Sugawara T, Tanaka T, Sato H, Hanatani K, Okuyama K, Shinkai N, Sakuragi N, Makinoda S, Fujimoto S
Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Sapporo.
Nihon Sanka Fujinka Gakkai Zasshi. 1991 Feb;43(2):145-51.
The aim of this study is to elucidate the change in serum levels of gynecological tumor markers throughout the period from the early gestational stage to puerperium. We measured eight tumor markers of--CA 125, TPA, SCC, AFP, haptoglobin, ferritin, CA19-9 and CEA--in 17 healthy women with a normal course of pregnancy, delivery and puerperium, and obtained the following results: 1) Profiles of change in serum levels of CA125, SCC, haptoglobin and ferritin were similar during pregnancy, with those levels being the highest at 4-15 weeks of gestation and declining gradually from 16 to 27 weeks. Serum levels of these four markers decreased significantly (p less than 0.01) at 16-27 and 28-40 weeks of gestation, respectively. 2) A significant (p less than 0.01) increase in CA125 and SCC was observed 2 hours after delivery compared with the levels in the first stage of delivery. However, these two markers decreased to the normal range after the fifth day postpartum. 3) Serum TPA decreased significantly (p less than 0.05) in 16-27 weeks of gestation, comparing with those of 4-15 weeks. Serum CA19-9 and CEA remained almost unchanged within the normal range throughout the period from pregnancy to puerperium. 4) Tumor markers of CA125, TPA, SCC, haptoglobin, ferritin and CEA of which serum levels decreased during the course of pregnancy and puerperium might be a clue to judge whether gynecological tumors in pregnant women are malignant or benign.
本研究的目的是阐明从妊娠早期到产褥期整个时间段内妇科肿瘤标志物血清水平的变化。我们对17名妊娠、分娩和产褥期过程正常的健康女性测量了8种肿瘤标志物——CA 125、组织多肽抗原(TPA)、鳞状细胞癌抗原(SCC)、甲胎蛋白(AFP)、触珠蛋白、铁蛋白、CA19-9和癌胚抗原(CEA),并得到以下结果:1)CA125、SCC、触珠蛋白和铁蛋白的血清水平在孕期变化情况相似,这些水平在妊娠4 - 15周时最高,从16周到27周逐渐下降。这四种标志物的血清水平在妊娠16 - 27周和28 - 40周时分别显著下降(p < 0.01)。2)与分娩第一阶段的水平相比,产后2小时观察到CA125和SCC显著升高(p < 0.01)。然而,这两种标志物在产后第五天降至正常范围。3)与4 - 15周相比,血清TPA在妊娠16 - 27周时显著下降(p < 0.05)。从孕期到产褥期,血清CA19-9和CEA在正常范围内几乎保持不变。4)在孕期和产褥期血清水平下降的CA125、TPA、SCC、触珠蛋白、铁蛋白和CEA等肿瘤标志物可能是判断孕妇妇科肿瘤是恶性还是良性的线索。