CAJ | 학술논문

目的探讨血清肿瘤抗原125（CA125）、肿瘤抗原199（CA199）、甲胎蛋白（AFP）及癌胚抗原（ CEA）水平对卵巢巧克力囊肿临床的诊断、治疗的价值。方法回顾性的分析和比较经手术确诊的卵巢巧克力囊肿疾病患者183例（患病组）、卵巢恶性肿瘤患者60例（病例对照组）以及进行健康体检的正常育龄妇女60例（正常对照组）血液中4种肿瘤标记物检测结果，并分析4种指标高低与疾病预后的关系。结果对照组血清CA125、CA199、AFP及 CEA 检测值的中位数和阳性率分别为22.55 U/ml、5.2％，19.40 U/ml、11.1％，1.40 ng/ml、0、0.78 ng/ml、0。卵巢巧克力囊肿组血清CA125、CA199、AFP及CEA检测值的中位数及阳性率分别为37.95 U/ml、23.03％，29.67 U/ml、42.41％，1.95 ng/ml、2.14％，0.56 ng/ml、0。轻度（Ⅰ～Ⅱ期）患者血清 CA125、CA199、AFP 及 CEA 中位数和阳性率分别为25.25 U/ml、0，20.16 U/ml、23.53％，1.50 U/ml、0和0.58 U/ml、0；中重度（Ⅲ～Ⅳ期）卵巢巧克力囊肿患者血清CA125、CA199、AFP及CEA中位数和阳性率分别为41.55 U/ml、25.31％，31.29 U/ml、44.68％和2.05 U/ml、2.42％，0.56 U/ml、0。卵巢恶性肿瘤CA125、CA199、AFP 及 CEA 检测值的中位数和阳性率分别为188.4 U/ml、81.70％，150.75 U/ml、51.67％，6.9 ng/ml、26.67％，4.40 ng/ml、16.7％。卵巢巧克力囊肿患者血清CA125、CA199和AFP的灵敏度、特异度及正确度分别为23.30％、95％及41.18％，42.41％、90％及55.50％，2.19％、100％及31.5％。卵巢巧克力囊肿患者血清CA125、CA199浓度和阳性率明显高于对照组，差异有统计学意义（均P＜0.05），AFP的浓度与对照组相比，差异有统计学意义（ P＜0.05），但是阳性率比较差异无统计学意义（ P＞0.05）。 CEA差异无统计学意义（ P＞0.05）。卵巢巧克力囊肿患者血清CA125、CA199、CEA及AFP水平和阳性率血清明显低于恶性卵巢肿瘤组，差异有统计学意义（ P＜0.05）。结论测定血清CA125、CA199水平可协助卵巢巧克力囊肿的诊断、病情判断和指导治疗，二者联合测定可提高疾病诊断敏感性。同时AFP及CEA虽然对于协助卵巢巧克力囊肿的诊断无意义，但是对于鉴别诊断有明显意义。而且CA125和CA199水平是影响卵巢巧克力囊肿预后的因素之一。目的探討血清腫瘤抗原125（CA125）、腫瘤抗原199（CA199）、甲胎蛋白（AFP）及癌胚抗原（ CEA）水平對卵巢巧剋力囊腫臨床的診斷、治療的價值。方法迴顧性的分析和比較經手術確診的卵巢巧剋力囊腫疾病患者183例（患病組）、卵巢噁性腫瘤患者60例（病例對照組）以及進行健康體檢的正常育齡婦女60例（正常對照組）血液中4種腫瘤標記物檢測結果，併分析4種指標高低與疾病預後的關繫。結果對照組血清CA125、CA199、AFP及 CEA 檢測值的中位數和暘性率分彆為22.55 U/ml、5.2％，19.40 U/ml、11.1％，1.40 ng/ml、0、0.78 ng/ml、0。卵巢巧剋力囊腫組血清CA125、CA199、AFP及CEA檢測值的中位數及暘性率分彆為37.95 U/ml、23.03％，29.67 U/ml、42.41％，1.95 ng/ml、2.14％，0.56 ng/ml、0。輕度（Ⅰ～Ⅱ期）患者血清 CA125、CA199、AFP 及 CEA 中位數和暘性率分彆為25.25 U/ml、0，20.16 U/ml、23.53％，1.50 U/ml、0和0.58 U/ml、0；中重度（Ⅲ～Ⅳ期）卵巢巧剋力囊腫患者血清CA125、CA199、AFP及CEA中位數和暘性率分彆為41.55 U/ml、25.31％，31.29 U/ml、44.68％和2.05 U/ml、2.42％，0.56 U/ml、0。卵巢噁性腫瘤CA125、CA199、AFP 及 CEA 檢測值的中位數和暘性率分彆為188.4 U/ml、81.70％，150.75 U/ml、51.67％，6.9 ng/ml、26.67％，4.40 ng/ml、16.7％。卵巢巧剋力囊腫患者血清CA125、CA199和AFP的靈敏度、特異度及正確度分彆為23.30％、95％及41.18％，42.41％、90％及55.50％，2.19％、100％及31.5％。卵巢巧剋力囊腫患者血清CA125、CA199濃度和暘性率明顯高于對照組，差異有統計學意義（均P＜0.05），AFP的濃度與對照組相比，差異有統計學意義（ P＜0.05），但是暘性率比較差異無統計學意義（ P＞0.05）。 CEA差異無統計學意義（ P＞0.05）。卵巢巧剋力囊腫患者血清CA125、CA199、CEA及AFP水平和暘性率血清明顯低于噁性卵巢腫瘤組，差異有統計學意義（ P＜0.05）。結論測定血清CA125、CA199水平可協助卵巢巧剋力囊腫的診斷、病情判斷和指導治療，二者聯閤測定可提高疾病診斷敏感性。同時AFP及CEA雖然對于協助卵巢巧剋力囊腫的診斷無意義，但是對于鑒彆診斷有明顯意義。而且CA125和CA199水平是影響卵巢巧剋力囊腫預後的因素之一。
목적탐토혈청종류항원125（CA125）、종류항원199（CA199）、갑태단백（AFP）급암배항원（ CEA）수평대란소교극력낭종림상적진단、치료적개치。방법회고성적분석화비교경수술학진적란소교극력낭종질병환자183례（환병조）、란소악성종류환자60례（병례대조조）이급진행건강체검적정상육령부녀60례（정상대조조）혈액중4충종류표기물검측결과，병분석4충지표고저여질병예후적관계。결과대조조혈청CA125、CA199、AFP급 CEA 검측치적중위수화양성솔분별위22.55 U/ml、5.2％，19.40 U/ml、11.1％，1.40 ng/ml、0、0.78 ng/ml、0。란소교극력낭종조혈청CA125、CA199、AFP급CEA검측치적중위수급양성솔분별위37.95 U/ml、23.03％，29.67 U/ml、42.41％，1.95 ng/ml、2.14％，0.56 ng/ml、0。경도（Ⅰ～Ⅱ기）환자혈청 CA125、CA199、AFP 급 CEA 중위수화양성솔분별위25.25 U/ml、0，20.16 U/ml、23.53％，1.50 U/ml、0화0.58 U/ml、0；중중도（Ⅲ～Ⅳ기）란소교극력낭종환자혈청CA125、CA199、AFP급CEA중위수화양성솔분별위41.55 U/ml、25.31％，31.29 U/ml、44.68％화2.05 U/ml、2.42％，0.56 U/ml、0。