血清CA125和CEA用于卵巢囊肿鉴别诊断中的价值分析

Evaluation of serum CA125 and CEA for differential diagnosis of ovarian cysts

目的探究血清糖类抗原(CA125)和癌胚抗原(CEA)用于卵巢囊肿鉴别诊断中的临床价值。方法选取2012年8月至2014年12月山东省烟台市北海医院妇产科收治的60例卵巢癌患者设为恶性组,同期收治的60例良性卵巢囊肿患者设为良性组,并选取同期体检的79例健康体检者作为对照组,所有患者均经病理诊断确诊,在所有受检者知情同意的情况下进行血清CA125和CEA的检测对比,分析阳性表达率与卵巢囊肿恶性程度的相关性。结果 CA125水平对比显示,恶性组显著高于良性组和对照组,差异具有统计学意义(t值分别为25.419、27.858,均P<0.05),良性组显著高于对照组(t=4.677,P<0.05);CEA水平对比显示,恶性组同样显著高于良性组和对照组,差异具有统计学意义(t值分别为14.306、13.715,均P<0.05)。恶性组患者的CA125、CEA水平均显著高于其他两组,差异具有统计学意义(t值分别为25.419、27.858、14.306、13.715,均P<0.05),良性组与对照组相比无显著差异(t=1.709,P>0.05)。CA125阳性率恶性组显著高于良性组和对照组(χ2值分别为17.319、19.847,均P<0.05),良性组与对照组相比无显著差异(χ2=2.007,P>0.05);CEA阳性率恶性组显著高于良性组和对照组(χ2值分别为8.665、9.404,均P<0.05),良性组与对照组相比无显著差异(χ2=0.756,P>0.05);联合检出率恶性组显著高于良性组和对照组(χ2值分别为20.858、22.716,均P<0.05),良性组显著高于对照组(χ2=2.437,P<0.05)。从检出率对比来看,恶性组联合检出率显著高于CA125和CEA的单项阳性率(χ2值分别为3.906、,8.055,均P<0.05),良性组联合检出率与CA125和CEA的单项阳性率对比无显著差异(χ2值分别为0.413,1.796,均P>0.05)。结论血清CA125和CEA能够对卵巢囊肿的良恶性作出鉴别诊断,联合检测能够为早期卵巢癌的诊断提供可靠依据,值得临床应用和推广。

Objective To explore the clinical value of serum CA125 and CEA in differential diagnosis of ovarian cysts. Methods Sixty cases of ovarian cancer admitted in department of gynecology and obstetrics in Shandong Province Yantai City Beihai Hospital were selected in malignant group,who were chosen during the period of August 2012 to December 2014. At the same period 60 patients with benign ovarian cyst were selected in benign group,and another 79 healthy cases were selected in control group. All patients were confirmed pathologically. In the case of informed consent of all subjects,serum CA125 and CEA were detected to analyze the correlation between positive expression rate and malignant degree of ovarian cysts. Results Detection results displayed that CA125 level in the malignant group was significantly higher than in the benign group and the control group,and the difference was statistically significant（ t value was 25. 419 and 27. 858,respectively,both P〈0. 05）,and that in the benign group was significantly higher than in the control group（ t = 4. 677,P〈0. 05）. CEA level comparison showed that the level in the malignant group was significantly higher than in the benign group and the control group,and the difference was statistically significant（ t value was 14. 306 and 13. 715,respectively,both P〈0. 05）. CA125 and CEA levels in the malignant group were significantly higher than in the other two groups,and the differences were significant（ t value was25. 419,27. 858,14. 306 and 13. 715,respectively,all P〈0. 05）,but the benign group was not remarkably different from the control group（ t = 1. 709,P〉0. 05）. CA125 positive rate of the malignant group was significantly higher than in the benign group and the control group（ χ2value was 17. 319 and 19. 847,respectively,both P〈0. 05）,but the difference between benign group and control group was not significant（ χ2= 2. 007,P〉0. 05）. CEA positive rate of the malignant group was significantly higher than in the benign group and the control group（ χ2value was 8. 665 and 9. 404,respectively,both P〈0. 05）,but no significant difference was found between the benign group and the control group（ χ2= 0. 756,P〉0. 05）. Joint detection rate was significantly higher in the malignant group than in the benign group and the control group（ χ2value was 20. 858 and 22. 716,respectively,both P〈0. 05）,and that was significantly higher in the benign group than in the control group（ χ2= 2. 437,P〈0. 05）. Seen from the detection rate,joint detection of malignant group was significantly higher than single positive rate of CA125 and CEA（ χ2value was 3. 906 and 8. 055,respectively,both P〈0. 05）,and benign joint detection rate was not remarkably different from single CA125 and CEA positive rate（ χ2value was 0. 413 and 1. 796,respectively,both P〉0. 05）. Conclusion Serum CA125 and CEA can make a differential diagnosis of benign and malignant ovarian cysts,and joint detection can provide a reliable basis for early diagnosis of ovarian cancer. It is worthy of clinical application and promotion.