血清CA125和CA199与子宫内膜异位症患者术后妊娠率关系研究

Relationship between serum CA125,CA199 and postoperative fertility rate in patients with endometriosis

目的探讨术前血清CA125和CA199水平与子宫内膜异位症合并不孕患者术后妊娠率的关系。方法随访汕头市中心医院2012年1月至2015年6月138例手术治疗的子宫内膜异位症患者,分析术前血清CA125、CA199水平与内异症的严重程度、术后自然妊娠率的关系,以及内异症的严重程度与患者术后自然妊娠率的关系。结果术前血清CA125、CA199水平与子宫内膜异位症的严重程度显著相关（P=0.001,P=0.018）;术后自然妊娠组的CA125、CA199水平低于未妊娠组（CA125的中位数两组分别为49.00 kU/L,53.38 k U/L;CA199的中位数两组分别为15.11 kU/L,23.48 kU/L）,但其差异无统计学意义（P值分别为0.770、0.407）。对于不同程度的内异症（Ⅰ～Ⅱ期,Ⅲ～Ⅳ期）,术后的自然妊娠率差异无统计学意义（61.5%,65.0%）。结论术前CA125、CA199水平对预测术后自然妊娠率无重要价值,Ⅲ～Ⅳ期患者术后妊娠率与Ⅰ～Ⅱ期类似,故皆可考虑先期待自然妊娠。

Objective To investigate the relationship between the concentrations of CA125,CA199 in preoperative serum and the postoperative pregnancy rate in patients with endometriosis-associated inferitility.Methods We retrospectively analyzed 138 eligible patients collected between January 2012 and June 2015,who were diagnosed with endometriosis and underwent surgery.We analyzed the relationship between the concentrations of CA125,CA199 in preoperative serum and r-AFS staging,postoperative pregnancy rate,and the relationship between r-AFS staging and spontaneous pregnancy rate.Results The concentrations of CA125,CA199 in preoperative serum was significantly associated with r-AFS staging（P=0.001,0.018 respectively）.The concentrations of CA125,CA199 in spontaneous-pregnancy group were lower in inferitility group（median concentrations of CA125 in two groups were 49.00 and 53.38,respectively,CA199 in two groups were 15.11 and 23.48,respectively）,but the differences were insignificant（P=0.770,P=0.407,respectively）.Different r-AFS staging（Ⅰ-Ⅱ/Ⅲ-Ⅳ stage）had no correlation with spontaneous pregnancy rate（61.5%,65.0%）.Conclusion Preoperative concentrations of CA125,CA199 do not have a significant predictive value in postoperative spontaneous-pregnancy rate.Patients with Ⅲ-Ⅳ stage endometriosis-associated inferitility have similar postoperative pregnancy rate to those withⅠ-Ⅱ stage.In this case,patients with endometriosis-associated inferitility might be expected to have spontaneous pregnancy after operation,in spite of different stage.