联合检测多项肿瘤指标对术前卵巢肿瘤的诊断意义  

Value of combined multiple tumor markers in the diagnosis of ovarian tumor

作　　者：马小玲[1] 冒小燕[1] 张玉泉[1] 

机构地区：[1]南通大学附属医院妇产科,南通226001

出　　处：《南通大学学报（医学版）》2007年第2期101-102,105,共3页Journal of Nantong University(Medical sciences)

摘　　要：目的:探讨多项肿瘤指标的联合检测对卵巢肿瘤性质的诊断意义。方法:对术后病理证实的卵巢肿瘤患者154例,分析其术前采用化学发光免疫法检测的多项肿瘤指标(CA125、CA153、CA199、甲胎球蛋白类、β2-微球蛋白、癌胚抗原、血清铁蛋白)的结果与临床诊断的关系。结果:(1)肿瘤指标在恶性、交界性和良性卵巢肿瘤中的阳性率有差异(P<0.05):恶性卵巢肿瘤中任一项指标为阳性的阳性率为88.0%(22/25),而交界性和良性分别为57.1%(4/7)、36.1%(47/122);且恶性组的任一项指标阳性均值明显高于后二者的,三者间差异有统计学意义(P<0.05)。(2)各肿瘤指标检测单项指标中CA125灵敏度为84.0%,特异性76.7%;与其他肿瘤指标联合检测可以提高其特异性和阳性预测值,但灵敏度明显下降。结论:术前多项肿瘤指标的联合检测对卵巢肿瘤性质的诊断有着一定的价值,但恶性卵巢肿瘤漏诊率很高,诊断仍需结合临床和其他检查。Objective ：To appraise the value of combined multiple tumor markers in the diagnosis of ovarian tumors. Methods：IS4 patients with ovarian tumors confirmed by pathological diagnosis pooperatively were tested with combined multiple tumor markers （including CA125,CA153,CA199,Alpha-fetoprotein,β2-Mcroglotulin,Carcinoembryonic antigen,Serum ferrtin） preoperatively by automated chemiluminescence assay, and the relations between the results and the pathological diagnosis were analyzed retrospectively. Results ： （1） There were statistical difference among the positive rates of tumor markers in malignant,borderline and benign ovarian tumors（P〈0.05）.The positive rates of the malignant ovarian tumors with one or several tumor markers being positive（88.0 %） were higher than those of the borderline （57.1%）and the benign （36.1%）,the positive level in malignant ovarian tumors was higher than the others（P〈0.05）.（2）Every tumor marker had its sensitivity and specificity, but CA125 was the best marker of all. Its sensitivity was 84.0%,and the specificity was 76.7%. When combined with the others, it could improve its specificity and positive predictive value,but the sensitivity declined greatly. Conclusion： Combined multiple tumor markers tested preoperatively are very useful in ascertaining the character of ovarian tumors ,but the false malignant ovarian tumor rate is very high ,so it is very important to find a more sensitive and specific tumor marker,and so far the better way to diagnose still is to be combined with clinical symptoms and other examinations.

关 键 词：卵巢肿瘤 CA125 CA153 CA199 甲胎球蛋白类 Β2-微球蛋白 癌胚抗原 血清铁蛋白 

分 类 号：R737.31[医药卫生—肿瘤]