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目的:探讨血清CA125、子宫内膜芳香化酶检测诊断子宫内膜异位症(endometriosis,EMs)的价值。方法:经腹腔镜或开腹手术确诊的EMs患者40例(EMs组),因盆腔炎行腹腔镜手术且排除EMs的患者20例(对照组),术前均抽血检测血清CA125水平,术中取其子宫内膜,采用免疫组织化学法检测芳香化酶的表达情况,并进行比较。结果:EMs组血清CA125水平高于对照组(P<0.05),Ⅲ~Ⅳ期EMs患者血清CA125水平较Ⅰ~Ⅱ期患者高(P<0.05),EMs组在位内膜芳香化酶阳性表达率高于对照组(P<0.05),Ⅲ~Ⅳ期EMs患者在位内膜芳香化酶阳性表达率与Ⅰ~Ⅱ期患者比较差异无统计学意义(P>0.05)。以血清CA125≥35 u/mL为临界值,诊断EMs的敏感性为55.0%,特异性为80.0%;免疫组织化学检测子宫内膜芳香化酶诊断EMs的敏感性为92.5%,特异性为90.0%;2种方法联合检测诊断EMs的敏感性95.0%,特异性70.5%。结论:血清CA125联合子宫内膜芳香化酶检测可提高EMs的早期诊断率和诊断准确性。
Objective: To investigate the value of serum CA125 and endometrial aromatase in diagnosis of endometriosis (EMs). Methods: 40 patients with EMs diagnosed by laparoscopy or laparotomy (EMs group), 20 patients with laparoscopic resection of pelvic inflammatory disease and exclusion of EMs (control group), serum CA125 level Take the endometrium, using immunohistochemistry to detect the expression of aromatase, and compared. Results: The level of serum CA125 in EMs group was higher than that in control group (P <0.05). The level of serum CA125 in stage Ⅲ ~ Ⅳ EMs patients was higher than that in stage Ⅰ ~ Ⅱ patients (P <0.05) (P <0.05). There was no significant difference in the positive rate of eutopic endometrial aromatase between stage Ⅲ ~ Ⅳ EMs patients and stage Ⅰ ~ Ⅱ patients (P> 0.05). The sensitivity and specificity of diagnosing EMs with serum CA125≥35 u / mL as the cutoff value were 55.0% and 80.0% respectively. The sensitivity and specificity of immunohistochemical detection of endometrial aromatase in the diagnosis of EMs were 92.5% and 90.0 %. The sensitivity of the two methods in detecting EMs was 95.0% and the specificity was 70.5%. Conclusion: Serum CA125 combined with endometrial aromatase test can improve the early diagnosis and diagnostic accuracy of EMs.