腹水细胞学检查对卵巢恶性肿瘤诊断价值的探讨
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摘要
目的:探讨腹水细胞学检查在卵巢恶性肿瘤诊断中的价值。方法:收集我院1997年2月～2006年7月有腹水妇科病人共135例,行腹水细胞学检查,计算灵敏度、特异度等流行病学指标,分析腹水细胞学检查对卵巢恶性肿瘤的诊断及预测价值。结果:1.腹水细胞学对诊断卵巢恶性肿瘤的灵敏度为69.6%、特异度为100%、阳性预测值为100%。2.腹水细胞学阳性率随临床期别增高而增高(P<0.05)。3.与其他组织类型卵巢恶性肿瘤比较,卵巢上皮性恶性肿瘤的腹水细胞检查阳性率显著增高(P <0.05),腹水细胞学检查阳性的卵巢恶性肿瘤淋巴结转移率明显增高(P <0.05)。4.腹水细胞学与血清CA125值有关(P<0.01)。血清CA125与腹水细胞学检查联合试验诊断卵巢上皮性肿瘤的灵敏度为为97.0%,阳性预测值为98.5%。结论:腹水细胞学检查联合血清CA125检查对卵巢恶性肿瘤的诊断及预后有预测价值,对卵巢恶性肿瘤患者施行新辅助化疗具有重要参考价值。
Objective: study abdominal dropsy cytological examination in the ovarian cancer value of examining a patient the under medical treatment. Methods: collects sufferers to be checked because of the abdominal dropsy and the high doubt to be the sufferer of the ovarian malignant tumor totally 135 example ,from J 2006 to 1997, a abdominal dropsy cytological examination, compute acuity, specificity etc. Epidemiology index sign, analyze related factor in hydrops abdominis in ovary cancer .Result: (1)Abdominal dropsy cytological examination is to acuity that examine a patient ovary malignant tumor as 69.6%, with the specificity is 100%.(2)Abdominal dropsy cytology positive rate of ovaries malignant tumor increases anotherly along with the period high but increase high. (P <0 05). (3 )Compares with cell granule and sex cordsa interstitial substance tumors, abdominal dropsy cytology positive rate in ovaries pithelial carcinoma shows increased highly(P <0.05), abdominal dropsy cytology positive rate of absorbent gland positivity the is obvious higher than negativity. (4)CA125 can improve acuity of ovarian cancer diagnosis with abdominal dropsy cytological examination (P <0.05) .Conclusion: Abdominal dropsy cytology and CA125 have suffererrtance value in ovarian cancer diagnosis and therapy .
Objective: study abdominal dropsy cytological examination in the ovarian cancer value of examining a patient the under medical treatment. Methods: collects sufferers to be checked because of the abdominal dropsy and the high doubt to be the sufferer of the ovarian malignant tumor totally 135 example ,from J 2006 to 1997, a abdominal dropsy cytological examination, compute acuity, specificity etc. Epidemiology index sign, analyze related factor in hydrops abdominis in ovary cancer .Result: (1)Abdominal dropsy cytological examination is to acuity that examine a patient ovary malignant tumor as 69.6%, with the specificity is 100%.(2)Abdominal dropsy cytology positive rate of ovaries malignant tumor increases anotherly along with the period high but increase high. (P <0 05). (3 )Compares with cell granule and sex cordsa interstitial substance tumors, abdominal dropsy cytology positive rate in ovaries pithelial carcinoma shows increased highly(P <0.05), abdominal dropsy cytology positive rate of absorbent gland positivity the is obvious higher than negativity. (4)CA125 can improve acuity of ovarian cancer diagnosis with abdominal dropsy cytological examination (P <0.05) .Conclusion: Abdominal dropsy cytology and CA125 have suffererrtance value in ovarian cancer diagnosis and therapy .
引文
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[2] Hu L ,Hofmann J ,Zaloudek C ,et al . Vascular endothelial gr4owth factor immunoneutralization plus Paclitaxel markedly reduces tumor burden and ascites in athymic mouse model of ovarian cancer [J] . Am J Pathol , 2002 ,161 (5) : 1917~1924
[3] Friedlander ML. Prognostic factors in ovarian cancer [J].Semin Oncol ,1998 ,25: 305~315
[4] [Zeimet AG,Widschwendter M ,Knabbe C ,et al. [J]Clin Oncol ,1998 ; 16 (5) : 1861~1868
[5] Zeimet AG,Marth C ,Offner FA ,et al . Human peritoneal mesothelial cells are more potent than ovarian cancer cells in producing tumor marker CA2125 [J] . Gynecol Oncol , 1996 ,62 (3)∶384~389
[6]乐杰.妇产科学[M].第五版.北京:人民卫生出版社,2002:342-344
[7]沈铿,郎景和主编.妇科肿瘤面临问题和挑战[M]..北京:人民卫生出版社,2002, 100-104
[8]李孟达,黄欣中晚期卵巢癌综合治疗疗效及影响因素的分析.[J].中华妇产科杂志, 1996;31(10):621
[9]程蓓.卵巢癌腹腔液细胞因子研究进展[J].国外医学肿瘤学分册,2006,27(6): 344-347
[10] Zeimet AG,Widschwendter M ,Knabbe C ,et al. [J] Clin Oncol ,1998 ;16 (5) : 1861~1868
[11]赵仲堂,王滨有,流行病学研究方法与应用[M]山东:科学出版社,2000,403-412
[12]王建华.流行病学.[M]第五版.北京:人民卫生出版社, 2001,152-166
[13] Yoshimura S. Scully RE. Bell DA. Taft PD. Correlation of ascitic fluid cytology with histologic findings before and after treatment of ovarian cancer. [J] Obstetrics & Gynecology. 1984,148(6):716-21 .
