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目的探讨肿瘤标志物糖抗原125(CA125)、CA199、甲胎蛋白(AFP)和癌胚抗原(CEA)水平在成熟性卵巢畸胎瘤诊断中的作用。方法选择2010年5月-2012年5月术后经病理证实为卵巢畸胎瘤患者434例,回顾性分析其各项临床资料,同时测定多种肿瘤标志物水平;从患者年龄、肿瘤大小、成分等方面进行分析,寻找畸胎瘤与血清CA199水平增高的相关因素。结果 434例中,420例术前测定血清CA125,47例CA125>35U/ml,除10例伴明确可以引起CA125升高疾病的患者外,阳性率为8.8%(37/420)。398例血清测定CA199,68例CA199>39U/ml,阳性率17.1%(68/398)。测定AFP者421例,3例AFP数值升高,其中2例为妊娠合并卵巢畸胎瘤。421例术前测定CEA,6例升高,阳性率1.4%(6/421)。CA199升高组肿瘤直径大于CA199正常组[(8.7±5.2)cm vs. (5.9±3.5)cm](P<0.05);CA199升高组双侧卵巢畸胎瘤发生率明显高于CA199正常组(27.9% vs. 13.9%)(P<0.05)。结论对于成熟性卵巢畸胎瘤患者,CA199是具有临床意义、阳性率最高的肿瘤标志物。双侧畸胎瘤、肿瘤直径越大,CA199阳性率越高。
Objective To investigate the role of tumor markers carbohydrate antigen 125 (CA125), CA199, AFP and CEA in the diagnosis of mature ovarian teratoma. Methods A total of 434 cases of ovarian teratoma confirmed by pathology from May 2010 to May 2012 were retrospectively analyzed, and the levels of various tumor markers were also determined. The age, tumor size, Components and other aspects of analysis, looking for teratoma and serum CA199 levels increased related factors. Results Of the 434 cases, 420 were preoperatively determined for serum CA125 and 47 for CA125> 35 U / ml. The positive rate was 8.8% (37/420) except for 10 patients with definite CA125-elevating disease. 398 cases of serum CA199, 68 cases of CA199> 39U / ml, the positive rate of 17.1% (68/398). AFP were measured in 421 cases, 3 cases of AFP increased, of which 2 cases of pregnancy with ovarian teratoma. In 421 cases, CEA was measured preoperatively, 6 cases were elevated, the positive rate was 1.4% (6/421). The tumor diameter in CA199 elevated group was larger than that in CA199 normal group (8.7 ± 5.2 cm vs 5.9 ± 3.5 cm) (P <0.05). The incidence of bilateral ovarian teratoma in CA199 elevated group was significantly higher than that in CA199 normal group (27.9% vs. 13.9%) (P <0.05). Conclusion For patients with mature ovarian teratoma, CA199 is the most clinically significant and positive tumor marker. Bilateral teratoma, the larger the tumor diameter, the higher the positive rate of CA199.