란소악성종류CA125、CA199、AFP 급 CEA 검측치적중위수화양성솔분별위188.4 U/ml、81.70％，150.75 U/ml、51.67％，6.9 ng/ml、26.67％，4.40 ng/ml、16.7％。란소교극력낭종환자혈청CA125、CA199화AFP적령민도、특이도급정학도분별위23.30％、95％급41.18％，42.41％、90％급55.50％，2.19％、100％급31.5％。란소교극력낭종환자혈청CA125、CA199농도화양성솔명현고우대조조，차이유통계학의의（균P＜0.05），AFP적농도여대조조상비，차이유통계학의의（ P＜0.05），단시양성솔비교차이무통계학의의（ P＞0.05）。 CEA차이무통계학의의（ P＞0.05）。란소교극력낭종환자혈청CA125、CA199、CEA급AFP수평화양성솔혈청명현저우악성란소종류조，차이유통계학의의（ P＜0.05）。결론측정혈청CA125、CA199수평가협조란소교극력낭종적진단、병정판단화지도치료，이자연합측정가제고질병진단민감성。동시AFP급CEA수연대우협조란소교극력낭종적진단무의의，단시대우감별진단유명현의의。이차CA125화CA199수평시영향란소교극력낭종예후적인소지일。
Objective To investigate the value of carbohydrate antigen 125 ( CA125 ) , carbohydrate antigen199(CA199),alpha fetoprotein (AFP) and carcino embryonic antigen (CEA) in the pathogenesis of endometrial cyst of ovary and its clinical potential value .Methods Retrospective analysis and comparison with surgically confirmed ovarian chocolate cyst disease 183 cases ( patients group ) , 60 ovarian cancer patients ( case-control group ) and normal health examination of women of childbearing age of 60 patients ( control group ) in the blood of four tumor marker test results .Results The median serum levels and positive rate of CA 125,CA199,AFP and CEA for control group were 5.2%,11.1%,0%and 0%.The positive rate of CA125,CA199,AFP and CEA and for ovarian chocolate cyst were 23.03%,42.41%,2.14% and 0%.The median serum levels and positive rate of CA125,CA199,AFP and CEA for malignant ovarian tumor were:81.70%,51.67%,26.67%,16.7%.Mild group (Ⅰ-Ⅱperiod) median serum levels and positive rate of CA125,CA199,AFP and CEA were:25.25 U/ml,0%;20.16 U/ml,23.53%;1.50 U/ml,0% and 0.58 U/ml,0%.Severe group (Ⅲ-Ⅳ period) ovarian chocolate cysts serum CA125,CA199,AFP and CEA in the median and the positive rate were:41.55 U/ml,25.31%;31.29 U/ml, 44.68%;2.05 U/ml,2.42%and 0.56 U/ml,0%.Patients′,with ovarian chocolate cysts ,serum CA125,CA199 and AFP sensitivity,specificity,and accuracy were 23.30%,95%,41.18%;42.41%,90%,55.50% and 2.19%, 100%, 31.5% The serum CA125, CA199, AFP concentration and positive rate was significantly higher in the endometriosis group than that in the control group , the difference was statistically significant ( P<0.05 ) , the CEA had no significant difference ( P>0.05 ) .The serum CA125 ,CA199 ,CEA and AFP level and positive rate of serum was significantly lower in the patients group than the group of malignant ovarian tumors , and the difference was statistically significant ( P<0.05 ) .Conclusions Serum CA125 and CA199 levels can assist in the diagnosis of ovarian chocolate cysts ,judge of the extent of the disease and guide the treatment ,the combination can improve the sensitivity of disease diagnostic .AFP and CEA for assisting the diagnosis of ovarian chocolate cysts are meaningless , but for the differential diagnosis of obvious are meanful .And CA125 and CA199 level is one of the factors which can affect the prognosis of endometriosis .