Concomitant Measurement of CA 125 and CA19-9 in Detecting Ovarian Malignancy: A Review Study of 64 Cases

合併測量CA125和CA19-9於卵巢腫瘤之偵測：64病例之臨床回顧

謝耀元(Yao-Yuan Hsieh) ； 蔡鴻德(Horng-Der Tsai) ； 張其真(Chi-Chen Chang) ； 葉聯舜(Lian-Shun Yeh) ； 林武周(Wu-Chou Lin) ； 張維君(Wei-Chun Chang)

《Mid-Taiwan Journal of Medicine》 3卷3期 (1998/09) Pp. 154-159

https://doi.org/10.6558/MTJM.1998.3(3).6

摘要

本研究的主旨為評估合併測量CA125和A19-9，是否較單獨測量CA125更能提高惡性卵巢腫瘤之偵測率。回溯1988年1月與1997年12月之間所有卵巢腫瘤並接受手術前測量CA125和CA19-9及進一步手術治療之病人。以CA125值＞35U/ml和＞65U/ml及CA199＞37U/ml為臨界點，計算並比較其敏感度，精確度，陽性預測值，與陰性預測值。共有的病人納入本研究之中，包括35名良性卵巢腫瘤，與29名惡性卵巢腫瘤之病人。統計結果發現在鑑別良性與惡性卵巢腫瘤方面，以CA125大於35U/ml當臨界值，比以CA19-9大於37U/ml當臨界值，前者之敏感性比後者為高（86.2% vs. 51.7%）。若進一步比較同時測量CA125和CA19-9，與單純測量CA125，前者只達到稍微提升之敏感性（93.1% vs. 86.2%）、陽性預測值（77.1% vs.75.8%）、與陰性預測值（93.1% vs. 87.1%），與相同之精確度（77.1% vs. 77.1%）。本研究的結果表示，CA125為一預測卵巢惡性腫瘤之一有效標記，同時測量CA125和A19-9並無法比單純測量CA125提供明顯提升之偵測率。除了黏液性囊腺癌外，單獨CA19-9並無法有效偵測其他之卵巢惡性腫瘤。

關鍵字

卵巢腫瘤

並列摘要

We conducted this study to evaluate whether concomitant measurement of CA125 and CA19-9 could provide the higher efficiency than CA125 alone in detecting ovarian malignancy. Between January 1988 and December 1997, all women with ovarian mass who accepted the preoperative serum assay of the CA125 and CA19-9 and further exploratory operation were included. Using the cutoff values of CA125 ＞35, ＞65 U/ml and CA19-9 ＞37 U/ml, the sensitivity, specificity, and predictive values for detecting ovarian malignancies were calculated and compared. Total 64 patients were enrolled in this series, which included 35 of benign and 29 of malignant tumor. CA125 (＞35U/ml) was more sensitive than CA19-9 (＞37U/ml) in the differentiating the benign and malignant ovarian masses (86.2% vs. 51.7%). Concomitant measurements of CA125 and CA19-9 do not offer the significantly higher sensitivity (93.1 vs. 86.2 %), positive (77.1 vs. 75.8%), and negative predictive values (93.1 vs. 87.1%) and similar specificity (77.1 vs. 77.1%) than that of CA125 assay alone in differentiating the ovarian malignancies. In conclusion, CA125 alone assay is valuable in detecting ovarian malignancy. The addition of CA19-9 with CA125 does not provide the obvious enhancement than the CA125 alone in detecting and differentiating the ovarian malignancies. Except for the mucinous cystadenocarcinoma, CA19-9 alone is not adequate for detecting other ovarian malignancies.

並列關鍵字

CA125 ； CA19-9 ； ovarian carcinoma