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目的探讨血清糖类抗原153(CA153)、糖类抗原125(CA125)、糖类抗原199(CA199)、癌坯抗原(CEA)联合检测在早期卵巢癌诊断中的临床应用价值。方法选择2013年1月-2015年12月岱山第一人民医院确诊的早期卵巢癌患者60例(卵巢癌组)、30例卵巢良性疾病患者(良性组)、30例健康人(健康组)的血清,采用化学发光法进行检测,对比各组中上述肿瘤标志物的水平,并分析各肿瘤标志物诊断早期卵巢癌的能力。结果卵巢癌组患者的血清CA153、CA125、CA199、CEA水平均显著高于良性组和健康组(P<0.05)。CA153鉴别诊断卵巢恶性肿瘤的灵敏度为48.33%、特异度为80.00%、ROC曲线下面积为0.634;CA125鉴别诊断卵巢恶性肿瘤的灵敏度为61.67%、特异度为85.00%、ROC曲线下面积为0.682;CA199鉴别诊断卵巢恶性肿瘤的灵敏度为38.33%、特异度为81.67%、ROC曲线下面积为0.621;CEA鉴别诊断卵巢恶性肿瘤的灵敏度为33.33%、特异度为93.33%、ROC曲线下面积为0.611;联合检测鉴别诊断卵巢恶性肿瘤的灵敏度为85.00%、特异度为96.67%、ROC曲线下面积为0.902。结论血清CA153、CA125、CA199、CEA单独应用诊断早期卵巢癌的灵敏度较低,将其联合应用可以显著的提高诊断的灵敏度和特异度。
Objective To investigate the clinical value of combined detection of serum carbohydrate antigen 153 (CA153), carbohydrate antigen 125 (CA125), carbohydrate antigen 199 (CA199) and carcinoembryonic antigen (CEA) in the diagnosis of early ovarian cancer. Methods Sixty patients with early ovarian cancer (ovarian cancer group), 30 patients with benign ovarian disease (benign group) and 30 healthy people (healthy group) diagnosed by the First People’s Hospital of Dai-Shan from January 2013 to December 2015 were enrolled in this study. Serum were detected by chemiluminescence method, comparing the level of the above tumor markers in each group, and analyzing the ability of each tumor marker in diagnosing early stage ovarian cancer. Results The levels of serum CA153, CA125, CA199 and CEA in ovarian cancer patients were significantly higher than those in benign and healthy controls (P <0.05). The sensitivity and specificity of CA153 in the diagnosis of ovarian cancer were 48.33%, 80.00% and 0.634, respectively. The sensitivity and specificity of CA125 in differentiating ovarian cancer were 61.67% and 85.00%, respectively. The area under the ROC curve was 0.682. The sensitivity and specificity of CA199 in the diagnosis of ovarian cancer were 38.33%, 81.67% and 0.621, respectively. The sensitivity and specificity of CEA in the diagnosis of ovarian cancer were 33.33% and 93.33%, respectively. The area under the ROC curve was 0.611. The sensitivity of combined detection of malignant ovarian tumor was 85.00%, the specificity was 96.67%, and the area under ROC curve was 0.902. Conclusions The sensitivity of serum CA153, CA125, CA199 and CEA alone for the diagnosis of early stage ovarian cancer is low. Combined application of them can significantly improve the sensitivity and specificity of diagnosis.