目的 探讨血清CA125、CA199、CEA联合检测在卵巢癌诊断中的临床价值.方法 采用化学发光微粒子免疫分析技术(CMIA)测定72例卵巢癌患者、51例妇科良性疾病患者和60例健康女性血清中CA125、CA199、CEA的含量.结果 卵巢癌组的CA125、CA199、CEA的水平和阳性率显著高于健康对照组(P<0.05);卵巢癌组的CA125、CA199的水平和阳性率显著高于妇科良性疾病组(P<0.05);3项肿瘤标志物中,CA125阳性率最高(75%); CA125、CA199、CEA联合检测的敏感性为88.89%,特异性为88.29%,阳性预测值为83.12%,阴性预测值为92.45%;与CA125单项指标相比较,联合检测的特异性略有下降,其余指标均高于单项检测;Ⅰ期、Ⅱ期卵巢癌患者CA125单项检测的阳性率(Ⅰ期:27.27%、Ⅱ期:46.67%)明显低于Ⅲ期、Ⅳ期患者(Ⅲ期:94.12%、Ⅳ期:100%),CA125、CA199、CEA联合检测明显提高了Ⅰ期、Ⅱ期卵巢癌患者诊断的阳性率(Ⅰ期:63.64%、Ⅱ期:80%).结论 CA125、CA199和CEA 3项联合检测是检查卵巢癌较为理想的标志物组合.%Objective To evaluate the clinical value of the combined detection of serum CA125 ,CA199 ,CEA on diagnosis of o-varian cancer. Methods Chemiluminescent microparticle immunoassay (CMIA) was used to detect the serum levels of CA125, CA199,CEA in 72 patients with ovarian cancer,51 patients with benign gynecologic diseases and 60 healthy women. Results The levels and positive rates of CA125 ,CA199 ,CEA in patients with ovarian cancer were significantly higher than those in healthy controls (P<0. 05) ;The levels and positive rates of CA125 ,CA199 in patients with ovarian cancer were obviously higher than those in patients with benign gynecologic diseases(P<0. 05) ;The positive rate of CA125(75%) was the highest among that of three tumor markers; The sensitivity, specificity, positive and negative predictive value of combined detection of CA125, CA199 , CEA was 88. 89%,88. 29%, 83. 12% and 92. 45% .respectively; Compared with CA125 alone,the specificity of combined detection decreased slightly,while other indicators were higher than those of CA125 detection;The positive rates of CA125 for ovarian cancer patients in stage Ⅰ and Ⅱ (stage Ⅰ :27. 27%, stage Ⅱ :46. 67%) were obviously lower than those in stage Ⅲ and Ⅳ (stage Ⅲ :94. 12%, stage Ⅳ :100%). The combined detection of CA125 ,CA199 ,CEA greatly improved the positive rates for patients in stage Ⅰ and Ⅱ (stage Ⅰ :63. 64% ,stage Ⅱ:80%). Conclusion The combined detection of CA125 ,CA199 ,CEA is an ideal marker on diagnosis of ovarian cancer.
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