目的：讨术前血清肿瘤标志物（TM ）CA125、CA199、CA724及血清铁蛋白（SF）联合检测对卵巢癌的临床诊断价值。方法抽取53例卵巢癌患者、45例卵巢良性肿瘤患者及对照组48名健康妇女的血清，采用罗氏2010电化学发光分析仪检测4种 TM 水平。结果卵巢癌患者4项 TM 血清水平及单独检测和联合检测阳性率均显著高于相应的卵巢良性肿瘤组及对照组（P＜0.01）；3项（CA125＋ CA724＋ SF）及4项联合检测的敏感性（SE）、阴性预测值（NPV）和约登指数（YI）均显著高于单独检测（P＜0.01），且2项联合检测的此3值也高于单独检测，但只有 CA724＋ SF 与之有统计学意义（P＜0.05），2项联合检测（CA125＋ CA724）此3值高于其他3种2项联合检测（P＞0.05）；4项及3项联合检测 SE 、特异性（SP）、阳性预测值（PPV ）、NPV 和 YI 各值间差异无统计学意义（P＞0.05）。结论联合检测中，4项联合检测敏感性最高，3项联合检测具有较高性价比，总之，选择合理的 TM 联合检测组合有助于卵巢癌临床的早期诊断和鉴别。%Objective To explore the early diagnostic value of combined detection of serum tumor markers (TM ) CA125 ,CA199 ,CA72-4 and SF for ovarian cancer before operation .Methods Roche Elecsys 2010 method was used to detect and compare serum levels of CA 125 ,CA199 ,CA724 and SF in 53 patients with ovarian carcino-ma ,45 patients with benign ovarian tumor and 48 healthy women for control .Results The serum levels of four TM in ovarian cancer group were significantly higher than those in normal control group ( P < 0.01) ;the SE , NPV and YI of the four TM combined detection and three combined detection of (CA125 + CA724 + SF) were sig-nificantly higher than those of single tumor marker detection (P< 0.01) ;the SE ,NPV and YI of two TM com-bined detection were also higher than those of single tumor marker detection ,but only two combined detection (CA724 + SF) has statistical significance ( P < 0.05 ) ; the SE , NPV and YI of two TM combined detection (CA125 + CA724) were higher than other two combined detections (P> 0.05) ;the difference of SE ,SP ,PPV , NPV and YI for the four TM combined detection and three types of two combined detection has no statistical sig -nificance (P > 0.05 ) .Conclusion The four TM combined detection has the highest sensitivity ,and three TM combined detection also has high diagnostic values .In short ,a reasonable choice of TM combined detection con-tributes to the early clinical diagnosis and identification of ovarian cancer .
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