CA125、CA199联合超声检查在卵巢上皮性癌诊断中的价值  

Diagnostic value of combined measurement of CA125,CA199 and Doppler ultrasound in patients with epithelial ovarian cancer.

作　　者：吴晓慧[1] 刘芳荪[1] 李卫平[1] 狄文[1] 

机构地区：[1]上海交通大学医学院附属仁济医院妇产科,上海200001

出　　处：《中国实用妇科与产科杂志》2009年第12期928-931,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：上海市科学技术委员会重点项目(07JC14031)

摘　　要：目的探讨二维超声、彩色多普勒血流显像检查与血清CA125、CA199联合检测对卵巢上皮性癌的诊断价值。方法选取2004年6月至2008年6月上海交通大学医学院附属仁济医院妇产科收治的卵巢上皮性肿瘤患者115例,行二维超声、彩色多普勒血流检查,同时用化学发光法检测CA125、CA199水平,并将诊断结果与病理结果进行对照。结果CA125+CA199、CA125+CA199+阻力指数(RI)、CA125+CA199+超声评分(U)、CA125+CA199+RI+U联检良恶性肿瘤的敏感性分别为78.0%、86.4%、86.4%、91.5%,CA125、CA199、RI、U单检的敏感性分别为62.7%、39.0%、69.5%、61.0%,联检与单检敏感性比较,差异有统计学意义(P<0.05)。联检与病理结果的一致性和临床诊断价值也较各指标单检高,CA125、CA199、RI和U联检可提高Ⅰ～Ⅱ期卵巢上皮性癌及黏液性囊腺癌、透明细胞癌的敏感性;恶性风险指数(RMI)对卵巢上皮性癌的临床价值也较高。结论血清肿瘤标志物与二维超声、彩色多普勒血流显像联合应用能够进一步提高诊断的敏感性或特异性,并可检出更多的早期卵巢癌,RMI有望成为其联合的参考模式。Objective To investigate the clinical value of combined measurement of serum CA125, CA199, two-dimensional Doppler ultrasound and color Doppler flow imaging for the diagnosis of epithelial ovarian cancer. Methods A total of 115 patients with epithelial ovarian tumor were examined by two-dimensional ultrasound and color Doppler flow imaging before operation. The levels of serum CA125, CA199 were measured by chemiluminescence analysis at the same time. All the diagnoses were compared with clinical pathology. Results The sensitivities for different combined measurements of CA125, CA199, ultrasound score, resistance index were 78.0% ,86.4% ,86.4% ,91.5% ,and the sensitivities for respective measurements of them were 62. 7% , 39. 0% ,69. 5% ,61.0%, the differences of sensitivity for combined measurement and respective measurement of CA 125, CA199, uhrasound score, resistance index were significant （ P 〈 0. 05 ）. There were also high coincidences with clinical pathology and high diagnosis value. Combined measurement of CA125, CA199, ultrasound score and resistancet index could improve diagnostic sensitivity of early epithelial ovarian cancer, mucous cystoadenocarcinoma and clear-cell carcinoma. Risk of malignancy index is also useful for the diagnosis of epithelial ovarian cancer. Conclusion Combined measurement of tumor markers in serum, two-dimensional Doppler ultrasound and color Doppler flow imaging can improve diagnostic sensitivity or specificity; hence it facilitates the early diagnosis of epithelial ovarian cancer. Risk of malignancy index is very likely to be the mode of combined measurement of tumor markers in serum, two-dimensional Doppler uhrasound and color Doppler flow imaging.

关 键 词：卵巢上皮性癌 CA125 CA199 阻力指数 恶性肿瘤风险指数 

分 类 号：R71[医药卫生—妇产科学]