评价术前CA125水平对晚期子宫内膜癌的预测作用  

Preoperative Assessment of Prediction Function of CA125 Level on the Advanced Endometrial Carcinoma

作　　者：李伟雄[1] 余文辉[1] 周小梅[1] 花纯宏[1] 王霞灵[2] 

机构地区：[1]广东省深圳市中医院检验科,518033 [2]广东省深圳市中医院妇产科,518033

出　　处：《中国全科医学》2005年第7期558-560,共3页Chinese General Practice

摘　　要：目的　评价晚期子宫内膜癌术前CA125水平的预测作用。方法　回顾性分析术前CA125水平与子宫内膜癌的病理组织分级、宫壁肌层浸润深度、宫外淋巴血管受累范围、淋巴结状况和临床分期之间的关系。结果　CA125水平升高与子宫内膜癌晚期和淋巴结状况(是否浸润) 有关, 也与子宫肌层浸润深度、肿瘤病理组织分级有关。接受器操作特性(ROC) 曲线显示子宫内膜癌浸润的深度、宫外淋巴血管受累范围及肿瘤病理组织分级等在预测晚期子宫内膜癌的准确度分别为73%、78%和80%。CA125水平预测晚期子宫内膜癌的准确度可高达94%, 将CA125临界值定为35kU/L时, 其敏感度和特异性分别为97%和90%, 阴性预测值为97%, 阳性预测值为78%。结论　CA125可作为子宫内膜癌淋巴转移(阳性淋巴结) 和宫外蔓延扩散的一种重要的预测指标。Objective The purpose of this study was to evaluate the prediction function of the preoperative levels of CA125 on the prediction of advanced endometrial carcinoma.Methods We conducted a retrospective analysis of the correlation of preoperative CA125 with grade, depth of invasion, lymph vascular space involvement (LVSI), lymph node (LN) status and age.Results High CA125 levels correlated with advanced-stage and positive LN status. High levels CA125 also correlated with the deepest invasion, the presence of LVSI, and the highest grade. Receiver-operator characteristic (ROC) curves demonstrated that depth of invasion, LVSI, and grade accurately predicted advanced-stage disease 73%, 77% and 80%, respectively. CA125 levels, however, correctly predicted advanced stage 94%. The sensitivity and specificity of a CA125 cut-off level of 35 kU/L were 97% and 90%, respectively, with a positive predictive value of 78% and a negative predictive value of 97%.Conclusion CA125 appears to be a significant independent predictor of positive LN status and the extrauterine spread of endometrial carcinoma.

关 键 词：CA125水平 晚期子宫内膜癌 预测作用 术前 肌层浸润深度 组织分级 肿瘤病理 回顾性分析 阴性预测值 阳性预测值 淋巴结 临床分期 预测指标 淋巴转移 外淋巴 准确度 癌浸润 接受器 临界值 特异性 敏感度 血管 

分 类 号：R714.221[医药卫生—妇产科学] R737.33[医药卫生—临床医学]