CA125单项与多项肿瘤指标联合检测在卵巢癌诊断中的比较

The Comparison of CA125 Alone and Multiterm Tumor Index Combined Detection in the Diagnosis of Ovarian Cancer

目的：探讨血清糖类抗原125（CA125）及CA125联合CA199、CA153、癌胚抗原（CEA）检测在卵巢癌诊断中的意义。方法：采用化学发光微粒子免疫检测法测定71例卵巢癌患者、10例卵巢交界性肿瘤患者和42例卵巢良性肿瘤患者血清中CA125、CA199、CA153和CEA的含量,阳性诊断标准分别为：CA125〉35 k U/L,CA199〉37 k U/L,CA153〉30 k U/L,CEA〉5μg/L。结果：在单项肿瘤标记物中,CA125的阳性率最高（84.5%）,敏感度、特异度和准确度指标平稳。在不同的联合检测方案中CA199、CA153与CA125联合检测方案最优,较CA125单项检测敏感度和准确度均有提高。晚期卵巢癌（Ⅲ～Ⅳ期）患者的CA153、CA125含量高于早期卵巢癌（Ⅰ～Ⅱ期）患者（P〈0.001）。结论：CA199、CA153、CEA与CA125在卵巢癌鉴别诊断中均有一定价值,并可以根据CA153、CA125含量判断患者卵巢癌的分期,CA199、CA153与CA125联合检测是诊断卵巢癌较为理想的标记物组合。

Objective：To evaluate the clinical value of serum CA125 and CA125 combined with CA199, CA153, CEA detections in the diagnosis of ovarian cancer. Methods： Chemiluminescent microparticle immunoassay was used to detect the serum levels of CA125, CA199, CA153 and CEA in 71 patients with ovarian cancer, 10 patients with borderline ovarian tumors and 42 patients with benign ovarian tumors. Positive diagnostic criteria of the four tumor marker： CA199〉 37 k U/L, CA153〉30k U/L, CEA 〉5 μg/L, CA125〉 35 k U/L. Results： The positive rate（84.5%） of CA125 was highest among that of four tumor markers. The sensitivity, specificity and accuracy of CA125 were smooth. The combined detection of CA199, CA153, CA125 was optimal in the four different combinations. Compared with CA125 alone, the sensitivity and accuracy of combined detection of CA199, CA153, CA125 were significantly increased. The levels of CA153 and CA125 for ovarian cancer patients in stage Ⅲ-Ⅳwere obviously higher than those in stage Ⅰ-Ⅱ（P〈0.001）. Conclusions： CA199, CA153, CEA and CA125 have some value in the differential diagnosis of ovarian cancer. And we can determine the stage of ovarian cancer patients according to CA153,CA125 content. The combined detection of CA199, CA153 and CA125 is an ideal marker on diagnosis of ovarian cancer.