卵巢癌患者测定血脂和血浆CA125水平对辅助诊断和鉴别诊断的临床价值

Clinical Value of Determing Blood Lipid and Plasma CA125 Levels in Assistant and Differential Diagnosis in the Patients with Ovarian Cancer

目的:探讨卵巢癌患者测定血脂和血浆CA125水平对辅助诊断和鉴别诊断的临床研究。方法:化学法和放射免疫分析测定了136例卵巢癌患者(其中48例Ⅰ期、52例Ⅱ期和36例Ⅲ～Ⅳ期)、41例卵巢巧克力囊肿和54例子宫内膜异位症患者治疗前后的血脂(TC、TG、HDL-C和LDL-C)和CA125水平,并与60例正常对照组(女性)进行了比较分析。结果:136例卵巢癌患者治疗前血脂TC和HDL-C水平随恶性程度的增加而逐渐降低。从48例Ⅰ期卵巢癌较之正常对照组稍降低至36例Ⅲ～Ⅳ期卵巢癌明显降低(P>0.05～P<0.01)。治疗后除36例Ⅲ～Ⅳ期卵巢癌仍降低外(P<0.05),其他各组均恢复正常。41例卵巢巧克力囊肿和54例子宫内膜异位症患者治疗前血脂水平基本正常或增高(P均>0.05,个别P<0.05),治疗后均恢复正常(P均>0.05)。136例卵巢癌患者治疗前血浆CA125水平随恶性程度的增加而逐渐增高,从48例Ⅰ期卵巢癌较之正常对照组稍增高至36例Ⅲ～Ⅳ期卵巢癌显著增高(P>0.05～P<0.01),并较之41例卵巢巧克力囊肿和54例子宫内膜异位症明显增高(P均<0.01);治疗后除36例Ⅲ～Ⅳ期卵巢癌患者血浆CA125水平仍增高外(P<0.05),其他各组均恢复正常。结论:卵巢癌患者较卵巢和子宫良性疾病患者血脂TC和HDL-C水平明显降低和血浆CA125水平明显增高,因而是卵巢癌辅助诊断和鉴别诊断的一种有效指标,并具有监察疗效的临床价值。

Objective To explore clinical study of determing blood lipid and plasma CA125 levels in assistant and differential diagnosis in the patients with ovarian cancer. Methods Blood lipid and plasma CA1251evels（with RIA and biochemistry respectively） were determined in 136 patients with ovarian cancer（including I stage 48 cases, II stage 52 cases and III - IV stage 36 cases） ,in 41 patients with ovarian chocolate cyst and in 54 patients with endometriosis in the before and after therapy and to make a comparative then. Results Blood lipid TC and HDL-C levels in 136 patients with ovarian cancer were lowered gradually with degree of malignancies. In 48 I stage patients with ovarian cancer a little lower（P 〉0.05） ,but in 36 III- IV stage patients with ovarian cancer were significantly lower than those in 60 controls（P 〈0.01 ）. After therapy,in 36 III - IV stage patients with ovarian cancer still increased （P 〈0.05）, other groups were recovery normal levels（P all 〉0.05）. Blood lipid levels in 41 paients with ovary chocolate cyst and in 54 patients with endometriosis were normal or a little increased before therapy,and were recovery normal levels after therapy（P all 〉 0. 05 ）. Plasma CA125 levels in pretreatment 136 patients with ovarian cancer were elevated gradually with enforce the degree of severity. In 48 I stage patients with ovarian cancer showed a little increased（P 〉0.05） ,but in 36 III-IV stage patients with ovarian cancer were markedly higher than those in 60 controls（P 〈0.01）. Plasma CA125 levels in 136 patients with ovarian cancer in 41 patients with ovary chocolate cyst and in 54 patients with endometriosis （P all 〈 0.01 ）. After therapy, in 36 III-IV stage patients with ovary cancer still increased （P 〈 0.05）, other groups were recovered to normal levels （P all 〉 0.05 ）. Conclusion Blood lipid TC and HDL- C levels in patients with ovarian cancer were significantly lower and CA125 levels were significantly higher than those in uterus benign diseases, so this is a useful index for assistant and differential diagnosis for ovarian cancer at early stage and also passess with clinical value monitoring therapeutic effects.