CA199、CA125和YKL40单项与联合检测在卵巢上皮性肿瘤临床诊断中价值比较

Study on the Clinical Single and Combined Detection Value of Three Tumor Markers YKL40,CA125 and CA199 in the Patients with Ovarian Epithelial Tumor

目的：探讨肿瘤标志物CA199、CA125和YKL40在卵巢上皮性肿瘤患者体内表达情况及其与疾病临床分期之间的关系。方法将2013年5月~2015年6月在本院收治的61例原发性卵巢癌患者纳入恶性肿瘤组,选取同期本院确诊为卵巢上皮性良性肿瘤患者60例纳入良性肿瘤组,对照组则选取本院妇科体检结果正常的妇女60例,采用免疫分析法测定三组血清CA199、CA125表达情况,采用免疫组织化学方法检测卵巢组织中YKL40表达情况。结果恶性肿瘤组患者CA199、CA125和YKL40阳性表达率显著高于良性肿瘤组和对照组,差异极显著性（P〈0.01）；良性肿瘤组显著高于对照组（P〈0.05）；不同肿瘤病理分期中,Ⅲ、Ⅳ期患者的CA199、CA125和YKL40阳性表达率显著高于Ⅰ、Ⅱ期患者（P〈0.05）；YKL40在不同类型卵巢上皮性肿瘤患者体内阳性表达率差异不显著（P〉0.05）,而CA199和CA125分别在黏液性和浆液性卵巢癌患者体内检出率较高（P〈0.05）。结论随着卵巢上皮性肿瘤恶性程度的升高 CA199、CA125和 YKL40阳性表达率逐渐上升,联合检测 CA199、CA125和YKL40能显著提高疾病临床诊断的准确率,从而为疾病的临床发生、发展以及预后提供重要的判断依据。

Objective To investigate the expression of CA199,CA125 and YKL40 in ovarian epithelial tumor and provide reliable parameters for the clinical diagnosis and prognosis of this disease. Methods 61 cases of primary ovarian cancer patients were enrolled into malignant tumor group,treated in our hospital during May 2013 to 2015 June. 60 cases of ovarian benign epithelial tumor patients and 60 cases of healthy women were enrolled into benign tumor group and control group,respectively. The expression of CA125 and CA199 in serum of three groups was determined by immune analysis. The expression of YKL40 in ovarian tissues was determined by immunohistochemistry. Results The positive expression rates of CA199,CA125 and YKL40 in malignant tumors group were significantly higher than that of benign tumor group and con-trol group,and the difference was very significant （P〈0. 01）. The positive expression rates of CA199 CA125 and YKL40 in benign tumor group was significantly higher than that of control group,the difference was significant （P〈0. 05）. In different pathological stages,the positive expression of inⅢandⅣperiod were significantly higher than that of I andⅡperiod. The positive expression rate of YKL40 in different types of ovarian epithelial tumor patients was not significantly different （ P〉0. 05）,and CA125 and CA199 were significantly higher in mucinous and serous ovarian cancer patients （P〈0. 05）,re-spectively. Conclusion The positive expression rate of CA199,CA125 and YKL40 increased with the changing of ovari-an epithelial tumor malignant degree,combined detection of CA199,CA125 and YKL40 can significantly improve the accu-racy of clinical diagnosis,so as to provide an important basis for the clinical development and clinical diagnosis of ovarian epithelial tumor.