戊酸雌二醇联合甲羟孕酮治疗子宫内膜异位症的疗效及对血清CA125、CA199、VEGF水平的影响

目的:探讨戊酸雌二醇联合甲羟孕酮治疗子宫内膜异位症的疗效及对血清糖类抗原125(CA125)、糖类抗原199(CA199)、血管内皮生长因子(VEGF)水平的影响。方法:选择本院2016年6月～2018年1月收治的134例子宫内膜异位症患者,按随机数字表法分为对照组(n=76)和观察组(n=58),对照组采用甲羟孕酮治疗,观察组在对照组基础上联合戊酸雌二醇治疗,比较两组临床疗效,治疗前后血清CA125、CA199、VEGF水平,囊肿直径、月经不调评分、痛经评分和不良反应发生情况。结果:观察组总有效率高于对照组,差异有统计学意义(P0.05)。治疗前,两组血清CA125、CA199、VEGF水平,囊肿直径、月经不调评分、痛经评分比较差异无统计学意义(P0.05);治疗后,两组血清CA125、CA199、VEGF水平、囊肿直径、月经不调评分及痛经评分均下降,观察组低于对照组,差异有统计学意义(P0.05)。两组均有乏力、失眠及潮热发生,组间总副反应发生率差异无统计学意义(P0.05)。结论:戊酸雌二醇联合甲羟孕酮能够提高子宫内膜异位症的疗效,有效降低血清CA125、CA199及VEGF水平,安全性较高。     

Effects of adiponectin,plasma D-dimer,inflammation and tumor markers on clinical characteristics and prognosis of patients with ovarian cancer

BackgroundTo investigate the effects of adiponectin (ADPN), plasma D-dimer (D-D), inflammation, and tumour markers on clinical characteristics and prognosis of patients with ovarian cancer.MethodsA total of 80 patients with ovarian cancer treated in our hospital from April 2017 to November 2019 were enrolled as study subjects and evenly divided into an observation group (patients with ovarian cancer) and a control group (patients with the benign ovarian tumour) based on the results of the postoperative pathological biopsy. The levels of ADPN, plasma D-D, inflammatory factors, and serum tumour markers carbohydrate antigen 125 (CA125), human epididymis protein 4 (HE4), and risk of ovarian malignancy algorithm (ROMA) were compared between the two groups. The diagnostic value of serum tumour markers CA125, HE4, and ROMA in ovarian cancer was explored. The correlations of ROMA changes with the changes in the levels of ADPN, plasma D-D, high-sensitivity C-reactive protein (hs-CRP), CA125, and HE4 were analysed. Additionally, the related risk factors affecting the development of ovarian cancer were subjected to univariate and multivariate logistic regression analyses.ResultsIn comparison with the control group, the observation group exhibited a lowered ADPN level (p<0.05), notably raised levels of plasma D-D, inflammatory factors hs-CRP and interleukin-6 (IL-6) and serum tumour markers CA125 and HE4 and an evidently increased ROMA (p<0.05). Besides, the detection of serum ROMA showed the highest specificity and sensitivity and low false-positive rate and false-negative rate. The changes of ROMA were positively correlated with the changes in the levels of plasma D-D, hs-CRP, CA125, and HE4 (p<0.05) and negatively associated with the changes in ADPN level (p<0.05). The results of the univariate analysis showed that abnormal ADPN, D-D, hs-CRP, IL-6, CA125, and HE4 levels were related to risk factors affecting the development of ovarian cancer. It was found through multivariate logistic regression analysis that decreased ADPN level and increased D-D, hsCRP, IL-6, CA125, and HE4 levels were independent risk factors affecting the development of ovarian cancer.ConclusionsIn the case of ovarian cancer, the ADPN level declines, while the levels of plasma D-D, inflammatory factors, and serum tumour markers CA125, HE4, and ROMA rise obviously. Besides, the ROMA level displays a positive relation to the content of CA125, HE4, plasma D-D, and inflammatory factors and a negative association with the ADPN level.     

