血清CA125、P、β-hCG和E_2在早期预测异位妊娠中的价值

Value of serum CA125,P,β-hCG and E_2 in predicting ectopic pregnancy

目的通过监测血清糖类抗原125(CA125)、孕酮(P)、人绒毛膜促性腺激素(β-hCG)和雌二醇(E_2)的水平,探讨如何早期诊断异位妊娠。方法选取自2011年6月至2013年5月在衢化医院治疗的有异位妊娠症状的妇女40例为研究组、同期正常宫内妊娠妇女25例为对照组,运用酶联免疫法测定各组血清中的CA125、P、β-hCG和E_2水平。结果血清中CA125、P,β-hCG和E_2值在研究组中分别为:15.60±1.025IU/mL、19.98±1.997nmol/mL、61.36±2.096mIU/mL、21.12±1.508pg/mL;而在对照组中分别为46.36±3.538IU/mL、93.40±5.809nmol/mL、127.94±9.944mIU/mL、85.82±5.216pg/mL,两组各指标比较均具有显著性差异(t值分别为13.223、4.835、3.762、5.499,均P<0.01)。若将CA125诊断异位妊娠的切割点定义为20.37IU/mL,则诊断异位妊娠的特异性和敏感性分别为96%与85%,阳性预测值与阴性预测值分别为85%、73%;若将P诊断异位妊娠的切割点定义为55.63nmol/mL,则诊断异位妊娠的特异性和敏感性分别为100%与88%,阳性预测值与阴性预测值分别为100%、83%。结论血清CA125、P可以作为预测或早期诊断异位妊娠临床较敏感的指标。

Objective To investigate how to diagnose ectopic pregnancy early by monitoring the serum levels of CA125, progesterone （P） , β-hCG and estradiol （E2）. Methods Serum levels of CA125, P, β-hCG and E2 were measured by enzyme-linked immunosorbent assay （ELISA） in 40 women with ectopic pregnancy and 25 women with normal intrauterine pregnancy in Zhejiang Qubua Hospital between June 2011 and May 2013. Results The serum levels of CA125, P, β-hCG and E2 in study group were 15.60 ± 1. 025IU/mL, 19.98± 1. 997 nmol/mL, 61.36 ± 2. 096mlU/mL and 21.12 ± 1. 508pg/mL, respectively, and they were 46.36 ± 3. 538IU/mL, 93.40 ± 5. 809nmo]/ mL, 127.94 ~ 9. 944mIU/mL and 85.82 ± 5. 216pg/mL, respectively in control group. There were significant differences between two groups （ t value was 13. 223,4. 835, 3. 762 and 5. 499, respectively, all P 〈 0.01 ）. When using CA125 concentration of 20.37IU/mL as cut-off value for diagnosis or prediction of ectopic pregnancy, the specificity was 96% and the sensitivity was 85%, and the positive and negative predictive value was 85% and 73% , respectively. When using progesterone concentration of 55.63nmol/ml as cut-off value for diagnosis of ectopic pregnancy, the sensitivity was 88% and the specificity was 100% , and the positive and negative predictive value was 100% and 83% , respectively. Conclusion The serum levels of CA125 and P can be taken as sensitive indexes to predict and diagnose ectopic pregnancy.