Kil Kicheol, Chung Jae-Eun, Pak Ho Jeong, Jeung In-Cheul, Kim Jang Heub, Jo Hyun Hee, Kim Mee-Ran
Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, 505 Banpo-dong, Sucho-gu, Seoul 137-701, Republic of Korea.
Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, 505 Banpo-dong, Sucho-gu, Seoul 137-701, Republic of Korea.
Eur J Obstet Gynecol Reprod Biol. 2015 Feb;185:131-5. doi: 10.1016/j.ejogrb.2014.12.008. Epub 2014 Dec 16.
To evaluate the usefulness of CA125 levels in the differential diagnosis of adenomyosis and myoma. This has been addressed by few, if any, previous studies.
Preoperative serum CA125 levels were measured in 2149 women who were diagnosed at total hysterectomy as having adenomyosis, myoma, endometriosis, and/or normal pelvis. Their medical records were retrieved and reviewed.
The mean serum CA125 level in the adenomyosis patients was significantly greater than that in the patients diagnosed with myoma (65.21±96.60 U/mL vs.12.86±14.23 U/mL, respectively; P<0.001). In the differential diagnosis of adenomyosis and myoma, the cut-off serum CA125 level with the highest accuracy (78.8%) and highest diagnostic value (61.2%) was 19 U/mL. Using this cut-off value, the negative predictive value was 69.5%, and the positive predictive value was 76.5%. These results are clearly superior to those of the empirical single cut-off value of 35 U/mL. Receiver operating characteristic curve analysis revealed the area under the curve for differentiating adenomyosis from myoma was 0.776, indicating good diagnostic performance.
In the differential diagnosis of adenomyosis and myoma, cut-off values for CA125, particularly the cut-off value of 19 U/mL, provide improved diagnostic performance. Serum CA125 testing can be performed during the initial screening of women with possible adenomyosis to differentiate this condition from myoma, although the diagnostic accuracy of using CA125 testing alone is limited.
评估CA125水平在子宫腺肌病和子宫肌瘤鉴别诊断中的作用。此前几乎没有相关研究涉及此问题。
对2149名在全子宫切除术中被诊断为患有子宫腺肌病、子宫肌瘤、子宫内膜异位症和/或盆腔正常的女性，测量其术前血清CA125水平。检索并查阅她们的病历。
子宫腺肌病患者的血清CA125平均水平显著高于被诊断为子宫肌瘤的患者（分别为65.21±96.60 U/mL和12.86±14.23 U/mL；P<0.001）。在子宫腺肌病和子宫肌瘤的鉴别诊断中，准确性最高（78.8%）和诊断价值最高（61.2%）的血清CA125临界值为19 U/mL。使用该临界值时，阴性预测值为69.5%，阳性预测值为76.5%。这些结果明显优于经验性的单一临界值35 U/mL。受试者工作特征曲线分析显示，区分子宫腺肌病和子宫肌瘤的曲线下面积为0.776，表明诊断性能良好。
在子宫腺肌病和子宫肌瘤的鉴别诊断中，CA125的临界值，尤其是19 U/mL的临界值，能提高诊断性能。在对可能患有子宫腺肌病的女性进行初步筛查时，可以进行血清CA125检测，以将这种疾病与子宫肌瘤区分开来，尽管单独使用CA125检测的诊断准确性有限。