血清CA125 和OPN 联检在卵巢癌患者中的诊断价值

目的:探讨CA125和OPN联检在卵巢癌诊断中的应用价值。方法:以50例正常健康人为对照,对经组织病理学确诊的69例卵巢癌患者和54例卵巢良性肿瘤患者术前行血清CA125(放免法)和OPN(ELISA法)测定。比较二种血清标志物在正常人、卵巢良性肿瘤和卵巢癌病例中的表达水平。以正常人血清OPN均值±1.96S作为上下界,计算OPN临界值,大于临界值即为OPN阳性。血清CA125≥35 U/mL为阳性。比较三组病例中血清CA125和OPN单检及联检的灵敏度及特异性。比较二种血清标志物在卵巢癌及卵巢良性肿瘤的不同组织分型中的灵敏度。结果:卵巢癌组血清CA125和OPN的水平均显著高于正常对照组和卵巢良性肿瘤组(P<0.01),OPN临界值为27 ng/mL。在卵巢癌诊断中CA125、OPN检测的敏感度分别为66.7%和85.5%,二者联检的敏感度为95.7%。同时二者联检对浆液性囊腺癌、粘液性囊腺癌和子宫内膜样腺癌的敏感度分别为91.7%、70.0%和66.7%。结论:血清CA125和OPN是卵巢癌诊断的敏感性指标,二者联检可提高卵巢癌、特别是粘液性卵巢癌诊断的敏感度。     

Evaluation of serum CA 125 levels in patients with pelvic pain related to endometriosis

The aim of the study was to investigate the clinical value of the serum CA 125 level for diagnosing and determining the severity of endometriosis and pelvic pain associated with endometriosis. Eighty-six women who underwent operative laparoscopy were enrolled. Sixty-nine women with endometriosis and 17 without endometriosis participated in this study. In all of the patients, endometriosis was diagnosed and classified into stages according to the Revised American Fertility Society (R-AFS) classification. The mean serum CA 125 levels were determined in each patient. We also investigated the relationship between serum CA 125 concentration and the intensity of dysmenorrhea and dyspareunia in the study group. The mean serum CA 125 levels of women with endometriosis were higher than those of the control group (p<0.050). However, the mean serum CA 125 levels were higher in stage IV than in other stages of endometriosis according to the R-AFS classification. On the other hand, the percentage of patients with serum CA 125 levels >35 U/mL was elevated in the subgroups with severe dyspareunia and severe dysmenorrhea versus the asymptomatic subgroup but the differences had no statistical significance. In conclusion, CA 125 serum levels were related to endometriosis and R-AFS score in the evaluated patient series. No correlation was found between serum levels of CA 125 and pelvic pain in patients with endometriosis.     

上皮性卵巢癌患者CT、MRI影像学特征及与血清标志物CEA、CA199、CA125水平的相关性研究

摘要 目的：探讨上皮性卵巢癌患者电子计算机断层扫描（CT）、磁共振成像（MRI）影像学特征及与血清标志物癌胚抗原（CEA）、糖类抗原199（CA199）、糖类抗原125（CA125）水平的相关性。方法：回顾性分析2014年4月-2020年2月于我院83例诊断为上皮性卵巢癌患者的CT、MRI影像学资料,以手术病理结果作为金标准。分析患者的CT、MRI影像学特征,检测患者血清CEA、CA199、CA125水平,评价患者CT、MRI影像学特征与血清CEA、CA199、CA125水平的相关性。结果：上皮性卵巢癌肿瘤横截面最大径为14.2mm-121.7mm,平均（18.6±4.3）mm,上皮性卵巢癌以混杂密度/信号为主,形态不规则,病灶多为囊实性,可见壁结节及分隔改变,增强后可见分隔或壁结节明显强化,可伴有腹水、腹膜转移、淋巴结转移。血清CEA、CA199、CA125水平分别为（66.35±7.52）ng/mL、（183.59±22.62）U/mL、（225.27±25.34）U/mL。上皮性卵巢癌边界清晰、不清晰的血清CA199、CA125水平组间差异有统计学意义（P＜0.05）;上皮性卵巢癌形态圆形/类圆形/椭圆形、分叶状、形态不规则的血清CA199、CA125水平组间差异有统计学意义（P＜0.05）;上皮性卵巢癌患者有壁结节、腹膜转移、淋巴结转移的血清CEA、CA199、CA125水平组间差异有统计学意义（P＜0.05）;其余CT、MRI影像学表现特征组间血清CEA、CA199、CA125水平差异无统计学意义（P＞0.05）。上皮性卵巢癌边界与血清CA125水平呈正相关（P＜0.05）,上皮性卵巢癌形态与血清CA199、CA125水平呈正相关（P＜0.05）,壁结节与血清CA125水平呈正相关（P＜0.05）,腹膜转移、淋巴结转移与血清CEA、CA199、CA125水平呈正相关（P＜0.05）,其余指标之间无明显相关性（P＞0.05）。结论：上皮性卵巢癌CT、MRI影像表现具有特征性,血清CEA、CA199、CA125水平的检测有助于对早期上皮性卵巢癌的诊断以及不同病理类型的判断,CT、MRI影像学特征与血清CEA、CA199、CA125水平具有相关性,可判断疾病的进展及患者预后情况,对指导临床综合治疗及评估患者预后可提供客观依据。     

