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 Selected Serum Proteins CA125 and OPN as Diagnosis of Ovarian Cancer

Objective:To evaluate the value of serum proteins CA125 and OPN as diagnosis of ovarian cancer.Methods: The expression of serum CA125 and OPN in 69 patients with ovarian cancer,54 patients with ovarian benign tumor and 50 normal persons were detected by RIA and ELISA.The concentration of serum E2 and SO were examined by ELISA and the relationship was analyzed.We contrasted the sensitivity and specificity of combined determination of CA125 and OPN in three groups.We contrasted the sensitivity of combined determination of CA125 and OPN in different pathologic-types of ovarian cancer.Results: The serum CA125 and OPN in cancer group is higher expressed than the other two groups,with statistical significance(P < 0.01).The sensitivities of CA125 and OPN are 66.7% and 85.5% in the diagnosis of ovarian cancer,the combined determination one is 95.7%.In patients with ovarian serous adenocarcinoma,mucous adenocarcinoma and endometrioid adenocarcinoma,the sensitivities of combined determination of CA125 and OPN are 91.7%,70.0% and 66.7%.Conclusion: The measurement of serum CA125 and OPN is an effective method in the diagnosis for patients with ovarian cancer.The positive rate can be increased by the combined use of CA125 and OPN for patients with mucous adenocarcinoma.