肿瘤标记物联合检测对CA125阴性卵巢癌预后判断的价值

Combined Detection of Tumor Markers in the Prognosis of CA125 Negative Epithelium Ovarian Cancer

目的探讨肿瘤标记物联合检测对CA125阴性上皮性卵巢癌预后判断的价值。方法采用放射免疫法,检测68例CA125阴性卵巢癌患者中血清CA125、CA199、CA724、AFP、HCG-β、TAM含量,采用酶联免疫法,检测血清CEA水平。免疫组织化学法检测肿瘤组织中CA125表达水平。结果在CA125免疫组织化学CA125阴性卵巢癌中,Ⅱ型(P=0.04)及Ⅲ-Ⅳ期(P<0.01)患者比例降低。复发病例中,CA125敏感性为66.7%(12/18),曲线下面积为0.81。CA199、CEA联合检测能够提高CA125对肿瘤复发的预测效率。联合检测CA724、AFP、β-HCG、TAM不能提高预测价值。结论血清CA125阴性卵巢上皮癌的随访,应结合CA125免疫组织化学结果,免疫组织化学CA125阳性患者可联合检测CA125、CA199、CEA等肿瘤标记物。

Objective To explore the effect of combined detection of tumor markers in prognosis of CA 125 negative epi-thelial ovarian cancer(EOC).Methods The CA125,CA199,CA724,AFP,HCG-β,TAM level in serum of 68 cased of CA125 negative EOC patients were detected by radioimmunoassay ,and CEA level was detected by enzyme linked immunosorbent assay . Expression level of CA125 in tumor tissues were detected by immunohistochemical method .Results The proportion of type Ⅱand FIGOⅢ-Ⅳstage EOC was lower in CA125 negative EOC(P=0.04 and P<0.01,respectively).The CA125 sensitivity was 66.7%(12/18)in patients with persistent and recurrent EOC ,and AUC was 0.82.CA199 and CEA can increase diagnostic effi-ciency of CA125 in tumor relapse,but CA724,AFP,HCG-β,TAM assay can not increase diagnostic efficiency of CA 125 in tumor relapse .Conclusion Follow-up study of serum CA125 negative ovarian epithelial carcinoma should be combined with CA 125 im-munohistochemical results.Immunohistochemical joint detection of CA125 positive patients can detect CA125,CA199,CEA and other tumor markers .