Tissue quantification of CA 125 in epithelial ovarian cancer.

The objectives of this study were the determination of CA 125 in the cytosol of healthy and carcinomatous ovarian tissue by immunoanalysis, analysis of its correlation with the biological characteristics of ovarian carcinoma, determination of serum CA 125 levels, and study of the prognostic value of the marker in cytosol. The levels of the marker depend not only on the tumor's production rate, so its determination in tissue can indicate more accurately if the tumor is a producer of the marker and establish its value for the prognosis of the disease. Determination of CA 125 in tissue was performed by immunoanalysis in 50 ovarian epithelial cancer samples, 13 benign pathology samples and 32 healthy ovary samples. The presurgical serum level of the marker was also obtained. The correlation between the CA 125 level in the cytosol and the different biological characteristics of the ovarian carcinoma, the serum levels of the marker and survival were analyzed. The CA 125 level proved to be higher in malignant tissue (p < 0.0001). There was a significant association between the tissue marker and histological type (high CA 125 was associated with serous and endometrioid tumors) and between the marker and survival. No relation with stage was found. There was a correlation between the CA 125 level in the cytosol and serum both variables being dependent, with a correlation coefficient of 0.44. This good correlation speaks in favor of the usefulness of CA 125 determination in serum in the follow-up of ovarian cancer. Tumors having high tissue expression of CA 125 were found to have a double relative risk of death, independently of tumor stage.     

CA 125: the past and the future

Over the last 15 years, substantial progress has been made in understanding the potential and the limitations of the CA 125 assay. More than 2000 papers have been published concerning laboratory and clinical studies of CA 125. The original CA 125 assay utilized the OC 125 antibody that recognizes the CA 125 epitope on a high molecular weight glycoprotein. Despite repeated attempts, the gene encoding the peptide component has not yet been cloned. Monoclonal antibodies have been raised against other epitopes expressed by this molecule, leading to the development of the CA 125-II assay that exhibits less day-to-day variation. Using either assay, elevated levels of CA 125 are detected in a number of benign conditions, including endometriosis. CA 125 is most consistently elevated in epithelial ovarian cancer, but can be expressed in a number of gynecologic (endometrial, fallopian tube) and non-gynecologic (pancreatic, breast, colon and lung) cancers. The best established application of the CA 125 assay is in monitoring ovarian cancer. The rate of decline in CA 125 during primary chemotherapy has been an important independent prognostic factor in several multivariate analyses. Persistent elevation of CA 125 at the time of a second look surgical surveillance procedure predicts residual disease with > 95% specificity. Rising CA 125 values have preceded clinical detection of recurrent disease by at least 3 months in most, but not all studies. Given the modest activity of salvage chemotherapy, this information has not yet impacted on survival. Rising CA 125 during subsequent chemotherapy has been associated with progressive disease in more than 90% of cases. CA 125 may serve as an effective surrogate marker for clinical response in phase II trials of new drugs. CA 125 levels can aid in distinguishing malignant from benign pelvic masses, permitting effective triage of patients for primary surgery. Early detection of ovarian cancer remains the most promising application of CA 125. An algorithm has been developed that estimates the risk of ovarian cancer (ROC) based upon the level and trend of CA 125 values. A major trial has been initiated that uses the ROC algorithm to trigger transvaginal sonography and/or subsequent laparotomy. Such a trial could demonstrate improvement in survival through early detection. This strategy should provide adequate specificity, but sensitivity for early stage disease may not be optimal. In the future, improved sensitivity may be attained using multiple markers and neural network analysis. Most serum tumor markers have been proteins or carbohydrates, but lipid markers such as lysophosphatidic acid deserve evaluation. Genomic and proteonomic technologies should identify additional novel markers.     

