CAJ | 학술논문

目的探讨血清肿瘤标志物检测联合超声检查在卵巢成熟型畸胎瘤诊断中的临床意义。方法选取我院卵巢成熟型畸胎瘤手术患者422例。分析血清CA199、CA125、CA724、CEA、AFP在该患者中的表达以及超声诊断的符合率。结果（1）422例成熟型畸胎瘤患者中，测定CA199者230例，118例＞27 U/ml，阳性率为51.30％（118/230）。测定CA125者364例，79例＞35 U/ml，除外56例伴有明确可以引起CA125升高疾病（如早孕、子宫内膜异位症、卵巢囊肿蒂扭转、急性盆腔炎等）的患者，阳性率6.32％（23/364）。测定CA724者63例，2例＞6.9 U/ml，阳性率3.17％（2/63）。测定CEA者159例及AFP者142例，所有检测数值均在正常范围。（2）所有患者均行超声检查，其中有323例术前诊断且术后证实卵巢成熟型畸胎瘤，符合率76.54％（323/422）。（3）CA199阳性组畸胎瘤平均直径为（7.92±2.19）cm，大于阴性组[（4.86±1.65） cm]，差异有统计学意义（ P＝0.023），双侧畸胎瘤CA199阳性率大于单侧CA199阳性率，差异有统计学意义（ P＝0.003）。结论卵巢成熟型畸胎瘤的直径越大，CA199阳性率越高；双侧肿瘤的阳性率明显高于单侧。推测CA199在卵巢成熟型畸胎瘤的诊断中具有一定的临床意义，结合超声检查可以提高其术前诊断的准确性。
목적탐토혈청종류표지물검측연합초성검사재란소성숙형기태류진단중적림상의의。방법선취아원란소성숙형기태류수술환자422례。분석혈청CA199、CA125、CA724、CEA、AFP재해환자중적표체이급초성진단적부합솔。결과（1）422례성숙형기태류환자중，측정CA199자230례，118례＞27 U/ml，양성솔위51.30％（118/230）。측정CA125자364례，79례＞35 U/ml，제외56례반유명학가이인기CA125승고질병（여조잉、자궁내막이위증、란소낭종체뉴전、급성분강염등）적환자，양성솔6.32％（23/364）。측정CA724자63례，2례＞6.9 U/ml，양성솔3.17％（2/63）。측정CEA자159례급AFP자142례，소유검측수치균재정상범위。（2）소유환자균행초성검사，기중유323례술전진단차술후증실란소성숙형기태류，부합솔76.54％（323/422）。（3）CA199양성조기태류평균직경위（7.92±2.19）cm，대우음성조[（4.86±1.65） cm]，차이유통계학의의（ P＝0.023），쌍측기태류CA199양성솔대우단측CA199양성솔，차이유통계학의의（ P＝0.003）。결론란소성숙형기태류적직경월대，CA199양성솔월고；쌍측종류적양성솔명현고우단측。추측CA199재란소성숙형기태류적진단중구유일정적림상의의，결합초성검사가이제고기술전진단적준학성。
Objective To evaluate the clinical significance of serum tumor markers combine with the ultrasound checking in ovarian teratoma .Methods 422 patients with cystic teratoma of ovary diagnosed by postoperative were selected whose tumor markers including CA 199,CA125,CA724,CEA,AFP and the ultrasound checking were studied .Results 230 patients were tested for serum CA 199 and 118 patients had the levels above 27 U/ml with the positive rate of 51.30%.364 patients were tested for serum CA 125 and 79 patients had elevated CA125 levels(>35 U/ml).Excluded the 56 patients who suffered from other diseases which could cause increased CA125 levels ( for example early pregnancy , endometriosis , torsion of the pedicle of ovarian cyst , acute pelvic inflammatory disease and so on ) , the positive rate was 6.32%.63 patients were tested for CA 724 only two was abnormal and the positive rate was 3.17%.159 patients were detected CEA and 142 patients were detected AFP and no abnormal were found .All patients underwent the ultrasound check and 323 teratoma patients were diagnosed before operation and were proved after operation pathological diagnosis with the positive rate of 76.54%.The mean diameter of the CA199 positive group was(7.92 ±2.19)cm,which was bigger than that of the negative group (4.86 ±1.65) cm(P=0.023).The positive rate of the CA199 both sides was much higher than that of single side (P=0.003). Conclusions The bigger of the diameter of the mature cystic teratoma ,the higher of the positive rate of the CA 199. The positive rate of the CA199 was higher when teratomas was both sides .Combined with the ultrasound checking , CA199 may have clinical significance in the diagnosis of mature ovarian teratoma and improve the accuracy of preoperative diagnosis .