Caione C, Minelli L, Angiolillo M
Divisione di Ostetricia e Ginecologia, Ospedale Carlo Poma, Mantova.
Minerva Ginecol. 1994 Jun;46(6):321-35.
CA 125, CA 19.9, CEA, MCA, E2 and P levels have been assessed in the serum and in the ovarian mass fluid of 216 patients through echo-guided puncture to distinguish between functional, benign and malignant cystic neoplasm. Statistically evaluated data have been assessed through histological diagnosis in 122 cases: cyst fluid markers do not always differentiate ovarian carcinoma from benign cysts, while they have a significant concentration in persistent functional cysts (follicular and luteal) if compared with benign and malignant neoplasms. The following management is suggested: 1) Echo-guided puncture in case of simple, persistent ovarian cyst with low levels of CA 125 and CA 19.9 in serum; 2) Operation in case of fatty, chocolate or mucinous fluid. Wait and see if the fluid is either clear or hematic/chocolate with high P levels (luteal cyst); 3) Operation on simple cyst with high CA 125 ald low E2 and P levels (serous c.), in case of relapse or persistence after aspiration; 4) Wait and see if CA 125 is low and E2 and P levels are high (follicular c.).
通过超声引导穿刺，对216例患者的血清及卵巢肿物液中的CA 125、CA 19.9、癌胚抗原（CEA）、甲胎蛋白（MCA）、雌二醇（E2）和孕酮（P）水平进行了评估，以区分功能性、良性和恶性囊性肿瘤。对122例病例的统计评估数据通过组织学诊断进行分析：囊肿液标志物并不总能区分卵巢癌与良性囊肿，而与良性和恶性肿瘤相比，它们在持续性功能性囊肿（卵泡囊肿和黄体囊肿）中浓度显著。建议如下管理措施：1）对于血清中CA 125和CA 19.9水平较低的单纯性、持续性卵巢囊肿，进行超声引导穿刺；2）对于液体为脂肪性、巧克力样或黏液性的情况，进行手术。若液体清澈或为血性/巧克力样且P水平较高（黄体囊肿），则观察等待；3）对于CA 125水平高、E2和P水平低的单纯囊肿（浆液性囊肿），抽吸后复发或持续存在时进行手术；4）若CA 125水平低、E2和P水平高（卵泡囊肿），则观察等待。
