檢驗醫學
CEA、CA125、CA199及AFP聯合檢測對卵巢癌的診斷價值
曹文
【摘要】 目的 評價卵巢癌診斷中進行抗原199(carbohydrate antigen199,CA199)、糖鏈抗原125(carbohydrate antigen125,CA125)、癌胚抗原(carcinoembryonic antigen,CEA)、甲胎蛋白(alpha-fetoprotein,AFP)聯合檢測的價值,為卵巢癌疾病診斷工作提供參考,以盡早干預、促進患者預后。
【關鍵字】 卵巢癌診斷,CEA,CA125,CA199,AFP,檢測陽性率,卵巢良性腫瘤
中圖分類號:文獻標識碼:文章編號:
[Abstract]Objective To evaluate the value of combined detection of antigen 199 (CA199), carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA) and alpha fetoprotein (AFP) in the diagnosis of ovarian cancer, so as to provide reference for the diagnosis of ovarian cancer, and to intervene as early as possible and promote the prognosis of patients. Methods Selected patients with ovarian cancer and benign ovarian tumors admitted to our hospital from August 2018 to October 2019, 80 cases each were selected as observation group 1 and observation group 2. In addition, 80 healthy subjects in the same period were selected as the control group. After review and approval by the hospital ethics committee, the participants informed and agreed to cooperate, the observation group 1, observation group 2 and the control group were all tested for CEA, CA125, CA199, and AFP, and the corresponding test results of the three groups were compared and combined the positive rate of tests and individual tests.
卵巢癌是女性常見惡性腫瘤疾病,臨床中發現,近年來此類疾病患病率呈明顯遞增趨勢[1]。卵巢癌發病率僅次于宮頸癌和子宮內膜癌,但其病死率在生殖系統惡性腫瘤中居首位。卵巢癌早期階段患者無典型臨床癥狀,且缺乏特異的早期篩查標志物,早期診斷困難,多數患者發現情況下已處在晚期階段,甚至擴散到子宮、盆腔等器官,所以需盡早采取有效的診斷、治療措施,從而提高患者的生存質量[2]。研究發現,血清腫瘤標志物變化先于影像學、臨床癥狀,檢測操作方便,患者耐受度高[3]。因此在臨床中可用于腫瘤的鑒別診斷、臨床分期、預后判斷等,指導臨床診療,改善患者預后,目前卵巢癌病理類型復雜,復發率高,預后差。診斷及臨床分期判斷時仍缺乏高靈敏度、高特異度的腫瘤標志物。雖然,類抗原CA125、CA199等是腫瘤組織的特殊抗原,是診斷卵巢癌的敏感標志物,但是單項檢測漏診率較高,所以為了提高診斷準確性,開始嘗試聯合檢測手段,且檢驗陽性率較高[4]?;诖?,本文就我院同期的卵巢癌、卵巢良性腫瘤患者以及健康體檢者為例進行研究,分析CEA、CA125、CA199、AFP聯合檢測價值。
1 資料與方法
1.1 一般資料 研究對象選自2018年8月至2019年10月,獲得醫院倫理委員會批準,選取對象包括卵巢癌患者、卵巢良性腫瘤患者、健康體檢者,各選取80例,分別作為觀察1組、觀察2組、對照組。納入標準:①參與患者、家屬知情同意。②基線資料完整,參與者具有配合能力。排除標準:①人類免疫缺陷病毒感染等疾病患者。②精神病史等喪失配合能力患者。③心、肝、脾、腎等內臟器官病變患者。
觀察1組:年齡22~68歲,平均(47.50±5.60)歲;經病理確診,卵巢漿液性囊腺癌35例,卵巢黏液囊腺癌25例,透明細胞癌以及子宮內膜樣腺癌各10例。
觀察2組:年齡23~66歲,平均(47.02±5.30)歲;經病理確診,成熟性囊性畸胎瘤38例,黏液性囊腺瘤16例,漿液性囊腺瘤以及混合性囊腺瘤各13例。