超声联合肿瘤标志物检测诊断胎儿骶尾部畸胎瘤良恶性的鉴别价值

THE DIFFERENTIAL VALUE OF ANTENATAL ULTRASOUND AND TUMOR MARKER CHECK IN DIAGNOSING THE FETAL SACROCOCCYGEAL TERATOMA AND ITS MALIGNANCY

目的评价彩色多普勒超声联合血清肿瘤标志物诊断胎儿骶尾部畸胎瘤的临床价值，为胎儿骶尾部畸胎瘤良恶性的鉴别诊断提供依据。方法回顾性分析2007年1月-2012年1月在广州市妇女儿童医疗中心就诊32例骶尾部畸胎瘤胎儿，所有患儿产后手术病理确诊为畸胎瘤，其中成熟性畸胎瘤19例，未成熟畸胎瘤13例，收集其孕6月时超声检查资料及母体血清癌胚抗原（Carcinoembryonic Antigen，CEA）、糖链抗原125（Carbohydrate Antigen125，CA125）、糖链抗原153（Ccarbohydrate Antigen153，CA153）、糖链抗原（Carbohydrate Antigen199，CA199）的水平。两组对比研究。结果32例胎儿骶尾部畸胎瘤均能在产前超声检查中得到发现和诊断。未成熟畸胎瘤患者血清中CEA、CA-125、CA15—3的浓度明显高于成熟性畸胎瘤组，而CA19—9的浓度比较无明显差异。结论产前彩色多普勒超声可作为诊断胎儿骶尾部畸胎瘤的主要方法，而血清肿瘤标志物检查有助于良恶性的鉴别。

Objective To evaluate the differential value of antenatal ultrasound and tumor marker check in diagno-sing the fetal sacrococcygeal teratoma and its malignancy to afford a basis of differential diagnosis. Methods Retrospectively review the images of color Doppler ultrasonography and Tumor Markers data（ CEA ; CA125 ; Cal53 ; CA199 ） in 32 cases fetal sa- crococcygeal teratoma from Jan. 2007 to Jan. 2012 in Guangzhou Women and Children＇s Medical Center, all confirmed by postpartum operation pathology. Among whom 19 fetus with mature cystic teratoma, 13 cases with immature teratoma. Collect their data of uhrasonography in 6 month pregnancy, and maternity＇s CEA, CA125, CA153, CA199 levels, carry out contrast study between the two groups. Results Ultrasound diagnostic accuracy was 100% , the serum levels of CEA, CA - 125, CA153 were significantly higher than the normal group. Conclusion Prenatal uhrasonography and Tumor Markers are useful tools in diagnosis of fetal teratoma and differential its malignancy.