid CA 125 was more sensitive than serum CA 125 . Conclusion The CA 125 level is of great value in postoperative surveillance during follow up, and evaluation of the effectiveness of surgery. Measurement of CA 125 level in highly diluted peritoneal fluid (1∶100), can avoid the possible “crossing phenomenon” of serum CA 125 in the treatment and control groups, and the “Hook Effect” in undiluted peritoneal fluid specimens. It is feasable to get the peritoneal fluid through postoperative culdocentesis. (Shanghai Med J, 2000,23∶166 168)