血清CA125检测对绝经后子宫内膜癌的临床应用价值

摘要

Objective　 To assess preoperative value of serum CA125 determination for uterine endometrial carcinoma including myometrial invasion, lymph node metastasis, surveillance and recurrence of the carcinoma. To explore the relationship between serum CA125 levels and pathological grades of endometrial carcinoma.　Methods　Serum CA125 levels were determined by ELISA test in 67 cases of postmenopausal endometrial carcinoma. 　Results　There were significant differences in CA125 levels between patients with clinical stage Ⅲ、 Ⅳ cases and clinical stage Ⅰ, Ⅱ (P<0.01). Serum CA125 levels of 10 cases with recurrent carcinoma were positive. Serum CA125 levels of patients with papillary serous adenocarcinoma were significantly higher than those of adenocarcinoma. No relation was found between pathological grades and serum CA125 levels. 　Conclusions　Serum CA125 levels was a useful clinical parameter for determination of postmenopausal endometrial carcinoma preoperatively.%目的探讨血清CA125检测对绝经后子宫内膜癌术前判定分期、深肌层浸润、淋巴结转移和术后监测复发的价值及其与组织学类型和病理学分级的关系。方法用酶联免疫分析方法检测67例绝经后子宫内膜癌患者术前血清CA125水平。结果Ⅲ、Ⅳ期子宫内膜癌患者的CA125水平明显高于Ⅰ、Ⅱ期（P＜0.01），血清CA125水平术前诊断晚期（Ⅲ、Ⅳ期）子宫内膜癌的敏感性和特异性分别为87.5%和96.1%；有深肌层浸润患者的CA125水平(84.9 U/ml)明显高于浅肌层浸润和无肌层浸润者（分别为15.6 U/ml和7.3 U/ml，P＜0.01），血清CA125水平术前诊断深肌层浸润的敏感性和特异性分别为72.2%和93.9%；有淋巴结转移患者的CA125水平明显高于无淋巴结转移组（分别为86.1 U/ml和14.8 U/ml，P＜0.01），血清CA125水平术前诊断盆腔淋巴结转移的敏感性和特异性分别为92.9%和94.3%；所有复发患者的血清CA125均为阳性；乳头状浆液性腺癌患者的血清CA125水平(69.4 U/ml)明显高于腺癌(28.6 U/ml)；各病理学分级间血清CA125水平差异无显著性。结论血清CA125检测对绝经后子宫内膜癌患者术前判定临床分期、深肌层浸润、盆腔淋巴结转移以及术后监测复发具有一定的参考价值。