联合检测肿瘤标志物在卵巢肿瘤中的应用.docVIP

联合检测肿瘤标志物在卵巢癌中的应用 刘君△1, 宋静慧* 2,杨有莲* 2, （1.内蒙古医学院附属医院，内蒙古 呼和浩特 010050；2.内蒙古医学院附属医院）[1]严重威胁妇女健康,其发生、发展较为隐匿，由于卵巢癌早期无症状，缺乏有效的筛查手段，临床上80%的卵巢癌患者获得诊断时已是中晚期。因此早期确诊卵巢癌患者非常重要。应用多种血清肿瘤标志物联合检测有助于卵巢癌的早期发现，无疑也将提高卵巢癌患者的生存率，同时也有助于治疗中的病情监测、疗效评价及预后判断。 [关键词]:血清肿瘤标志物；联合检测；卵巢癌 The Application of Combined Measurement of Tumor Markers in Ovarian Cancer LIUJun, SONG Jing-hui ,YANG You-lian, (Affiliated Hospital, Inner Mongolia Medical College, Hohhot 010050 China) Abstract: Ovarian tumor is one of the three commonly malignant tumors in reproductive apparatus of females, which seriously threatens women’s health, as well as occurs and develops in negligence. Because there is no symptom in the early stage and lack of effective screening medium, 80% of people who are diagnosed ovarian cancer is in mid-term and later period. Therefore, it’s important for the sufferers to find out the ovarian cancer. With the application of combined measurement of tumor markers, it can assist ovarian cancer diagnosed in the early stage and increase the rate of subsistence. At the same time, the combined measurement is good to the observation of the patients’ condition, the evaluation of the curative effect and the determination of the prognosis Key words: The symbol of serum tumor; combined measurement; ovarian cancer 中图分类号：R711 卵巢位于盆腔深部，很难通过常规的体格检查查出卵巢早期的疾病，而且卵巢肿瘤早期无典型的临床表现，80%卵巢癌患者获得诊断时已是中晚期，其5年存活率仅为20%-30%[2]，而早期卵巢癌患者5年生存率为70- 90%[3]。为了提高卵巢肿瘤的早期诊断符合率，在分子生物学领域，人们发现了越来越多的肿瘤标志物[4]。联合检测肿瘤标志物的种类很多，其临床价值各不相同，现归纳总结，综述如下。 1多种血清癌相关糖链抗原相联合 1.1 血清癌相关糖链抗原125（serum tumor associated carbohydrate antigen125，CA125）属于IgG类糖蛋白,分子量 500 000，由肿瘤细胞分泌进入血液,是上皮性卵巢癌的主要检测指标[5],其临界值为35KU/L,单独检测灵敏度为80%-100%，特异性60%-90%[6]。 1.2血清癌相关糖链抗原199（serum tumor associated carbohydrate antigen199，CA199）分子量为10000，存在于胎儿胃、肠和胰的上皮，在成人的胰、肝和肺的浓度较低。有文献报道[7]CA199可能是诊断卵巢粘液性囊腺癌较为理想的指标，因其在消化道患者血清中可明显升高，所以应用时要排除来自消化道的肿瘤，还要与卵巢本身的良性疾病加以鉴别。其临界值为40KU/L，对卵巢癌的敏感性35.6%，特异性81.8%,粘液性卵巢癌灵敏度可达83.3%[6]。 1.3癌胚抗原（carcino-embryonic antigen CEA）[8]。 1.4血清癌相关糖链抗原153（serum tumor