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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。
Objective: To investigate the diagnostic value of CA125 and OPN in the diagnosis of ovarian cancer. Methods: Totally 69 ovarian cancer patients and 54 ovarian benign tumor confirmed by histopathology were measured by serum CA125 (radioimmunoassay) and OPN (ELISA) in 50 healthy volunteers. The expression levels of two serum markers in normal human, benign ovarian tumor and ovarian cancer were compared. The normal OPN serum mean ± 1.96S as the upper and lower bound, calculated OPN critical value, greater than the critical value is OPN positive. Serum CA125≥35 U / mL was positive. The sensitivity and specificity of serum CA125 and OPN in the three groups were compared. The sensitivity of the two serum markers in different histological types of ovarian and benign ovarian tumors was compared. Results: The levels of serum CA125 and OPN in ovarian cancer group were significantly higher than those in normal control group and benign ovarian tumor group (P <0.01). The critical value of OPN was 27 ng / mL. In the diagnosis of ovarian cancer CA125, OPN detection of the sensitivity were 66.7% and 85.5%, the two joint detection sensitivity was 95.7%. At the same time the two joint detection of serous cystadenocarcinoma, mucinous cystadenocarcinoma and endometrial adenocarcinoma sensitivity were 91.7%, 70.0% and 66.7%. Conclusion: The serum CA125 and OPN are the sensitive indexes for the diagnosis of ovarian cancer. The combination of the two can improve the sensitivity of diagnosis of ovarian cancer, especially of the mucinous ovarian cancer.