血清OPN、HE4和CA125检测对卵巢癌的临床意义

目的：探讨联合检测血清OPN、HE4和CA125对卵巢癌的临床意义。方法：选择2010年6月-2012年7月西安市中心医院妇科及陕西省肿瘤医院妇瘤科收治的35例卵巢癌患者、73例卵巢良性肿瘤患者及40例同期体检的健康妇女为研究对象,应用ELISA法检测患者手术前后血清OPN、HE4水平,电化学发光法检测患者手术前后血清CA125水平,计算3种肿瘤标志物单项以及联合检测在卵巢癌诊断中的敏感性及特异性。结果：（1）卵巢癌患者术前血清OPN、HE4和CA125水平分别为94.6±61.06ng/mL、412.3±278.62 pmol/mL和398.64±220.91 U/mL,与卵巢良性肿瘤组及正常对照组比较差异有统计学意义（P〈0.05）;（2）卵巢癌患者手术前与术后1月血清OPN、HE4和CA125水平比较,差异均有统计学意义（P〈0.05）;（3）血清OPN、HE4和CA125水平联合检测诊断卵巢癌的敏感性（94.3%）显著高于血清OPN、HE4和CA125单项指标检测（分别为37.1%、71.4%和77.1%）,联合检测与单项指标检测比较差异均有统计学意义（P〈0.05）,而血清OPN、HE4和CA125联合检测诊断卵巢癌的特异性（78.8%）稍低于血清OPN、HE4和CA125单项指标检测（分别为87.6%、100%和80.5%）,联合检测与单项指标检测的特异性比较差异无统计学意义（P〉0.05）。血清HE4单项指标检测的特异性高达100%。结论：联合检测卵巢癌患者血清OPN、HE4和CA125水平可作为诊断和评估卵巢癌预后的参考指标。     

GnRH-a对子宫内膜异位症患者血清CA125、EMAB及RANTES的影响

目的:探讨促性腺激素释放激素激动剂(Gn RH-a)对子宫内膜异位症患者血清CA125、EMAB及RANTES的影响。方法:选取我院收治的子宫内膜异位症患者92例,根据治疗方法不同分为两组,对照组予以常规治疗,治疗组在对照组基础上加用醋酸亮丙瑞林微球注射治疗。检测两组患者治疗前后血清CA125、EMAB及RANTES水平。结果:与治疗前相比,两组患者治疗后CA125、RANTES明显降低,EMAB转阴率明显升高,差异有统计学意义(P0.05);与对照组相比,治疗组患者治疗后CA125、RANTES水平降低,EMAB转阴率升高,差异有统计学意义(P0.05);治疗组不良反应发生率低于对照组,差异有统计学意义(P0.05)。结论:Gn RH-a能够降低子宫内膜异位症患者血清CA125、RANTES及EMAB水平,提高机体免疫功能,安全性较高,对临床具有指导意义。     

CA 125 in biological fluids

CA 125 is not a specific tumor marker, and is synthesized by normal and malignant cells of different origin (mainly in tissues derived from the müllerian epithelia) in a similar proportion. Abnormal CA 125 levels may be found in fluids of different origin (ascites, pleura, pericardium, amniotic fluid, cyst fluid, bronchoalveolar fluid, etc.) and in serum from patients with these fluids. Differences in serum CA 125 found in malignant or benign diseases may be related to the number of cells that synthesize the marker, and are highly dependent on the access to serum, where the marker is normally determined. Moreover, CA 125 is a very good tumor marker in ovarian and lung cancer. The sensitivity of CA 125 in ovarian cancer is related to stage (40-95%), histological type (lower levels in mucinous adenocarcinoma), and the marker is useful in the early detection of recurrence (sensitivity 80%) and in therapy monitoring. It's sensitivity in lung cancer is lower than in ovarian cancer, 39% in locoregional malignancies and 69% in metastatic disease, but clearly related to stage and histology (mainly in adenocarcinomas and large cell lung cancer) and it is useful in prognosis and disease monitoring.     

