术前测定血清CA125、CA199、CA724、CEA和GM-CSF在鉴别附件包块性质中的作用  

The role of tumor-associated antigens CA125,CA19 9,CA72 4,CEA and GM-CSF in differential diagnosis of ovarian cancer and benign ovarian masses

作　　者：万小平[1] 苏应宽[1] 刘新民[1] 王大华[2] 郭川流[2] 

机构地区：[1]山东省立医院妇科,250021 [2]山东省立医院核医学科,250021

出　　处：《现代妇产科进展》2000年第2期88-92,共5页Progress in Obstetrics and Gynecology

摘　　要：探讨术前测定患者血清CA12 5、CA19 9、CA72 4、CEA和GM -CSF水平在鉴别附件包块良恶性质中的作用。方法 :74例附件包块患者术前 1周内采外周血 ,用固相免疫放射法测定各种肿瘤标志物浓度 ,并与术后组织学诊断比较。计算各标志物单独和联合应用诊断卵巢癌的相应诊断参数。结果 :( 1)CA12 5(临界值 70U/ml)鉴别卵巢肿瘤性质的敏感性和特异性分别为 85 71%和 82 61% ,CA19 9(临界值 30U/ml)分别为 4 2 86%和 73 33% ,CA72 4 (临界值 3 8U/ml)分别为 53 57%和 90 90 % ,CEA(临界值 5ng/ml)分别为 4 6 4 3%和 4 8 89% ;( 2 )联合应用肿瘤标志物 :CA12 5联合CA19 9的敏感性和特异性分别为 89 2 9%和 73 33% ;CA12 5联合CA72 4的敏感性和特异性分别为 89 2 9%和 75 56% ;CA12 5联合CEA的敏感性和特异性分别为 92 86%和 4 0 0 0 % ;( 3)如果去除 9例子宫内膜异位症 ,CA12 5、CA19 9、CA72 4和CEA的特异性分别增至 89 19% ,80 55% ,94 2 9%和4 7 2 2 %。结论 :此项研究应用的肿瘤标志物中以CA12 5最为敏感。将CA12 5临界值定为 70U/ml时诊断效果最佳。CA72 4的特异性最高 ,但诊断卵巢癌的敏感性低。CEA的诊断价值有限 ,GM -CSF则无价值。CA12 5与其他肿瘤标志物联合检测时诊断的特异性会部分丧失。?Objective:To investigate the role of CA125,CA19 9,CA72 4,CEA and GM-CSF in differential diagnosis of ovarian cancer and benign ovarian masses,including concomitant measurement of multiple tumor markers Methods:Blood samples for the measurement of marker levels were drawn within one week before surgery from 74 patients undergoing laparotomy because of ovarian masses The tumor markers were measured with solid-phase immunoradiometric assays The measurements were compared with histopathologic findings Results:(1)In differential diagnosis of adnexal masses,the sensitivity and specificity of CA125 (with cutoff value 70U/ml)were 85 71% and 82 61%,CA19 9(with cutoff value 30U/L)were 42 83% and 73 33%,CA72 4(with cutoff value 3 8U/ml)were 53 57% and 90 90%,CEA(with cutoff value 5ng/ml) were 46 43% and 48 89% (2)When CA 125 was combined with CA19 9、CA72 4 and CEA respectively,the sensitivity and specificity were 89 29% and 73 33%,89 29% and 75 56%,92 86% and 40 0%,(3)If nine cases of ovarian endometriomas were ruled out,the specificity of CA125,CA19 9,CA72 4 and CEA would increase to 89 19%,80 55%,94 29% and 47 22% Conclusions:CA125 was the most sensitive for ovarian cancers CA125 with cutoff value of 70U/mL had best satisfactory effect on the differential diagnosis of ovarian masses Although CA72 4 had better specificity,it was not sensitive to ovarian cancer CEA had limited value in differential diagnosis of ovarian masses Perhaps,there was no room of GM-CSF in the preoperative diagnosis of ovarian cancers CA125 level in combination with other tumor markers will partly sacrifice the specificity If endometriomas was excluded,the specificity of CA125 and CA19 9 would increase greatly

关 键 词：卵巢肿瘤 鉴别诊断 肿瘤标记 生物学 

分 类 号：R737.31[医药卫生—肿瘤]