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卵巢未成熟型畸胎瘤治疗后肿瘤标志物的变化及其与预后的关系
杨文娟, 陆婕, 许胜峰
嘉兴市妇幼保健院妇科
摘要:
目的探讨卵巢未成熟畸胎瘤患者治疗后血清肿瘤标志物的变化及其与预后的关系。方法收集经病理确诊的卵巢未成熟畸胎瘤患者28例、卵巢畸胎瘤恶变患者7例及卵巢成熟畸胎瘤患者80例的临床资料,分析卵巢未成熟畸胎瘤患者术前、术后及化疗前后血清肿瘤标志物水平的变化及其与预后的关系。结果卵巢未成熟畸胎瘤患者血清甲胎蛋白(AFP)、糖类抗原(CA)125、CA19-9水平均高于卵巢成熟畸胎瘤患者,差异均有统计学意义(均P<0.05)。卵巢未成熟畸胎瘤患者术后血清AFP、鳞癌抗原(SCC)、CA19-9水平较术前均明显降低,差异均有统计学意义(均P<0.05);化疗3个疗程后血清AFP、癌胚抗原(CEA)水平较化疗前均明显降低,差异均有统计学意义(均P<0.05)。预后差(复发+死亡)组与未复发组术前血清肿瘤标志物水平比较差异均无统计学意义(均P>0.05),但是第3次化疗后未复发组血清AFP水平低于预后差组,差异有统计学意义(P<0.05)。结论AFP、SCC、CA19-9可作为手术后治疗效果的评价指标,AFP、CEA可作为化疗敏感性的评价指标。治疗后(术后+化疗后)AFP的变化趋势对患者的预后判断有一定的临床意义。
关键词:  卵巢未成熟畸胎瘤 卵巢成熟畸胎瘤 肿瘤标志物 预后
DOI:10.12056/j.issn.1006-2785.2018.40.2.2017-306
分类号:
基金项目:
Application of multiple tumor markers in management of ovarian immature teratoma
Jiaxing Maternal and Child Health Hosptial
Abstract:
Objective To evaluate the application of multiple tumor markers in the management of ovarian immature teratoma. Methods The clinical data of 80 patients with ovarian mature teratoma, 28 patients with ovarian immature teratoma and 7 patients with malignant transformation of ovarian mature teratoma admitted in Jiaxing Maternal and Child Healthcare Centre between January 2005 and December 2015, were retrospectively reviewed. The relationship of serum levels of multiple tumor markers with the therapeutic response and prognosis of patients was analyzed. Results Compared with the mature teratoma, the serum level of AFP, CA125 and CA19-9 in ovarian immature teratoma patients were significantly higher (all P<0.05). After surgical treatment serum AFP, SCC and CA19-9 levels significantly decreased in patients with immature teratoma (all P<0.05), and after 3 courses of chemotherapy the levels of AFP and CEA were further decreased (both P<0.05). The AFP level in patients with favorable prognosis after treatment were lower than those with poor prognosis (P<0.05), however, there were no significant differences in preoperative levels of other serum markers between patients with favorable prognosis and those with poor prognosis (all P >0.05). Conclusion The changes of serum AFP levels after treatment have a certain clinical value for the prediction of prognosis in patients with ovarian immature teratoma.
Key words:  Ovarian immature teratoma Ovarian mature teratoma Tumor markers Prognosis