| Ovarian cancer is one of the three major female genital malignant tumor , the incidence is the third of female genital malignant tumors. Ovarian cancer is a high degree of malignancy and fast-growing malignant tumors, because of ovarian cancer's occult happening ,the rapid progress and the lack of effective methods for early diagnosis, now,70%～80% of patients with ovarian cancer have been found in the late stage. Ovarian cancer is the highest mortality disease, the 5-year survival rate is only 20%～30%. Because the early survival rate of patients with ovarian cancer is nearly 90%, so the early diagnosis of ovarian cancer and early treatment are the key to improving the prognosis.Ovarian endometriosis, adenomyosis and tubal ovarian abscess are common benign gynecological diseases, endangering women's health.Although the combination of laparoscopic and biopsy in the diagnostic accuracy of endometriosis is almost 100%, but, after all, it is an invasive examination, and it should not be as a routine examination.The diagnose of adenomyosis mainly relies on signs,pelvic examination,B-ultrasonography and histopathological examination,lack of specific diagnostic methods. The clinical manifestations of pelvic abscess are complicated and diverse, and easily lead to misdiagnosis. There no satisfactory clinical non-invasive diagnostic methods for these diseases currently, therefore, to investigate a simple, economical and effective non-invasive diagnostic method is very important.CA125 is a glycoprotein of high molecular weight,it is the surface antigen of the epithelial cells of body cavity,it is expressed in cervix, endometrium, fallopian tubes, pelvic peritoneum and other body cavity epithelium which comes from the epithelium of Miller tube, mesepithelium and Miller tube's derivatives. Serum CA125 is one of the most common tumor markers of gynecology,and as a sensitive marker for ovarian cancer,it is widely used in the diagnosis ,differential diagnosis and the evaluation of prognosis of ovarian cancer. Serum CA125 is a tumor associated antigen, which is non-specific antigen, when the organization with CA125 antigen become dysplasia, concentrations of CA125 in blood and other body fluids increased. Serum CA125 elevated in endometrial cancer and some benign gynecological diseases, particularly in ovarian endometriosis, adenomyosis and tubal ovarian abscess patients.In this study, The level of CA125 in 255 patients, serum who had different gynecological diseases and undergo the surgery were analysed by electrochemiluminescence .The control group are 15 healthy woman in clinic. in order to explore the significant value of serum CA125 in diagnosis and differential diagnosis for epithelial ovarian cancer and other diseases such as endometriosis.Results: 1.The positive rate of serum CA125 in patients with epithelial ovarian cancer group was significantly higher than that of endometrial cancer group and cervical cancer group(P<0.01); The positive rate of serum CA125 in patients with epithelial ovarian cancer group was significantly higher than that of benign ovarian tumor group and uterine leiomyoma group(P<0.01); The levels of serum CA125 in epithelial ovarian cancer increased significantly, significantly higher than other groups (P<0.01); The levels of serum CA125 in early ovarian cancer group and advanced ovarian cancer group were significantly different (P<0.01); The levels of serum CA125 in serous cystadenocarcinoma group and mucinous cystadenocarcinoma group were significantly different (P<0.01); After the first chemotherapy , both of the positive rate and the level of serum CA125 were significantly lower than preoperatively (P<0.01).2.The serum CA125 in patients with ovarian endometriosis, adenomyosis and tubal ovarian abscess is elevated, the positive rate of serum CA125 in patients with ovarian endometriosis, was 62.1%,in patients with adenomyosis was 68.8 %, in patients with tubal ovarian abscess was 81.8%, were significantly higher than the normal control group(P<0.01), but the positive rate in patients with ovarian endometriosis, and adenomyosis were lower than that of ovarian cancer group (P<0.05);The levels of serum CA125 in ovarian endometriosis, tubal ovarian abscess, adenomyosis and endometrial cancer were significantly higher than control group (P<0.01), but lower than the ovarian cancer group (P<0.01); The level of serum CA125 is bteween 35U/ml and 199 U/ml in patients with endometriosis,tubo-ovarian abscess and adenmyosis being 51.7%,54.5% and 68.8%51.7% respectively, at the level of 35～199 U/ml, the positive rate were significantly higher than that in epithelial ovarian cancer, cervical cancer, benign ovarian and uterine leiomyoma group (P<0.05).3.The levels of serum CA125 in patients with malignant pelvic masses and in patients with benign pelvic masses were significantly different (P<0.01); When take CA125>35U/ml for the diagnostic criteria, the positive rate of CA125 serum in patients with benign pelvic masses was 43.4%, the positive rate of CA125 serum in patients with pelvic malignant tumor was 77.3%, the sensitivity, specificity, positive predictive value, negative predictive value and youden's index were 77.3%, 56.6%, 57.4%, 76.6% and 33.9% respectively.When take CA125>65U/ml for the diagnostic criteria, the positive rate of CA125 serum in patients with benign pelvic masses was 29%, the positive rate of CA125 serum in patients with pelvic malignant tumor was 73.6%. the sensitivity, specificity, positive predictive value, negative predictive value and youden's index were 73.6%, 71.0%, 65.9%, 78.0% and 44.6% respectively.The results of this study showed: Serum CA125 in patients with epithelial ovarian cancer increases; The level of serum CA125 in advanced ovarian cancer patients was significantly higher than patients with early stage; The serum CA125 level in serous cystadenocarcinoma was significantly higher than that in patients with mucinous cystadenocarcinoma; The level of serum CA125 in preoperative patients is higher than the level in patients who after the first chemotherapy. The serum CA125 level in patients with ovarian endometriosis, tubal ovarian abscess, adenomyosis and endometrial cancer was significantly higher than that of control group, but was significantly lower than that of epithelial ovarian cancer; and the level of serum CA125 is mainly below 200U/ml in patients with ovarian endometriosis, tubal ovarian abscesses, adenomyosis and other benign gynecological diseases, when serum CA125 is higher than 400U/ml, in particular, the possibility of ovarian cancerr should be taken into account when higher than 1000U/ml. The level of serum CA125 in patients with malignant pelvic masses was significantly higher than that of benign masses ; it will be more helpful to take 65U/ml as the critical value of serum CA125 for differential diagnosis in benign and malignant pelvic masses.Through this study we can come to the following conclusions:1.The level of serum CA125 in patients with epithelial ovarian cancer were significantly increased, was related to histological type, and was positively correlated with surgical-pathologic staging,the level of serum CA125 reduced significantly after the first chemotherapy.Serum CA125 play an important role in diagnosis, differential diagnosis, detecting condition and clinical observation of epithelial ovarian cancer. 2. Serum CA125 has important clinical significance in the diagnosis of ovarian endometriosis, tubal ovarian abscess, adenomyosis and endometrial cancer. 3.The level of serum CA125 is mainly below 200U/ml in patients with ovarian endometriosis, tubal ovarian abscesses, adenomyosis and other benign gynecological diseases, when serum CA125 is higher than 400U/ml, in particular, the possibility of ovarian cancer should be taken into account when higher than 1000U/ml.4.Serum CA125 has a certain degree of clinical significance in determining the nature of pelvic masses.5. it will be more helpful to take 65U/ml as the critical value of serum CA125 for differential diagnosis in benign and malignant pelvic masses.
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