【摘要】：目的：分析早期子宮內膜癌患者治療前血清CA125水平與臨床病理特征的相關性及評估術前CA125能否做為確定分期手術范圍及程度以及術后治療的依據。 方法：回顧性收集了2010年11月至2014年1月于我院就診的299例子宮內膜癌患者資料。共納入診斷為臨床早期子宮內膜癌且初始治療為手術的226例患者。根據術后組織學分級及國際婦產科聯(lián)盟2009分期，將其分為高危組（85例）和中低危組（141例）兩組。分析了治療前CA125水平與早期子宮內膜患者臨床病理特征的相關性及其預測早期子宮內膜癌危險因素及高風險患者的價值。 結果：治療前血清CA125水平與疾病的FIGO分期、肌層浸潤深度、治療方式、附件受累有關（p＜0.05），，而與年齡、絕經狀態(tài)、體重指數、淋巴結狀態(tài)、脈管間隙受累、分型、組織學分級、腹水細胞學無相關性。治療前CA125水平在高危組及中低危組間有顯著統(tǒng)計學差異(X2=7.587, p=0.006)。低風險組無淋巴結轉移，高危組淋巴結轉移率為9.23%，兩組間的淋巴結轉移率有統(tǒng)計學差異（X2=8.361, p=0.004）。當CA125的截斷值取35U/ml時，其預測高危患者的靈敏度、特異度、陽性預測值、陰性預測值及受試者工作特征曲線下面積分別為36.47%、80.14%、52.54%、67.66%及0.618。而當CA125的截斷值為22U/ml時,其預測高危患者的靈敏度為60%，特異度為61.7%。單因素及多因素Logistic回歸分析提示治療前CA125水平、組織學分級、脈管間隙受累及肌層浸潤深度均不是早期子宮內膜癌淋巴結轉移的危險因素（p＞0.05），僅FIGO（2009）Ⅲ期及Ⅳ期是淋巴結轉移的危險因素（p＜0.05）。用ROC曲線評價了CA125對早期子宮內膜癌危險因素的預測價值，提示CA125水平可預測淋巴結轉移、深肌層浸潤及附件受累，且預測附件受累的價值最高(AUC=0.923, p＜0.001)。 結論：治療前CA125水平可能對早期高風險子宮內膜癌有一定的預測價值，但單獨使用CA125的診斷準確性較低。CA125水平在早期子宮內膜癌中可預測淋巴結轉移、深肌層浸潤及附件受累，且預測附件受累的價值最高。因此，單獨使用治療前CA125水平來確定分期手術范圍及程度以及術后治療的證據不足。
[Abstract]:Objective: to analyze the correlation between serum CA125 level and clinicopathological features in patients with early endometrial cancer before treatment and to evaluate whether preoperative CA125 can be used as the basis for determining the scope and degree of staging and postoperative treatment. Methods: the data of 299 patients with endometrial cancer in our hospital from November 2010 to January 2014 were collected retrospectively. the data of 299 patients with endometrial cancer in our hospital from November 2010 to January 2014 were collected. A total of 226 patients with early clinical intimal cancer and initial treatment were included in the study. According to the postoperative histology grade and the 2009 stage of the International Union of Obstetrics and Gynecology, they were divided into two groups: high risk group (n = 85) and middle and low risk group (n = 141). The correlation between CA125 level before treatment and clinicopathological features of early endometrial patients and its value in predicting risk factors of early endometrial cancer and high risk patients were analyzed. Results: the level of serum CA125 before treatment was related to FIGO stage, depth of myenteric invasion, treatment mode and adnexal involvement, but related to age, menopausal status, body mass index, lymph node status, vascular space involvement and classification. There was no correlation between histologic grade and ascites Cytology. There was significant difference in CA125 level between high risk group and middle and low risk group before treatment (x2 鈮

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