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目的:通过单项及联合测定血清CA_(125)(卵巢癌相关抗原)、SF(血清铁蛋白)、LDH(乳酸脱氢酶)、ALP(碱性磷酸酶)、Ca(钙)及P(磷),以探讨卵巢癌的早期诊断方法。方法:34例卵巢良、恶性肿瘤患者(术前及术后)及15例正常妇女进行血清CA_(125)、SF、LDH、ALP、CQ及P的足量测定;前两者采用免疫放射法,后者以生化法测定。结果:(1)卵巢恶性肿瘤组术前CA_(125)、SF及LDH含量均高于卵巢良性肿瘤组及正常对照组(P<0.001),ALP、Ca及P含量在卵巢良、恶性肿瘤组及正常对照组之间无统计学差异(P>0.05)。(2)在单项指标测定中,CA_(125)、SF及LDH的阳性率分别为:80.0％、80.0％及50.0％;特异性分别为:92.86％、85.71％及85.71％;准确性分别为:85.29％、82.35％及64.71％。(3)在卵巢恶性肿瘤组中,Ⅲ、Ⅳ期患者血清CA_(125)及SF测定值明显高于Ⅰ、Ⅱ期,并有统计学差异(P<0.05)。(4)术后一周测定CA_(125)SF、LDH、ALP、Ca及P,在卵巢恶性肿瘤组中LDH术后测定值明显低于术前。并有统计学差异(P<0.05),余指标在卵巢恶性肿瘤组中术前及术后测定值之间无统计学差异。(5)在卵巢恶性肿瘤组,联合测定CA_(125)及SF时,其敏感性为90.0％,准确度为88.2％,当联合测定CA_(125)、SF及LDH时结果同上。结论:单项指标测定中CA_(125)诊断准确性为最好,其次为SF;CA_(125)及SF与卵巢癌的进展有关;联合测定CA_(125)、及SF与联合测定CA_(125)、中、SF、及LDH结果一样,即LDH不能提高诊断的阳性率。
OBJECTIVE: To determine whether serum CA 125, ovarian cancer-associated antigen, SF (ferritin), LDH (lactate dehydrogenase), ALP (alkaline phosphatase), Ca (calcium) and P ) To explore the early diagnosis of ovarian cancer. Methods: Serum levels of CA125, SF, LDH, ALP, CQ and P were measured in 34 patients with benign and malignant ovarian tumors (preoperative and postoperative) and 15 normal women respectively. The first two groups were immunostained , The latter by biochemical determination. Results: (1) The contents of CA 125, SF and LDH in preoperative ovarian cancer group were significantly higher than those in benign ovarian tumor group and normal control group (P <0.001). The levels of ALP, Ca and P were significantly higher in ovarian benign and malignant tumors And no significant difference between normal control group (P> 0.05). (2) The positive rates of CA 125, SF and LDH were 80.0%, 80.0% and 50.0% respectively in the single index measurement; the specificity were 92.86%, 85.71% and 85.71% respectively; the accuracy were : 85.29%, 82.35% and 64.71% respectively. (3) In the ovarian cancer group, the serum levels of CA 125 and SF in patients with stage Ⅲ and Ⅳ were significantly higher than those in stage Ⅰ and Ⅱ, and there was a significant difference (P <0.05). (4) The levels of CA 125, SF, LDH, ALP, Ca and P in one week after operation were significantly lower than those before operation in ovarian malignant tumor group. There was statistical difference (P <0.05). There was no significant difference between preoperative and postoperative values of remaining indicators in ovarian cancer group. (5) In the malignant ovarian tumor group, the sensitivity and the accuracy of CA 125 and SF were 90.0% and 88.2%, respectively. The results were the same as those of CA125, SF and LDH. Conclusions: The diagnostic accuracy of CA 125 was the best, followed by SF. The CA125 and SF were correlated with the progression of ovarian cancer. The combined detection of CA125 and SF with the combined detection of CA 125, , SF, and LDH results, that LDH can not increase the diagnostic positive rate.