血清肿瘤标志物检测联合超声检查对卵巢成熟型畸胎瘤诊断的意义

The significance of serum tumor markers combine with the ultrasound in mature cystic teratoma of ovary

目的探讨血清肿瘤标志物检测联合超声检查在卵巢成熟型畸胎瘤诊断中的临床意义。方法选取我院卵巢成熟型畸胎瘤手术患者422例。分析血清CA199、CA125、CA724、CEA、AFP在该患者中的表达以及超声诊断的符合率。结果 (1)422例成熟型畸胎瘤患者中,测定CA199者230例,118例>27U/ml,阳性率为51.30%(118/230)。测定CA125者364例,79例>35U/ml,除外56例伴有明确可以引起CA125升高疾病(如早孕、子宫内膜异位症、卵巢囊肿蒂扭转、急性盆腔炎等)的患者,阳性率6.32%(23/364)。测定CA724者63例,2例>6.9U/ml,阳性率3.17%(2/63)。测定CEA者159例及AFP者142例,所有检测数值均在正常范围。(2)所有患者均行超声检查,其中有323例术前诊断且术后证实卵巢成熟型畸胎瘤,符合率76.54%(323/422)。(3)CA199阳性组畸胎瘤平均直径为(7.92±2.19)cm,大于阴性组[(4.86±1.65)cm],差异有统计学意义(P=0.023),双侧畸胎瘤CA199阳性率大于单侧CA199阳性率,差异有统计学意义(P=0.003)。结论卵巢成熟型畸胎瘤的直径越大,CA199阳性率越高;双侧肿瘤的阳性率明显高于单侧。推测CA199在卵巢成熟型畸胎瘤的诊断中具有一定的临床意义,结合超声检查可以提高其术前诊断的准确性。

Objective To evaluate the eliniettl significance of serum tumor markers combine with the ultrasound checking in ovarian teratoma. Methods 422 patients with cystic teratoma of ovary diagnosed by postoperative were selected whose tumor markers including CA199, CA125, CA724, CEA, AFP and the ultrasound checking were studied. Results 230 patients were tested for serum CA199 and 118 patients had the levels above 27 U/ml with the positive rate of 51.30%. 364 patients were tested for serum CA125 and 79 patients had elevated CA125 levels（ 〉 35 U/ml）. Excluded the 56 patients who suffered from other diseases which could cause increased CA125 levels （for example early pregnancy, endometriosis, torsion of the pedicle of ovarian cyst, acute pelvic inflammatory disease and so on ）, the positive rate was 6. 32%. 63 patients were tested for CA724 only two was abnormal and the positive rate was 3.17%. 159 patients were detected CEA and 142 patients were detected AFP and no abnormal were found. All patients underwent the ultrasound cheek and 323 teratoma patients were diagnosed before operation and were proved after operation pathological diagnosis with the positive rate of 76. 54%. The mean diameter of the CA199 positive group was（7. 92 ±2. 19）cm,which was bigger than that of the negative group（4. 86 ± 1.65） cm（P = 0. 023 ）. The positive rate of the CA199 both sides was much higher than that of single side （ P = 0. 003 ）. Conclusions The bigger of the diameter of the mature cystic teratoma, the higher of the positive rate of the CA199. The positive rate of the CA199 was higher when teratomas was both sides. Combined with the ultrasound checking, CA199 may have clinical significance in the diagnosis of mature ovarian teratoma and improve the accuracy of preoperative diagnosis.