血清HE4、FS、SMRP及CA125在卵巢癌患者中的表达及临床意义

目的:探讨血清人附睾蛋白4(HE4)、卵泡抑素(FS)、可溶性间皮素相关蛋白(SMRP)、糖类抗原125(CA125)在卵巢癌患者中的表达水平及临床意义。方法:选取2014年6月-2017年9月我院收治的卵巢癌患者60例作为卵巢癌组,另选取同期收治的卵巢良性肿瘤患者32例作为良性组,选取同期健康体检妇女40例作为对照组,检测三组受试者血清HE4、FS、SMRP、CA125水平,对比三组HE4、FS、SMRP、CA125阳性表达率,并分析血清HE4、FS、SMRP、CA125对卵巢癌的诊断价值。结果:三组受试者的HE4、FS、SMRP、CA125水平整体对比有统计学意义(P0.05),其中卵巢癌组与良性组HE4、FS、SMRP、CA125水平高于对照组,且卵巢癌组高于良性组,差异有统计学意义(P0.05)。三组受试者的HE4、FS、SMRP、CA125阳性表达率整体对比有统计学意义(P0.05),卵巢癌组与良性组HE4、FS、SMRP、CA125阳性表达率高于对照组,且卵巢癌组高于良性组,差异有统计学意义(P0.05)。联合检测的灵敏度高于FS、SMRP单项检测,差异有统计学意义(P0.05),联合检测的特异度高于HE4、FS、SMRP、CA125单项检测,但差异无统计学意义(P0.05)。结论:卵巢癌患者血清HE4、FS、SMRP、CA125水平及阳性表达率均较高,四项指标联合检测可提高诊断卵巢癌的灵敏度及特异度。     

定坤丹联合复宫宁颗粒治疗子宫内膜异位症的疗效及对血清MCP-1、sICAM-1、CA125水平的影响

目的:探讨定坤丹联合复宫宁颗粒治疗子宫内膜异位症的疗效及对血清单核细胞趋化蛋白-1(MCP-1)、可溶性细胞间粘附分子(s ICAM-1)、CA125水平的影响。方法:选择2014年12月至2016年12月我院接诊的96例子宫内膜异位症患者,通过随机数表法将其分为观察组(n=48)和对照组(n=48)。对照组给予醋酸亮丙瑞林微球注射液联合定坤丹治疗,观察组在对照组基础上联合复宫宁颗粒治疗,两组均连续治疗3个疗程。比较两组治疗前后卵泡生成激素(FSH)、黄体生成激素(LH)、雌二醇(E2)及血清MCP-1、s ICAM-1、CA125水平的变化,临床疗效及不良反应的发生情况。结果:治疗后,观察组临床疗效总有效率明显高于对照组(93.75%vs.70.83%,P<0.05),FSH、LH明显低于对照组,E2明显高于对照组(P<0.05);两组血清MCP-1、s ICAM-1、CA125较治疗前均显著降低(P<0.05),观察组以上指标明显低于对照组(P<0.05)。此外,观察组潮热、多汗、阴道出血总发生率明显低于对照组(P<0.05)。结论:与醋酸亮丙瑞林微球注射液联合定坤丹治疗相比,定坤丹联合复宫宁颗粒治疗子宫内膜异位症的效果更好,其可有效改善患者卵巢内分泌功能,缓解临床症状,其内在机制可能和降低血清MCP-1、s ICAM-1、CA125水平相关。     

Molecular imprinted nanoelectrodes for ultra sensitive detection of ovarian cancer marker

The relentless discovery of cancer biomarkers demands improved methods for their detection. In this work, we developed protein imprinted polymer on three-dimensional gold nanoelectrode ensemble (GNEE) to detect epithelial ovarian cancer antigen-125 (CA 125), a protein biomarker associated with ovarian cancer. CA 125 is the standard tumor marker used to follow women during or after treatment for epithelial ovarian cancer. The template protein CA 125 was initially incorporated into the thin-film coating and, upon extraction of protein from the accessible surfaces on the thin film, imprints for CA 125 were formed. The fabrication and analysis of the CA 125 imprinted GNEE was done by using cyclic voltammetry (CV), differential pulse voltammetry (DPV) and electrochemical impedance spectroscopy (EIS) techniques. The surfaces of the very thin, protein imprinted sites on GNEE are utilized for immunospecific capture of CA 125 molecules, and the mass of bound on the electrode surface can be detected as a reduction in the faradic current from the redox marker. Under optimal conditions, the developed sensor showed good increments at the studied concentration range of 0.5-400 U mL(-1). The lowest detection limit was found to be 0.5 U mL(-1). Spiked human blood serum and unknown real serum samples were analyzed. The presence of non-specific proteins in the serum did not significantly affect the sensitivity of our assay. Molecular imprinting using synthetic polymers and nanomaterials provides an alternative approach to the trace detection of biomarker proteins.     