[14]王建华.流行病学.[M]第五版.北京:人民卫生出版社, 2001,152-166
[15]江森.郎景和,必须重视卵巢恶性肿瘤的诊断?治疗及预防[J].中华妇产科杂志, 1992, 27:321-324
[16] Yoshimura S. Scully RE. Bell DA. Taft PD. Correlation of ascitic fluid cytology with histologic findings before and after treatment of ovarian cancer. [J] Obstetrics & Gynecology. 1984,148(6):716-21
[17]李东平,张云霞,傅才英等.腹腔液细胞学检查在妇科肿瘤诊断中的价值[J].解放军医学杂志,2002,27(8):749
[18] Puls LE , Dainhot T , Hunteo E , et al . The prognostic implication of ascites in advanced stage ovarian carcinoma. [J].Gynecol Oncol , 1996 , 61 :1092111
[19]连利娟.林巧稚妇科肿瘤学[M].第3版.北京:人民卫生出版社, 2006,423-430
[20] Platsoucas CD. Human autologous tumor-specific T cells in malignant melanoma. [J] Cancer & Metastasis Reviews. 2001,10(2):151-76
[21] Akiyama M. Takahashi Y. Hirose M. Yamamoto Y. Ishiguro T. Noda Y. Risk factors for retroperitoneal lymph node metastasis in ovarian cancer. [J] Nippon Sanka Fujinka Gakkai Zasshi - Acta Obstetrica et Gynaecologica Japonica. 1994, 46(3):260-4
[22] Simsek T , simsek M , Pesterelli E , et al . The effect of platinum2based combination chemotherapy on the lymph nodes in advanced2stage epithelial ovarian cancer : does it decrease the incidence of lymph node involvement [J] . Obstet Gynecol ,2002 ,22(6)∶666~668
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[24]李庆菊,苗华芹,李庆水等.卵巢癌合并腹水的治疗[J].肿瘤防治研究,2001, 28(1): 54-55
[25] Imachi M. Tsukamoto N. Shigematsu T. Saito T. Kamura T. Nakano H. Fine- needle aspiration cytology in patients with gynecologic malignancies. [J] Gynecologic Oncology. 1992,46(3):309-12
[26] LIAN LI et al The clinical application of monoclonal antibody of ovarian carcinoma [J] Chinese Joumal of Obstetrics and Gynecoloy,1985,205-257
[27]任琼珍,胡建铭,卵巢癌腹水形成的相关因素分析[J].SUZHOU UNIVVERSITYJOURNAL OF MEDICAL OF MEDICAL SCIENCE ,2004;24 (2):264-265
[28] Adachi S,Noda T,Kiyozuka Y,et al.The importance of CA125 immunohistochemical staining in patients with ovarian cancer [J] . Nippon Sanka Fujinka Gakkai Zasshi ,2004 ,46 (9)∶896~902
[29] Chen JT,Yu Ke,Chang M,et al .Use of PAPNET testing to relatuate preceeding negative cervical smears of women with high grade squamous intraepithelial lesionand carcinoma [J].Acta Cytol,1998,42(suppl):466
[30] Buttin BM,CohnDE,HerzogTJ.Meigs’syndrome with an elevated CA125 from bengign Brenner tumors:in process citation.[J].Obstet Gynecol,2001,98(5Pt 2): 980-982
[31]陈丽花.血清CA125测定在盆腔疾病中的诊断价值[J].中国热带医学杂志,2005, 5:1276 1277
[32] Saygili L,Guclu S.Lslu T.et al .Can serum CA125 leces preliet the optional primaty cyoreduction in patient with advanced ovarian carcinoma [J].Gynecol Oncol.2007. 86(1):57-61
[33] Leitao M. Boyd J. Preopcrative CA125 leves in patients with hereditary compared to sporadio epthehal ovarian carcinoma. [J].Gynecol Oncol.2006.84(3):413-415
[1]连利娟.林巧稚妇科肿瘤学.[M].第3版.北京:人民卫生出版社,2006.401-455
[2]成文彩,蔡桂如.卵巢癌腹腔化疗.[J].国外医学妇产科分册,1999,20.216
[3]李志刚,李孟达.卵巢恶性肿瘤合并腹水的术前诊断及处理.[J].实用妇科杂志,1996, 12:135
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