CA125在诊断卵巢子宫内膜异位囊肿破裂中的临床价值

发布时间：2018-01-16 17:09

本文关键词：CA125在诊断卵巢子宫内膜异位囊肿破裂中的临床价值　出处：《青岛大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨血清CA125水平与卵巢子宫内膜异位囊肿破裂可能性的相关性及临床意义,为该类疾病手术风险预测、术前评估、术后随访提供理论依据。方法:选取自2011年1月-2016年12月在青州市妇幼保健院妇科收治并行手术治疗,术后病理证实为卵巢子宫内膜异位囊肿患者150例为研究对象,其中卵巢子宫内膜异位囊肿破裂者50例为实验组;卵巢子宫内膜异位囊肿未破裂患者100例为对照组。搜集两组患者临床资料进行对比,所有患者术前均行血清肿瘤标记物:CA199、CA125、CEA、AFP检查及常规血、尿、便RT,凝血、生化、心电图、胸片、CT、B超等常规检查。手术过程顺利,术后切除组织均送病理确诊。收集患者术前、术后1天、1周、1月血相关标本采用全自动电化学发光分析仪进行检测。结果:(1)两组患者平均年龄分别为33.10±7.8岁、34.76±7.3岁(P0.05),平均月经周期分别为31.23±5.2天、33.41±5.4天(P0.05)。两组患者囊肿直径均主要集中在5-10cm,两组数据比较X2=2.05,P0.05(P=0.35),两组患者年龄、月经周期、异位囊肿直径大小等临床参数无统计学差异。(2)两组患者血清CA125水平差异有统计学意义(X2=28.125,P0.05),而CA199、CEA、AFP均无统计学意义(X2=0.054、2.260、0.857,P0.05)。(3)实验组中当检测血清CA125≥35u/ml时诊断卵巢子宫内膜异位囊肿破裂的灵敏度是90%,特异度是55%,阳性的预测值50%,阴性的预测值91.67%。当CA125≥70u/ml时诊断卵巢子宫内膜异位囊肿破裂的灵敏度是82%。,特异度是88%,阳性的预测值83.64%,阴性的预测值92.63%。(4)CA125≥70u/ml组与CA12570u/ml组比较,前者发生卵巢子宫内膜异位囊肿破裂的几率明显增加,差异有统计学意义(X2=39.13,P0.05)(5)两组患者术后1天、1周随访血清CA125水平,差异有统计学意义(X2=73.50,P0.01),(X2=72.53,P0.01),而术后1月两组患者血清CA125水平无明显差异。(X2=1.53,P0.05)结论:血清CA125水平有望成为诊断卵巢子宫内膜异位囊肿破裂的敏感指标之一。CA125水平在子宫内膜异位症的术前评估、术后随访过程中具有重要的指导意义。
[Abstract]:Objective: To investigate the correlation between serum CA125 levels and ovarian endometriosis cyst rupture possibility and clinical significance, a risk predictor for treatment of this disease, preoperative evaluation, and provide a theoretical basis for the follow-up after surgery. Methods: from January 2011 December -2016 in Qingzhou maternal and child health hospital and underwent surgery, postoperative pathology for ovarian endometriosis cyst in 150 cases as the research object, the rupture of ovarian endometriotic cysts in 50 cases as experimental group; ovarian endometriosis patients with unruptured 100 cases as control group. To collect the clinical data of two groups were compared, all patients underwent preoperative serum tumor markers: CA199, CA125 CEA, AFP, and blood routine examination, urine RT, blood biochemical, electrocardiogram, chest X-ray, CT and ultrasound routine examination. The operation went smoothly, after the removed tissues were sent for pathological diagnosed were collected. Before operation, 1 days, 1 weeks after operation, blood samples in January were detected with automatic electrochemiluminescence analyzer. Results: (1) the average age of patients in two groups were 33.10 + 7.8, 34.76 + 7.3 (P0.05), the average menstrual cycle were 31.23 + 5.2 + 5.4 days (33.41 days. P0.05). Two groups of patients with cyst diameter were mainly concentrated in 5-10cm, two groups of data comparison of X2=2.05, P0.05 (P=0.35), two groups of patients with age, menstrual cycle, no significant difference between the clinical parameters of diameter of cyst. (2) the difference between the two groups of patients with serum CA125 level was statistically significant (X2=28.125, P0.05). CA199, CEA, AFP were not statistically significant (X2=0.054,2.260,0.857, P0.05). (3) in the experimental group while serum CA125 greater than or equal to 35u/ml sensitivity in the diagnosis of rupture of ovarian endometrioma was 90%, the specificity was 55%, the positive predictive value of 50%, negative predictive value of 91.67%. when CA125 is greater than or equal to 70u/ml diagnosis Sensitivity of broken ovarian endometrial cyst rupture is 82%., the specificity was 88%, the positive predictive value of 83.64%, negative predictive value of 92.63%. (4) CA125 = 70u/ml group compared with CA12570u/ml group, the incidence of rupture of ovarian endometrioma was significantly increased, the difference was statistically significant (X2=39.13, P0.05 (5) 1 days) the two groups of patients after 1 weeks of follow-up, the serum level of CA125, the difference was statistically significant (X2=73.50, P0.01), (X2=72.53, P0.01), while no significant difference after January two. Serum CA125 levels (X2=1.53, P0.05). Conclusion: the serum level of CA125 is expected to become one of the diagnostic level of.CA125 sensitive index rupture of ovarian endometriotic cyst evaluation in endometriosis before surgery, has an important guiding significance to the follow-up process.

【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R711.71

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