肿瘤标志物在卵巢恶性肿瘤早期误诊预防中的价值

目的:探讨糖类抗原CA125、CEA与CA199联合检测对卵巢癌有一定的鉴别诊断价值。方法:应用化学发光免疫法对126例经病理查证实的卵巢癌患者(试验组)、104例良性肿瘤患者(对照组)进行血清CA125、CEA与CA199检测。结果:试验组血清检测结果和阳性率均明显高于对照组(P<0.01),联合检测阳性率高于单项检测(P<0.01)。结论:应用检验医学进行CA125、CEA与CA199联合检测对卵巢癌有一定的鉴别诊断价值。可降低误诊率。     

Molecular cloning of the CA125 ovarian cancer antigen: identification as a new mucin, MUC16

CA125 is an ovarian cancer antigen that is the basis for a widely used serum assay for the monitoring of patients with ovarian cancer; however, detailed information on its biochemical and molecular nature is lacking. We now report the isolation of a long, but partial, cDNA that corresponds to the CA125 antigen. A rabbit polyclonal antibody produced to purified CA125 antigen was used to screen a lambdaZAP cDNA library from OVCAR-3 cells in Escherichia coli. The longest insert from the 54 positive isolated clones had a 5797-base pair sequence containing a stop codon and a poly(A) sequence but no clear 5' initiation sequence. The deduced amino acid sequence has many of the attributes of a mucin molecule and was designated CA125/MUC16 (gene MUC16). These features include a high serine, threonine, and proline content in an N-terminal region of nine partially conserved tandem repeats (156 amino acids each) and a C-terminal region non-tandem repeat sequence containing a possible transmembrane region and a potential tyrosine phosphorylation site. Northern blotting showed that the level of MUC16 mRNA correlated with the expression of CA125 in a panel of cell lines. The molecular cloning of the CA125 antigen will lead to a better understanding of its role in ovarian cancer.     

血清TC、TG和LDL-C水平与老年卵巢良恶性肿瘤的相关性分析

摘要 目的：探讨与分析血清总胆固醇（TC）、甘油三脂（TG）和低密度脂蛋白胆固醇（LDL-C）水平与老年卵巢良恶性肿瘤的相关性。方法：2018年8月至2021年4月选择在本院诊治的老年卵巢癌患者72例与老年良性卵巢肿瘤患者72例作为恶性组与良性组,同期选择在本院进行健康体检的老年人72例作为正常组。检测三组血清TC、TG、LDL-C水平、血清肿瘤标志物水平并进行相关性分析。结果：恶性组、良性组的血清TC、TG和LDL-C水平高于正常组,恶性组高于良性组（P<0.05）;三组的血脂异常率分别为77.8 %、44.4 %和6.9 %,对比有差异（P<0.05）。恶性组、良性组的血清CA125、CA153和CA199水平高于正常组,恶性组高于良性组（P<0.05）。在老年卵巢肿瘤144例患者中,偏相关分析显示：TC、TG、LDL-C、CA125、CA153、CA199与卵巢癌存在相关性（P<0.05）;Pearson分析显示：TC、TG、LDL-C与CA125、CA153、CA199存在相关性（P<0.05）。二元Logistic回归分析显示：TC、TG、LDL-C均为导致卵巢癌发生的影响因素（P<0.05）。结论：老年卵巢良恶性肿瘤患者多伴随有血清TC、TG和LDL-C水平的异常,与血清肿瘤标志物水平存在相关性,是引发老年卵巢癌发生的重要因素。     

