CA125联合超声在术前预判交界性浆液性卵巢肿瘤保留生育功能手术可行性的价值  

The value of CA125 combined with ultrasound in the preoperative prediction of fertility-sparing surgical treatment in women with serous borderline ovarian tumors

作　　者：赵万成[1] 杨清[1] Zhao Wancheng;Yang Qing(Department of Gynaecology and Obstetrics,Shengjing Hospital of China Medical University,Liaoning Shenyang 110004,China.)

机构地区：[1]中国医科大学附属盛京医院妇产科,辽宁沈阳110004

出　　处：《现代肿瘤医学》2018年第20期3281-3284,共4页Journal of Modern Oncology

基　　金：沈阳市科技计划人口与健康专项基金(编号:17-230-9-10)

摘　　要：目的:通过对交界性浆液性卵巢肿瘤(serous borderline ovarian tumors,SBOTs)中CA125及超声结果进行回顾性分析,探究CA125联合超声在术前预判交界性浆液性卵巢肿瘤保留生育功能手术中的应用价值。方法:收集并分析2010年至2015年于中国医科大学附属盛京医院行全面分期手术的169例SBOTs患者的CA125及超声结果。结果:17～40岁SBOTs患者66例,占总人数的39. 05%;Ⅰ_a或Ⅰ_c期SBOTs患者100例,占总人数的59. 17%。大部分Ⅰ_a或Ⅰ_c期SBOTs CA125在正常范围内(48. 00%,48/100)或稍增高(22. 00%,22/100),而Ⅱ-Ⅲ期明显升高(χ~2=25. 532,P=0. 000)。术前超声提示附件区肿物为囊实性者共计117例,占总人数69. 23%;超声提示肿物为单侧且分期为Ⅰ_a或Ⅰ_c期者94例(78. 33%,94/120),明显多于双侧者(χ~2=62. 902,P=0. 000);超声提示盆腔积液≥2 cm者Ⅰ_a或Ⅰ_c期仅2例,而Ⅱ-Ⅲ期19例,两者差异具备统计学意义(χ~2=47. 747,P=0. 000)。结论:CA125正常或稍升高、超声提示附件区单侧囊实性肿物、盆腔积液无明显增多是大部分Ⅰ_a或Ⅰ_c期SBOTs的特点,据此可对于年轻要求保留生育功能的患者术前预判考虑给予保留生育功能手术治疗。Objective：To explore the value of CA125 combined with ultrasound in the preoperative prediction of fertility-sparing surgical treatment in women with serous borderline ovarian tumors. Methods：The CA125 and ultra-sound results of 169 SBOTs in Shengjing Hospital of China Medical University from 2010 to 2015 were collected and analyzed. Results ： Among all SBOTs eases,66 eases aged 17 to 40 years old, accounting for 39.05% of the total num-ber,and 100 eases were in stage Ⅰa or c ,accounting for 59.17%. The CA125 level of most SBOTs in stage Ⅰa or Ⅰc were in normal range （48.00% ,48/100） or slightly increased （22.00% ,22/100） ,while those in stage Ⅱ -Ⅲ were significantly higher （X^2 = 25. 532,P = 0.000）. Pre-operation ultrasound showed 117 eases （69.23%） were cystic and solid tumors in the annex area,94 eases （78.33% ,94/120） were unilateral tumors and in stage Ⅰa or Ⅰc stage,which is significantly more than those eases with bilateral tumors （ X^2 = 62. 902, P = 0. 000）. Ultrasound showed only 2 eases in stage IA or IC with pelvic fluid 〉 2 cm,while 19 eases in stage Ⅱ -Ⅲ ,the difference was statistically significant （X^2 = 47. 747,P = 0. 000）. Conclusion：Most of the Ⅰa or Ⅰc SBOTs has normal or slightly elevated CA125, unilateral cystic and solid tumors in the annex area and no significant increase of pelvic fluid under ultrasound. According to the features mentioned above, the fertility-sparing surgical treatment may be consid-ered preoperatively to give those young patients with the requirement of keeping reproductive function.

关 键 词：CA125 超声 交界性卵巢肿瘤 

分 类 号：R737.31[医药卫生—肿瘤]