Pinto M M, Kotta S
Department of Pathology and Laboratory Medicine, Bridgeport Hospital, CT 06610, USA.
Diagn Cytopathol. 1996 Mar;14(2):121-5. doi: 10.1002/(SICI)1097-0339(199603)14:2<121::AID-DC4>3.0.CO;2-M.
One hundred and twenty-two fine needle aspirates (FNA) from female patients were studied to determine whether CA-125 assay contributed to cytologic diagnosis and CEA assay. Cytologic examination was done on Papanicolaou-stained smears and cell blocks, CEA by EIA (Abbott Laboratory, > 5 ng/ml cutoff) and CA-125 by RIA (Abbott Laboratory, North Chicago, IL, > 66 mu/ml cutoff). Final diagnosis were correlated with histologic diagnosis when available, clinical, radiologic studies, and follow-up.
29 benign, 93 malignant. Sensitivities and specificities: cytology, 91%, 100%; CEA: 59%, 86%; CA-125, 50%, 55%. CEA plus cytology sensitivity, 97%. CA-125 content was highest in endometrial/ovarian carcinoma (39,899 mu/ml) and < 5,000 mu/ml in other tumors and benign FNA in contrast to CEA which showed highest levels in carcinomas of colon, pancreas, and lung (> 280 ng/ml). While elevated CEA enhances the sensitivity of cytologic diagnosis of carcinomas of the colon, pancreas, and lung, low CEA and high CA-125 content supports an ovarian/endometrial primary.
对122例女性患者的细针穿刺抽吸物(FNA)进行研究,以确定CA-125检测和癌胚抗原(CEA)检测是否有助于细胞学诊断。对巴氏染色涂片和细胞块进行细胞学检查,采用酶免疫测定法(EIA,雅培实验室,临界值>5 ng/ml)检测CEA,采用放射免疫测定法(RIA,雅培实验室,伊利诺伊州北芝加哥,临界值>66 mu/ml)检测CA-125。最终诊断与可用的组织学诊断、临床、放射学研究及随访结果相关。
29例良性,93例恶性。敏感性和特异性:细胞学分别为91%、100%;CEA分别为59%、86%;CA-125分别为50%、55%。CEA联合细胞学检查的敏感性为97%。与CEA相比,CA-125含量在子宫内膜癌/卵巢癌中最高(39,899 mu/ml),在其他肿瘤和良性FNA中<5,000 mu/ml,而CEA在结肠癌、胰腺癌和肺癌中水平最高(>280 ng/ml)。虽然CEA升高可提高结肠癌、胰腺癌和肺癌细胞学诊断的敏感性,但CEA水平低且CA-125含量高支持卵巢/子宫内膜原发性肿瘤。