标题：膀胱尿路上皮癌患者血清CA125的检测及其临床意义

      作者：冯 瑞，李中兴，沈 斌，王 星，葛广成，吴 丹，贾跃军
    (镇江市第二人民医院泌尿外科，江苏 镇江 212002)

      卷次： 2015年26卷20期

      【摘要】 目的 探讨膀胱尿路上皮癌患者临床血清CA125检测与肿瘤病理之间的联系。方法 对我科
2003年8月至2015年3月就诊的251例膀胱尿路上皮癌患者(病例组)行膀胱镜病理及影像学检查明确病理类型，
同时行血清CA125检测，观察不同类型病理的CA125检测结果，并进行统计学分析。同时选取100例正常成人
行血清CA125检测作为对照组。结果 100例正常人CA125均阴性表达，251例膀胱尿路上皮癌患者中CA125
阴性表达92例，占36.7%，阳性表达159例，占63.3%；CA125阳性表达在单发肿瘤中100例，多发肿瘤59例；两者
比较差异无统计学意义(P>0.05)；122例瘤体≤1.5 cm的患者中阳性表达78例，129例瘤体>1.5 cm的患者中阳性
表达81例，两者比较差异无统计学意义(P>0.05)；57例G1级肿瘤中阳性表达15例，占26.32%，139例G2级肿瘤中
阳性表达95例，占68.35%，55例G3级肿瘤中阳性表达49例，占89.09%，G1级与G2级比较(P=0.041)、G1级与G3级
比较(P=0.033)、G2级与G3级比较(P=0.015)差异均有统计学意义；14例Tis期阳性表达1例，占7.14%，115例T1期
阳性表达64例，占55.65%，61例T2期阳性表达38例，占62.30%，34例T3期阳性表达31例，占91.18%，27例T4期
阳性表达25例，占92.59%，Tis期与T1期比较差异无统计学意义(P=0.925)，而T1期与T2期比较(P=0.031)、T2期与
T3期比较(P=0.013)、T3期与T4期比较(P=0.008)差异均有统计学意义。结论 膀胱尿路上皮癌患者中CA125的阳
性表达与肿瘤数目及大小无关；与肿瘤的病理分级和临床分期相关；随着肿瘤级别和临床分期的改变，不同级别
和分期的肿瘤阳性表达率逐渐升高，并与肿瘤的浸润有相关性。

      【关键词】 膀胱尿路上皮癌；CA125；病理分级；临床分期；相关性

      【中图分类号】 R737.14 【文献标识码】 A 【文章编号】 1003—6350（2015）20—3018—03


Detection of serum CA125 in patients with bladder urothelial carcinoma and the clinical significance.
FENG
Rui, LI Zhong-xing, SHEN Bin, WANG Xing, GE Guang-cheng, WU Dan, JIA Yue-jun. Department of Urology, the
Second Hospital of Zhenjiang City, Zhenjiang 212002, Jiangsu, CHINA

【Abstract】 Objective To investigate the correlation between detection of serum CA125 in bladder urothelial
carcinoma and the pathology of the tumor. Methods A total of 251 patients of bladder urothelial carcinoma in our de-
partment from August 2003 to March 2015 (the study group) underwent pathological and imaging examination in cys-
toscopy for pathological type, and the serum CA125 levels were also detected. The CA125 detection results of differ-
ent pathological types were observed. At the same time, 100 healthy adult people were selected and underwent serum
CA125 detection (the control group). Results In the control group, the expression of CA125 was negative in all the
patients. In the study group, CA125 was negatively expressed in 92 cases (36.7%) and positively expressed in 159 cas-
es (63.3%), including 100 cases of solitary tumor and 59 cases of multiple tumor, with no statistically significant differ-
ence (P>0.05). CA125 was positively expressed in 78 of the 122 patients with tumors≤1.5 cm and in 81 of the 129 pa-
tients with tumors>1.5 cm, showing no statistically significant difference (P>0.05). Positive expression of CA125 was
found in 15 of the 57 patients of G1 grade tumor (accounting for 26.32%), 95 of the 139 patients of G2 grade tumor
(68.35%), 49 of the 55 patients of G3 grade tumor (89.09%), with statistically significant difference between G1 grade
and G2 grade (P=0.041), G1 grade and G3 grade (P=0.033), as well as G2 grade and G3 grade (P=0.015). CA125 was
positively expressed in 1 of the 14 patients of Tis stage (7.14%), 64 of the 115 patients of T1 stage (55.65%), 38 of the
61 patients of T2 stage (62.30%), 31 of the 34 patients of T3 stage (91.18%), as well as 25 of the 27 patients of T4 stage
·论 著·doi:10.3969/j.issn.1003-6350.2015.20.1098 (92.59%), with no statistically significant difference between Tis stage and T1 stage (P=0.925), but statistically signifi-
cant difference between T1 stage and T2 stage (P=0.031), T2 stage and T3 stage (P=0.013), T3 stage and T4 stage (P=
0.008). Conclusion Positive expression of CA125 in patients of bladder urothelial carcinoma show no correlation
with the number and size of tumor, but it is associated with the pathological grading and clinical staging of tumor.
With the increase of the pathological grade and clinical stage, the positive expression rate of CA125 rise gradually,
which has correlation with tumor infiltration.