糖类抗原125在子宫浆液性癌诊断和预测中的价值

Value of serum carbohydrate antigen 125 in the diagnosis and prediction of uterine serous carcinoma

目的探讨血清肿瘤标志物糖类抗原125(CA125)水平与子宫浆液性癌患者的临床病理因素和预后的关系。方法收集经术后病理活组织检查确诊的66例子宫浆液性癌患者临床资料,记录其术前CA125检查结果,分析子宫浆液性癌患者术前CA125阳性与临床病理因素间的关系及其对预后的影响。结果病理分期为Ⅰ~Ⅱ期和Ⅲ~Ⅳ期子宫浆液性癌患者的术前血清CA125阳性率分别为22%(8/37)和72%(21/29)。Ⅲ~Ⅳ期子宫浆液性癌患者的血清CA125阳性率高于Ⅰ~Ⅱ期者(P<0.001)。有深肌层浸润、附件转移、淋巴结转移患者的术前血清CA125阳性率分别高于无或浅肌层浸润、无附件转移、无淋巴结转移患者(P均<0.05)。术前血清CA125阳性与淋巴血管间隙受累无关(P>0.05)。将病理分期、深肌层浸润、附件转移、淋巴结转移与血清CA125阳性率进行多因素分析,显示病理分期Ⅲ~Ⅳ期是CA125阳性的危险因素(OR=14.476,P=0.001)。术前血清CA125阳性和阴性的子宫浆液性癌患者间的无进展生存率和总体生存率比较差异均无统计学意义(P均>0.05)。结论子宫浆液性癌患者的术前血清CA125水平有助于预测其病理分期。

Objective To investigate the relationship between of preoperative serum level of carbohydrate antigen 125 （CA125） and clinicopathological factors and prognosis of patients diagnosed with uterine serous carcinoma（USC ） . Methods Clinical data of 66 patients diagnosed with USC by postoperative pathological biopsy were collected. The results of preoperative CA125 test were recorded to analyze the relationship between preoperative positive rate of serum CA125 and clinicopathological factors and its effect on clinical prognosis of USC patients. Results The preoperative positive rates of serum CA125 in USC patients who were pathologically graded as stage Ⅰ to Ⅱ and Ⅲ to Ⅳ were 22% （8/37） and 72% （21/29 ） . The positive rate of serum CA125 in patients with stage Ⅲ-Ⅳ USC was significantly higher than that in the stage Ⅰ-Ⅱ counterparts （ P 〈0.001 ） . The preoperative positive rates of serum CA125 in patients with deep muscular layer infiltration, adnexal metastasis and lymph node metastasis were considerably higher compared with the data in those without these signs （all P 〈0.05 ） . Preoperative positive serum CA125 was not associated with lymphatic vessel involvement （ P 〉0.05 ） . Multivariate analysis of pathological staging, deep muscular infiltration, adnexal metastasis, lymph node metastasis, and positive rate of serum CA125 revealed that Ⅲ-Ⅳ pathological stage was a risk factor for positive serum CA125 （ OR=14.476, P =0.001 ） . There was no significant difference in the progression-free survival and overall survival rates between USC patients with positive and negative preoperative serum CA125 （all P 〉0.05 ） . Conclusion Preoperative serum CA125 level contributes to predicting the pathological staging of patients diagnosed with USC.