D-D和CA125联检在卵巢癌鉴别诊断中的价值

Assessment of D-Dimer Combined Detection with CA125 in Differential Diagnosis of Ovarian Cancer

目的:通过测定分析卵巢癌与卵巢良性肿瘤患者的血浆D-二聚体(D-D)水平和血清CA125,旨在探讨联合使用D-D和CA125检测在卵巢癌鉴别诊断中的价值。方法:测定84例卵巢癌患者与83例卵巢良性肿瘤患者的血浆D-D水平和血清CA125。结果:卵巢癌患者D-D测定结果为(1284±142)μg/L,卵巢良性肿瘤D-D测定结果为(406±56)μg/L,两组测定结果差异有统计学意义(P<0.01)。卵巢癌患者CA125测定结果高于卵巢良性肿瘤(不包括浆液性囊腺瘤)(P<0.01);设定CA125≤35 U/ml作为截止值时,其对卵巢癌的诊断灵敏度为45%,特异性为73%。联用D-D和CA125作为诊断指标时,卵巢癌的诊断灵敏度为65%,特异性达82%;D-D比值+CA125比值对卵巢癌的阴性预测值为0.98。结论:卵巢癌患者的血浆D-D水平和血清CA125水平明显高于卵巢良性肿瘤,联用D-D和CA125检测可提高卵巢癌的诊断灵敏度和特异性,降低误诊率。

Objective To study the variation of D-Dimer and CA125 in patients of ovarian cancer and benign ovarian tumors,and to explore its value in the differential diagnosis of ovarian malignancies.Methods The plasma D-Dimer in 84 patients of ovarian cancer and 83 patients of benign ovarian tumors were detected by SYSMEX CA7000,and the serum CA125 in patients from the above two groups were detected by Elecsys 2010.Results The level of plasma D-Dimer was（1284 ± 142） μg / L and（406 ± 56） μg / L in patients of ovarian cancer and of benign ovarian tumors respectively,the results of the two groups had statistical significance（P 0.01）.The CA125 level in patients of ovarian cancer showed obviously higher than that of benign ones（serous cystadenoma not included）（P 0.01）.Taken 35 U / ml as the cut-off value of CA125,the sensitivity was 45% and the specificity was 73% in the diagnosis of ovarian cancer.While combined D-Dimer and CA125,the sensitivity was 65% and the specificity was up to 82%.The negative predictive value for ovarian cancer,got from D-Dimer ratio plus CA125 ratio,was 0.98.Conclusion The D-Dimer and CA125 levels in patients of ovarian cancer were significantly higher than that of benign ovarian tumors.The use of D-Dimer combined detection with CA125 can improve the sensitivity and specificity in diagnosis of ovarian cancer,thus lower the rate of misdiagnosis.