摘要
目的探讨血清糖类抗原(carbohydrate antigen,CA)125、CA19-9对卵巢交界性肿瘤(borderline ovarian tumor,BOT)及上皮性卵巢癌(epithelial ovarian cancer,EOC)的诊断价值。方法以术后组织病理为金标准,180例卵巢上皮性肿瘤患者中60例BOT者为BOT组,120例EOC者为EOC组。比较2组患者血清CA125、CA19-9水平与其临床病理特征。结果 EOC组血清CA125水平(361.75u/mL)高于BOT组(17.61u/mL)(P〈0.01),EOC组和BOT组血清CA19-9水平(10.20、10.26u/mL)比较差异无统计学意义(P〉0.05);CA125、CA19-9鉴别BOT、EOC的AUC分别是0.850(95%CI:0.794~0.907,P=0.000)、0.448(95%CI:0.363~0.533,P=0.078),当CA125的cut-off值为51.21u/mL时,其敏感性、特异度、阳性预测值、阴性预测值、阳性似然比、阴性似然比分别为80%、80%、88.9%、66.7%、4.00、0.25,CA125鉴别BOT、EOC的准确性为80%;浆液性EOC、浆液性肿瘤(包括BOT、EOC)的CA125阳性率(88.2%、73.0%)高于CA19-9(18.6%、17.7%)(P〈0.05);浆液性肿瘤的CA125阳性率(73.0%)高于黏液性肿瘤(30.8%),黏液性肿瘤的CA19-9阳性率(34.6%)高于浆液性肿瘤(17.7%)(P〈0.05)。结论当CA125〉51.21u/mL,对EOC和BOT的鉴别诊断有重要价值,而CA19-9对其鉴别无意义。
Objective To explore the value of the detection of carbohydrate antigen(CA)125 and CA19-9 to the differential diagnosis of borderline ovarian tumor(BOT)and epithelial ovarian cancer(EOC).Methods Regarding the postoperative pathology results as the gold standard,180 patients with epithelial ovarian tumors were divided into BOT group(n=60)and EOC group(n=120),and the levels of serum CA125 and CA19-9and the clinicopathological features were analyzed and compared between two groups.Results The serum CA125 level was significantly higher in EOC group((361.75)u/mL)than that in BOT group((17.61)u/mL)(P〈0.05),and there was no significant difference in the CA19-9level between two groups(10.20,10.26u/mL)(P〉0.05).The AUC values of CA125 and CA19-9for BOT and EOC were 0.850(95% CI:0.794 to 0.907,P=0.000)and 0.448(95% CI:0.363 to 0.533,P=0.078).When the cut-off value of CA125 was 51.21u/mL,the sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio and negative likelihood ratio were 80%,80%,88.9%,66.7%,4 and 0.25.The accuracy of CA125 for BOT and EOC was 80%.The positive rates of CA125(88.2%,73.0%)were significantly higher than those of CA19-9(18.6%,17.7%)in serous EOC and serous tumors(including BOT,EOC)(P〈0.05).The positive rate of CA125 in serous tumors(73.0%)was significantly higher than that of mucinous tumors(30.8%)(P〈0.05),and the positive rate of CA19-9 in mucinous tumors(34.6%)was significantly higher than that in serous tumors(17.7%)(P〈0.05).Conclusion CA125〉51.21u/mL has an important value to the differential diagnosis of EOC and BOT,and CA19-9 has no value.
出处
《中华实用诊断与治疗杂志》
2016年第4期372-374,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
河南省医学科技公关计划(201301007)
关键词
卵巢交界性肿瘤
上皮性卵巢癌
CA125
CA19-9
敏感性
特异度
Borderline ovarian tumor
epithelial ovarian cancer
carbohydrate antigen 125
carbohydrate antigen 19-9
sensitivity
specificity