摘要: 目的 对CA125诊断子宫内膜异位症的临床意义进行分析并探讨可能影响CA125水平的相关因素。方法 以2011年1月至2014年1月在我院诊断为卵巢囊肿或子宫腺肌病并进行手术治疗的150例患者为研究对象，其中卵巢异位囊肿或卵巢巧克力囊肿69例，设定为A组；卵巢囊肿52例，设定为B组；子宫腺肌病29例，设定为C组；对比分析CA125水平，并分析临床相关影响CA125水平的因素。结果 血清CA125水平在A和C组明显高于B组，相比差异有统计学意义 (t=24.55，P＜0.01；t=21.11，P＜0.01)；A组及C组之间，CA125水平相比差异无统计学意义（t=-1.72，P=0.08）,三组CEA及AFP水平相比差异无统计学意义（P＞0.05）；A组、B组和C组患者均检测CA125>35IU/mL，为阳性，A组及C组患者CA125阳性率明显高于B组，相比差异有统计学意义（P＜0.05）；CA125水平越高，rAFS分期越高，相比差异有统计学意义（P＜0.05）；采用Logistic多元回归分析筛选相关因素，发现CA125水平与rAFS分期粘连评分呈正相关性，但与痛经及不孕的发生率无明显相关性，分别在月经周期增生期及分泌期测定卵巢内异位囊肿组患者CA125水平，发现CA125水平与月经周期时段无明显相关性（P＞0.05），不同流产和生育次数之间及是否合并子宫腺肌病的CA 125水平之间无明显差异 ( P>0.05)。结论 血清CA125水平可以作为鉴别卵巢囊肿与子宫内膜异位囊肿及子宫腺肌病的一个指标，对于术前评估子宫内膜异位症的严重程度有重要的参考价值。

Abstract: Objective To investigate the clinical significance of CA125 in diagnosis of endometriosis and to explore the possible related factors influencing CA125 level. Methods 150 cases diagnosed as ovarian cysts or adenomyosis patients were involved in this study which including 69 cases of cyst of the ovary (Group A), 52 cases of ovarian cyst (Group B), 29 cases of uterine adenomyosis (Group C). The serum CA125 levels were determined and clinical related factors were analyzed. Results The serum CA 125 levels in Group A and Group C were significantly higher than that of Group B (P < 0.01). There was no significantly difference on CA 125 levels between Group A and Group C (P>0.05). The CEA and AFP levels in three groups had no significant difference (P > 0.05). The positive rate of CA 125 in Group A and Group C was significantly higher than that of Group B (P < 0.05). The higher level of CA125 showed higher rAFS staging (P < 0.05). The CA125 level was positively related with the staging of the adhesion score of rAFS, but not correlated with the incidence of dysmenorrhea and infertility. Conclusion The serum CA125 levels can be used as an index to identify ovarian cysts, endometriotic cyst and uterine adenomyosis, and it might have important reference value for preoperative evaluation of the severity of endometriosis.