卵巢_____卵巢上皮性癌;_CA125;

卵巢上皮性癌血清CA125、CA724、Cu.ZnSOD测定的临床意义

http://www.100md.com 《新疆医科大学学报》 2005年第6期

卵巢,,卵巢上皮性癌;,CA125;,CA724;,铜锌超氧化物歧化酶,1资料与方法,2结果,3讨论,参考文献：

     摘要: 目的：探讨卵巢上皮性癌血清CA125、CA724、铜锌超氧化物歧化酶(Cu.ZnSOD)水平测定的临床意义。方法：采用放射免疫法测定42例卵巢上皮性癌患者、66例卵巢良性病变患者及15例正常对照血清CA125、CA724、Cu.ZnSOD水平，并对随访超过4个月的15例卵巢上皮性癌患者定期测定血清CA125、CA724、Cu.ZnSOD水平，同时对不同期别及有无残留癌灶的卵巢上皮性癌患者的各标记物水平进行了比较。结果： (1)卵巢上皮性癌组血清CA125、CA724、Cu.ZnSOD水平明显高于卵巢良性病变组(P<0.05), 卵巢良性病变组明显高于正常对照组(P<0.05)。(2)界值提高后的CA125和CA724联合测定对卵巢上皮性癌诊断价值最高，敏感性和特异性分别为88.0%和86.0%。(3)Ⅲ、Ⅳ期卵巢上皮性癌患者血清CA125、CA724水平高于Ⅰ、Ⅱ期(P<0.05)。 (4)残留癌灶直径≤2 cm的卵巢上皮性癌患者血清CA125、CA724水平低于残留癌灶直径>2 cm者(P<0.05)。(5)卵巢上皮性癌血清CA125水平变化与病情变化呈正相关(P<0.05)，相关系数rs=0.39，符合率为67.6%。(6)血清CA125、CA724联合检测预测复发的敏感性为100%, 先于临床复发3~4个月升高。结论：(1)血清CA125、CA724水平对卵巢上皮性癌的诊断有肯定价值，联合测定优于单项检测，尤以界值提高后联合检测为佳。(2)血清CA125水平动态检测可作为监测病情变化、判断疗效、反映肿瘤负荷的可靠指标。(3)血清CA125、CA724可提前临床3~4个月预测复发，两者联合敏感性达100%。(4)血清Cu.ZnSOD可提示卵巢存在病变。

    关键词: 卵巢上皮性癌; CA125; CA724; 铜锌超氧化物歧化酶

    Clinical value of serum CA125, CA724, and Cu.ZnSOD in epithelial ovarian cancer

    ZHANG Yunxia, LI Tingfang

    (Department of Gynecologic Oncology, Affiliated Tumor Hospital, Xinjiang Medical University, Urumqi 830011, China)

    Abstract: Objective: To assess the value of serum CA125、CA724、and Cu.ZnSOD in diagnosis and management of ovarian cancer. Methods: CA125、CA724、and Cu.ZnSOD were measured using the radioimmunoassay. All markers were measured in 42 patients with proven epithelial ovarian cancer 、66 patients with benign ovarian disease and 15 healthy persons. CA125、CA724、and Cu.ZnSOD were measured in 15 patients with ovarian cancer who were submitted to surgical staging and cytoreduction followed by adjuvant platinum based chemotherapy over 4 courses. Results: The CA125、CA724 and Cu.ZnSOD levels of patients with proven epithelial ovarian cancer were higher than patients with benign ovarian disease ,and the CA125、CA724 and Cu.ZnSOD levels of patients with benign ovarian disease were higher than healthy persons. For these enhanced cutoff limits being 85U/ml for CA125, 4.8U/ml for CA724, the combination of CA125 with CA724 increased the sensitiviry to 88.0% and the specificity to 86.0%. The CA125 and CA724 levels in patients with stage Ⅲ and stage Ⅳ of epithelial ovarian cancer were higher than patients with stage Ⅰand stage Ⅱ of epithelial ovarian cancer. There was a positive correlation between the CA125 levels and the clinical course, the correlation coefficient was 0.39 and the agreement rate is 67.6%. The combination of CA125 with CA724 increased the senitivity to 100% in detection of relapse. The CA125 and CA724 levels increased before clinical recurrence with a median lead time of 3 months. Conclusions: (1) When these cutoff limits are enhanced, the combination of CA125 with CA724 leads to an improved discrimination between malignant and benign ovarian disease. (2) Determination of CA125 levels may aid in monitoring the response to treatment in patients with epithelial ovarian cancer. (3) CA125 and CA724 levels increased before clinical recurrence with a median lead time of 3 months. (4) Determination of Cu.ZnSOD levels may aid in discrimination patients from healthy females. ......

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