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目的探讨血清YKL-40和CA125联合检测在卵巢癌诊断中的应用价值。方法分别用酶免分析法(EIA)和微粒子酶免分析法(MEIA)测定39例卵巢癌、27例卵巢良性肿瘤及40例健康对照妇女血清YKL-40和CA125水平,YKL-40以健康对照组95%可信区间的上限值为阳性,比较YKL-40和CA125在三组间、卵巢癌病人不同临床分期和手术治疗前后水平和阳性率的差异。结果正常对照组血清YKL-40水平的95%可信区间的上限值为71.9ng/mL;卵巢癌患者血清YKL-40水平及阳性率显著高于卵巢良性肿瘤组和对照组(t>4.83,P<0.01),而卵巢良性肿瘤组和对照组之间差异无统计学意义(t=0.96,P>0.05)。Ⅲ/Ⅳ期卵巢癌患者血清YKL-40水平显著高于Ⅰ/Ⅱ期患者(167.9ng/mLvs87.7ng/mL,t=1.86,P<0.01)。卵巢癌患者术后第3天和第7天血清YKL-40水平显著低于术前水平(t>2.92,P<0.01);未能手术切除的患者血清YKL-40水平显著高于手术切除者(t=4.06,P<0.01)。YKL-40联合CA125诊断卵巢癌的灵敏度为87.2%,特异性为91.0%,阳性预测值为85.0%,阴性预测值为92.4%;YKL-40与CA125联合诊断早期卵巢癌的灵敏度从CA125单指标的33.3%提高到66.7%。结论YKL-40是一种新的诊断卵巢癌的肿瘤标志物,联合YKL-40与CA125检测可提高对早期卵巢癌诊断的灵敏度。
Objective To investigate the value of combined detection of serum YKL-40 and CA125 in the diagnosis of ovarian cancer. Methods Serum levels of YKL-40 and CA125 in 39 cases of ovarian cancer, 27 cases of ovarian benign tumor and 40 healthy controls were detected by enzyme-linked immunosorbent assay (EIA) and microparticle enzyme immunoassay (MEIA), respectively. The upper limit of the 95% confidence interval was positive. The differences of the levels and positive rates of YKL-40 and CA125 between the three groups and between different clinical stages of ovarian cancer patients and before and after surgery were compared. Results The upper limit of 95% confidence interval of serum YKL-40 level in normal control group was 71.9ng / mL. The level of serum YKL-40 and the positive rate of serum YKL-40 in ovarian cancer patients were significantly higher than those in benign ovarian tumor group and control group (t> 4.83 , P <0.01). There was no significant difference between benign ovarian tumor group and control group (t = 0.96, P> 0.05). Serum levels of YKL-40 in patients with stage Ⅲ / Ⅳ ovarian cancer were significantly higher than those in stage Ⅰ / Ⅱ patients (167.9ng / mL vs 87.7ng / mL, t = 1.86, P <0.01). The level of serum YKL-40 in patients with ovarian cancer was significantly lower than that before operation (t> 2.92, P <0.01) on the 3rd and 7th day after operation. The level of serum YKL-40 in patients with failed ovarian cancer was significantly higher than that of the patients undergoing resection (t = 4.06, P <0.01). The sensitivity of YKL-40 combined with CA125 in the diagnosis of ovarian cancer was 87.2%, the specificity was 91.0%, the positive predictive value was 85.0% and the negative predictive value was 92.4%. The sensitivity of YKL-40 combined with CA125 in the diagnosis of early ovarian cancer was increased from CA125 single index 33.3% to 66.7%. Conclusion YKL-40 is a new tumor marker for the diagnosis of ovarian cancer. Combined detection of YKL-40 and CA125 may improve the sensitivity of early diagnosis of ovarian cancer.