卵巢癌患者血清HE4、CA125、CA72-4及炎性因子水平检测的临床价值评估

目的:探讨血清人附睾蛋白4(HE4)、糖类抗原125(CA125)、糖类抗原72-4(CA72-4)及炎性因子IL-6、IL-8、IL-17水平检测对卵巢癌患者的临床价值。方法:选取2015年2月至2017年2月我院收治的卵巢肿瘤患者81例,包括卵巢恶性肿瘤组39例及卵巢良性肿瘤组42例,另选42例健康人作正常对照组,比较各组及临床不同分期卵巢癌患者血清HE4、CA125、CA72-4、IL-6、IL-8、IL-17水平的差异。结果:卵巢恶性肿瘤组血清HE4、CA125、CA72-4、IL-6、IL-8及IL-17水平均显著高于对照组(P0.05),而卵巢良性肿瘤组与对照组以上指标比较差异并无统计学意义(P0.05);随卵巢癌分期增加,患者血清HE4、CA125、CA72-4、IL-6、IL-8及IL-17水平呈上升趋势,以血清HE4、CA125及IL-17增加较为显著(P0.05),而Ⅰ期、Ⅱ期及Ⅲ期卵巢癌患者血清CA72-4、IL-6及IL-8在增加并不明显(P0.05)。结论:卵巢癌患者血清HE4、CA125、CA72-4、IL-6、IL-8及IL-17水平较高,且随临床分期增加呈上升趋势,以上指标可能有助于卵巢癌的诊断、治疗及病情评估。     

Risk of diagnosis of ovarian cancer after raised serum CA 125 concentration: a prospective cohort study.

OBJECTIVE: To determine the risk of invasive epithelial ovarian cancer and fallopian tube cancer associated with a raised concentration of the tumour marker CA 125 in asymptomatic postmenopausal women. DESIGN: Serum CA 125 concentration was measured annually in study participants for one to four years. Participants with a concentration > or = 30 U/ml were recalled for abdominal ultrasonography. Follow up was by annual postal questionnaire. SETTING: General practice, occupational health departments, ovarian cancer screening unit in a teaching hospital. SUBJECTS: 22,000 volunteers, all postmenopausal women > or = 45 years of age; recruited between 1 June 1986 and 1 May 1990. INTERVENTION: Surgical investigation if the ultrasound examination was abnormal. MAIN OUTCOME MEASURES: Cumulative and relative risk of developing an index cancer (invasive epithelial cancer of the ovary or fallopian tube) after a specified CA 125 result. RESULTS: 49 index cancers developed in the study population during a mean follow up of 6.76 years. The overall cumulative risk of developing an index cancer was 0.0022 for the entire study population and was lower for women with a serum CA 125 concentration < 30 U/ml (cumulative risk 0.0012) but was appreciably increased for women with a concentration > or = 30 U/ml (0.030) and > 100 U/ml (0.149). Compared with the entire study population the relative risk of developing an index cancer within one year and five years was increased 35.9-fold (95% confidence interval 18.3 to 70.4) and 14.3-fold (8.5 to 24.3) respectively after a serum CA 125 concentration > or = 30 U/ml and 204.8-fold (79.0 to 530.7) and 74.5-fold (31.1 to 178.3) respectively after a concentration > or = 100 U/ml. CONCLUSION: CA 125 is a powerful index of risk of ovarian and fallopian tube cancer in asymptomatic postmenopausal women.     

血清孕酮、beta-HCG及CA125 水平在宫外孕诊断中的临床应用

目的：探讨血清孕酮、人绒毛膜促性腺激素（HCG）及癌抗原125（CA125）水平在宫外孕诊断中的临床应用价值。方法：选择 我院妇产科收治的61 例宫外孕患者作为观察组,同期选择正常早孕孕妇35例作为对照组,检测并对比两组血清孕酮、beta-HCG 48 h 内增长率及CA125 水平,研究三项指标分别检测和联合检测对宫外孕诊断的特异性、敏感性。结果：观察组血清孕酮、beta-HCG 48 h增长率及CA125 检测水平均显著低于对照组,比较差异有统计学意义（P<0.05）;单独应用时CA125 对于宫外孕具有较高的 特异性,而茁-HCG 48 h 内增长率具有较高的敏感性,三项指标联合检测特异性及敏感性均显著优于单一指标,比较差异具有统 计学意义（P<0.05）。结论：血清孕酮、beta-HCG及CA125 指标水平的分别检测或联合检测,对宫外孕的诊断均有一定的临床价值, 而三项指标的联合检测显著优于单一指标。     

CA 125 in benign gynecological conditions

The tumor marker CA 125 was initially thought to be specific for ovarian malignancies. Subsequently it was found to be raised in a variety of benign conditions, including pregnancy, pelvic inflammatory disease, tuberculosis and cirrhosis of the liver. With respect to gynecological tumors, CA 125 may be elevated in benign ovarian cysts, tubo-ovarian abscess, endometriosis, hyperstimulation syndrome, ectopic pregnancy and fibroids. These results demonstrate that CA 125 is a marker of non-specific peritoneal conditions.