本文關(guān)鍵詞：CA125在診斷卵巢子宮內(nèi)膜異位囊腫破裂中的臨床價值　出處：《青島大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 卵巢子宮內(nèi)膜異位囊腫 囊腫破裂 血清CA125

【摘要】：目的:探討血清CA125水平與卵巢子宮內(nèi)膜異位囊腫破裂可能性的相關(guān)性及臨床意義,為該類疾病手術(shù)風(fēng)險預(yù)測、術(shù)前評估、術(shù)后隨訪提供理論依據(jù)。方法:選取自2011年1月-2016年12月在青州市婦幼保健院婦科收治并行手術(shù)治療,術(shù)后病理證實為卵巢子宮內(nèi)膜異位囊腫患者150例為研究對象,其中卵巢子宮內(nèi)膜異位囊腫破裂者50例為實驗組;卵巢子宮內(nèi)膜異位囊腫未破裂患者100例為對照組。搜集兩組患者臨床資料進(jìn)行對比,所有患者術(shù)前均行血清腫瘤標(biāo)記物:CA199、CA125、CEA、AFP檢查及常規(guī)血、尿、便RT,凝血、生化、心電圖、胸片、CT、B超等常規(guī)檢查。手術(shù)過程順利,術(shù)后切除組織均送病理確診。收集患者術(shù)前、術(shù)后1天、1周、1月血相關(guān)標(biāo)本采用全自動電化學(xué)發(fā)光分析儀進(jìn)行檢測。結(jié)果:(1)兩組患者平均年齡分別為33.10±7.8歲、34.76±7.3歲(P0.05),平均月經(jīng)周期分別為31.23±5.2天、33.41±5.4天(P0.05)。兩組患者囊腫直徑均主要集中在5-10cm,兩組數(shù)據(jù)比較X2=2.05,P0.05(P=0.35),兩組患者年齡、月經(jīng)周期、異位囊腫直徑大小等臨床參數(shù)無統(tǒng)計學(xué)差異。(2)兩組患者血清CA125水平差異有統(tǒng)計學(xué)意義(X2=28.125,P0.05),而CA199、CEA、AFP均無統(tǒng)計學(xué)意義(X2=0.054、2.260、0.857,P0.05)。(3)實驗組中當(dāng)檢測血清CA125≥35u/ml時診斷卵巢子宮內(nèi)膜異位囊腫破裂的靈敏度是90%,特異度是55%,陽性的預(yù)測值50%,陰性的預(yù)測值91.67%。當(dāng)CA125≥70u/ml時診斷卵巢子宮內(nèi)膜異位囊腫破裂的靈敏度是82%。,特異度是88%,陽性的預(yù)測值83.64%,陰性的預(yù)測值92.63%。(4)CA125≥70u/ml組與CA12570u/ml組比較,前者發(fā)生卵巢子宮內(nèi)膜異位囊腫破裂的幾率明顯增加,差異有統(tǒng)計學(xué)意義(X2=39.13,P0.05)(5)兩組患者術(shù)后1天、1周隨訪血清CA125水平,差異有統(tǒng)計學(xué)意義(X2=73.50,P0.01),(X2=72.53,P0.01),而術(shù)后1月兩組患者血清CA125水平無明顯差異。(X2=1.53,P0.05)結(jié)論:血清CA125水平有望成為診斷卵巢子宮內(nèi)膜異位囊腫破裂的敏感指標(biāo)之一。CA125水平在子宮內(nèi)膜異位癥的術(shù)前評估、術(shù)后隨訪過程中具有重要的指導(dǎo)意義。
[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.

【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R711.71

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