芳香化酶细胞色素P450联合血清CA125检测在盆腔EMs中的诊断意义  

Significance of aromatasc cytochrome P450 combined with serum CA125 detection in diagnosis of pelvic endometriosis

作　　者：周赞华[1] 董海娜[1] 周丽红[2] 毛雪梅[2] 施倩[2] 

机构地区：[1]丽水学院医学与健康学院,浙江丽水323000 [2]丽水市中心医院,浙江丽水323000

出　　处：《中国妇幼保健》2017年第2期249-251,共3页Maternal and Child Health Care of China

基　　金：浙江省科技厅公益技术应用研究项目(2014C33249);浙江省自然科学基金一般项目(LY15H040009)

摘　　要：目的探讨子宫内膜细胞芳香化酶细胞色素P450(P450arom)联合血清CA125检测在诊断盆腔子宫内膜异位症(Endomctriosis,EMs)中的临床价值。方法选择2014年5月-2015年12月在丽水市中心医院经腹腔镜或开腹手术确诊的45例盆腔EMs患者为研究组,因宫颈上皮内瘤变(CIN)、宫颈癌(Ⅰ期)排除EMs且卵巢正常的患者45例为对照组,术前检测两组患者的血清CA125水平,术后应用免疫组化方法检测研究组患者在位及异位子宫内膜和对照组患者正常子宫内膜中P450arom的表达结果。结果研究组在位及异位内膜均有P450arom的强表达,对照组子宫内膜弱表达或无表达,两组比较,差异均有统计学意义(P<0.05)。研究组血清CA125水平高于对照组,两组比较,差异有统计学意义(P<0.05)。检测子宫内膜P450arom诊断EMs的敏感性、特异性和阳性预测值分别为77.8%、93.3%、92.1%;检测血清CA125诊断EMs的敏感性、特异性和阳性预测值分别为62.2%、91.1%、87.5%;两种方法联合检测诊断EMs的敏感性、特异性和阳性预测值分别为91.1%、88.8%、89.1%。结论在位子宫内膜P450arom检测有助于盆腔EMs的诊断,联合血清CA125检测可提高盆腔EMs的早期诊断率。Objective To explore the clinical value of endometrial aromatasc cytochrome P450（ P450arom） combined with serum CA125 detection in diagnosis of pelvic endometriosis. Methods Forty-five patients with pelvic endometriosis diagnosed by laparoscopy or laparotomy were selected from May 2014 to December 2015 as study group,45 patients with normal ovary and cervical intraepithelial neoplasia（ CIN） and cervical cancer of stage Ⅰ were selected as control group,serum CA125 levels before operation in the two groups were detected. Immunohistochemistry was used to detect P450 arom expressions in endometrial tissues in the two groups after operation.Results P450 arom was strongly expressed in cutopic endometrium and ectopic endometrium of patients in study group. But in control group,P450 arom expression was not found,the difference between them was statistically significant（ P 0. 05）. The level of scrum CA125 in study group was higher than that in control group,and the difference between them was significant（ P〈0. 05）. The sensitivity,specificity,and positive likelihood value of P450 arom in diagnosis of endometriosis were 77. 8 %,93. 3%,92. 1%,respectively; the sensitivity,specificity,and positive likelihood value of serum CA125 in diagnosis of endometriosis were 62. 2%,91. 1%,87. 5%,respectively; the sensitivity,specificity,and positive likelihood value of joint detection of P450 arom and serum CA125 in diagnosis of endometriosis were 91. 1%,88. 8%,89. 1%,respectively. Conclusion In eutopic endometrium,P450 arom detection is valuable for diagnosis of pelvic endometriosis,joint detection of P450 arom and serum CA125 may enhance the early diagnostic rate of pelvic endometriosis.

关 键 词：芳香化酶 CA125 子宫内膜异位症 

分 类 号：R711.71[医药卫生—妇产科学]