循环肿瘤细胞及糖类抗原125新型联用诊断模式在卵巢上皮性癌诊断中的价值  

The Diagnostic Value of a Novel Model Combined Circulating Tumor Cells with Carbohydrate Antigen 125 in Epithelial Ovarian Cancer

作　　者：王同霞 高妍 李圆[1] 王翕 谭焕然[2] 郭红燕[1] WANG Tongxia;GAO Yan;LI Yuan(Department of Obstetrics and Gynecology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院妇产科,北京100191 [2]北京大学医学部基础医学院药理学系,北京100191

出　　处：《实用妇产科杂志》2024年第4期286-290,共5页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨循环肿瘤细胞(CTCs)联合糖类抗原125(CA 125)对卵巢上皮性癌(EOC)的诊断价值。方法:选择2013年9月1日至2020年12月31日于北京大学第三医院收治经病理确诊的160例EOC患者和非癌对照(50例卵巢良性病变患者及40例健康成年女性)为研究对象。采用免疫磁珠分离法检测CTCs的表达,通过酶联免疫法检测CA 125的表达,并绘制受试者工作特征(ROC)曲线探讨两者诊断EOC的最佳组合方式。结果:①EOC患者与非癌对照时,CA 125>35 U/ml和CTCs阳性诊断EOC的敏感度分别为75.6%、79.4%,特异度分别为82.2%、91.1%。EOC患者与卵巢良性病变患者时,CA 125>35 U/ml及CTCs阳性诊断EOC的敏感度不变(仍分别为75.6%、79.4%),特异度均有所下降(分别为68.0%、86.0%)。②传统的并联试验诊断EOC的敏感度提高至95.0%,但特异度降低至58.0%;传统的串联试验诊断EOC的特异度提高至96.0%,但敏感度降低至60.0%。③定义CTCs及CA 125的新型联用诊断模式检出阳性为:CA 125≥90 U/ml或25 U/ml<CA 125<90 U/ml且CTCs阳性。采用新型联用诊断模式诊断EOC的敏感度为88.8%,特异度为86.0%。结论:CTCs或CA 125单独区分卵巢良恶性肿物时的敏感度均不高,且特异度偏低,特别是CA 125。传统的并联或串联试验不能提高EOC诊断效能;CTCs及CA 125新型联用诊断模式提高了EOC诊断的敏感度,同时保证了特异度没有降低。Objective:To explore the diagnostic value of circulating tumor cells(CTCs)combined with carbohydrate antigen 125(CA 125)in epithelial ovarian cancer(EOC).Methods:Our study enrolled 160 EOC patients diagnosed pathologically,and 100 patients without EOC(50 cases with benign ovarian tumors,and 40 cases were healthy)form Peking University Third Hospital between September 1,2023 to December 31,2020.The expression of CTCs was detected by using immunomagnetic bead separation method,and the expression of CA 125 was tested through enzyme-linked immunosorbent assay.The optimal combination of the two diagnostic methods were analyzed by ROC curves.Results:①The sensitivity of CA 125>35 U/ml and CTCs positive diagnosis for EOC in patients with or without EOC were 75.6%and 79.4%,and the specificity were 82.2%and 91.1%,respectively.The sensitivity of CA 125>35 U/ml and CTCs positive diagnosis for EOC remained unchanged in patients with EOC or benign ovarian diseases,while the specificity decreased to 68.0%and 86.0%,respectively.②The traditional parallel testing can increase the sensitivity of diagnosis to 95.0%,but reduce the specificity to 58.0%.The traditional serial test can increase the diagnostic specificity to 96.0%,but reduce the sens itivity to 60.0%.③The positive results of new diagnostic mode combined CTCs and CA 125 were defined as:CA 125≥90 U/ml or 25 U/ml<CA 125<90 U/ml with positive CTCs.The diagnostic sensitivity and specificity of EOC were 88.8%and 86.0%.Conclusions:Either CTCs or CA 125 has poor diagnostic efficiency when they were used alone,especially CA 125.The traditional parallel or series tests can not improve the diagnostic efficiency.Our study suggests a new diagnostic mode of CTCs and CA 125 which could significantly improve the sensitivity of diagnosis while avoiding the decreasion of specificity.

关 键 词：循环肿瘤细胞 糖类抗原125 卵巢上皮性癌 卵巢肿物 

分 类 号：R737.31[医药卫生—肿瘤]