Obstetrics and Gynecology, Nippon Medical School Musashikosugi Hospital, Kawasaki-shi, Japan
Obstetrics and Gynecology, Nippon Medical School Musashikosugi Hospital, Kawasaki-shi, Japan.
Int J Gynecol Cancer. 2020 Jun;30(6):831-836. doi: 10.1136/ijgc-2020-001210. Epub 2020 Apr 30.
Only few studies have focused on tumor markers used in the preoperative diagnosis of endometriosis-related ovarian neoplasms, and previous studies have only assessed serum CA125 levels. This study investigated the significance of preoperative tumor markers and clinical characteristics in distinguishing endometriosis-related ovarian neoplasms from ovarian endometrioma.
A case-control study was conducted on 283 women who were diagnosed with confirmed pathology with endometriosis-related ovarian neoplasms (n=21) and ovarian endometrioma (n=262) at a single institution from April 2008 to April 2018. The serum CA125, CA19-9, carcinoembryogenic antigen (CEA), sialyl Lewis-x antigen (SLX), and lactate dehydrogenase (LDH) levels, age, tumor size, and the presence of mural nodule of the patients were analyzed.
Patients with endometriosis-related ovarian neoplasms were more likely to be older (48 (range, 26-81) vs 39 (range, 22-68) years, P<0.001), have higher levels of CA19-9 (42 vs 19 U/mL, P=0.013), CEA (1.3 vs 0.84 ng/mL, P=0.007), SLX (41 vs 33 U/mL, P=0.050), and LDH (189 vs 166 U/mL, P<0.001) and larger tumor size (79 vs 55 mm, P=0.001), and present with mural nodule (85.7 vs 4.5 %, P<0.001) than those with ovarian endometrioma. The CA125 levels did not significantly differ between the two groups. The area under the curve for each factor was as follows: CA19-9 level, 0.672 (95% CI 0.52 to 0.83; P=0.013); CEA level, 0.725 (95% CI 0.58 to 0.87; P=0.007); SLX level, 0.670 (95% CI 0.53 to 0.84; P=0.050); LDH level, 0.800 (95% CI 0.70 to 0.90; P<0.001); age, 0.775 (95% CI 0.65 to 0.90; P<0.001); and tumor size, 0.709 (95% CI 0.56 to 0.86; P=0.001). Age was a better marker than CA19-9, CEA, and SLX levels according to the receiver operating characteristic curve analysis. The optimal cut-off values for age and tumor size were 47 years and 80 mm, respectively.
The assessment of serum CA19-9, CEA, SLX, and LDH levels may be a useful tool in the preoperative evaluation to differentiate between endometriosis-related ovarian neoplasms and ovarian endometrioma.
只有少数研究关注用于术前诊断子宫内膜异位症相关卵巢肿瘤的肿瘤标志物，并且以前的研究仅评估了血清 CA125 水平。本研究旨在探讨术前肿瘤标志物和临床特征在鉴别子宫内膜异位症相关卵巢肿瘤与卵巢子宫内膜瘤中的意义。
对 2008 年 4 月至 2018 年 4 月在一家单中心经病理证实的 283 名患有子宫内膜异位症相关卵巢肿瘤（n=21）和卵巢子宫内膜瘤（n=262）的女性进行病例对照研究。分析了患者的血清 CA125、CA19-9、癌胚抗原（CEA）、唾液酸化 Lewis-x 抗原（SLX）和乳酸脱氢酶（LDH）水平、年龄、肿瘤大小以及是否存在壁结节。
与卵巢子宫内膜瘤患者相比，子宫内膜异位症相关卵巢肿瘤患者的年龄更大（48（范围，26-81）岁 vs 39（范围，22-68）岁，P<0.001），CA19-9（42 vs 19 U/mL，P=0.013）、CEA（1.3 vs 0.84 ng/mL，P=0.007）、SLX（41 vs 33 U/mL，P=0.050）和 LDH（189 vs 166 U/mL，P<0.001）水平更高，肿瘤更大（79 vs 55 mm，P=0.001），且存在壁结节（85.7% vs 4.5%，P<0.001）的可能性更大。两组患者的 CA125 水平无显著差异。各因素的曲线下面积如下：CA19-9 水平，0.672（95%CI 0.52-0.83；P=0.013）；CEA 水平，0.725（95%CI 0.58-0.87；P=0.007）；SLX 水平，0.670（95%CI 0.53-0.84；P=0.050）；LDH 水平，0.800（95%CI 0.70-0.90；P<0.001）；年龄，0.775（95%CI 0.65-0.90；P<0.001）；肿瘤大小，0.709（95%CI 0.56-0.86；P=0.001）。根据受试者工作特征曲线分析，年龄优于 CA19-9、CEA 和 SLX 水平。年龄和肿瘤大小的最佳截断值分别为 47 岁和 80 mm。
评估血清 CA19-9、CEA、SLX 和 LDH 水平可能是术前评估鉴别子宫内膜异位症相关卵巢肿瘤与卵巢子宫内膜瘤的有用工具。
