摘要
目的研究血清肿瘤相关抗原125（CA125）水平在子宫内膜异位症危险分层中的作用。方法对685例子宫内膜异位症患者进行回顾性分析。根据修正的美国生育学会标准分期，将Ⅰ、Ⅱ期定为低危组（276例），Ⅲ、Ⅳ期定为高危组（409例）。用F检验统计不同盆腔状态患者术前血清CA125水平，应用多元回归分析血清CA125水平升高的意义，应用受试者操作特征曲线（ROC）评估术前血清CA125水平在子宫内膜异位症危险分层的应用价值。结果高危组血清CA125水平明显高于低危组，分别为（115．6±8．5）IU／mi及（35．3±2．2）IU／ml，P〈0．01。再者，腹膜黏连，网膜、卵巢、输卵管、结肠和后穹隆黏连或子宫内膜异位囊肿破裂患者血清CA125水平明显升高（P〈0．01，F检验）。将ROC曲线临界值定为65IU／ml，其敏感度为76％，特异度为71％，阳性预测值（PPV）为76％，阴性预测值（NPV）为93．2％。结论血清CA125检测可用于子宫内膜异位症危险分层，在子宫内膜异位症的诊断、治疗方案的选择及预后判断中具有重要的应用价值。
Objective To investigate the significance of serum CA125 level in the risk stratification for patients with endometriosis. Methods Descriptive retrospective analysis was performed on a total of 685 women undergoing surgery for endometriosis between June 1998 and December 2005. Ac cording to revised American Fertility Society （r-AFS） stages Ⅰ , Ⅱ ,Ⅲ , and IV endometriosis, all pa tients （n=685） were divided into high-risk group （stages Ⅲ and IV ,n=409） and low-risk group （stages Ⅰ and Ⅱ ,n=276）. Preoperative serum CA125 levels were compared between various pelvic complications using F statistics. Multiple regression analysis was employed to determine the significant of elevated serum CA125, and the receiver operating characteristic （ROC） curve was applied to assess the utility of serum CA125 in the risk stratification for patients with endometriosis. Results The mean serum CA125 levels were significantly higher in patients in high-risk group than that in low-risk group （115.6±8.5 IU/ml vs 35.3±2.2 IU/ml,P〈0.01,F test）. Furthermore, serum CA125 levels were significantly higher in patients with more extensive adhesion to the peritoneum, omentum, ovary, fallopian tube, colon, and posterior cul-de-sac, or with ruptured endometrioma （P〈0.01 ,F test）. Receiver operating characteristic （ROC） curve analysis with cutoff point of 65 IU/ml, showed sensitivity of 760/00, specificity of 71%, positive predictive value （PPV） of 76%, and negative predictive value （NPV） of 93.2% for endometriosis. Conclusion Our results display that preoperative CA125 assay may be applied to the risk stratification for patients with endometriosis, and it may play an important role in the diagnosis, selection of therapeutic strategy and judgement of prognosis evaluation in patients with endometriosis.
出处
《国际检验医学杂志》
CAS
2007年第12期1070-1072,1075,共4页
International Journal of Laboratory Medicine
