Clinical Significance Of Serum CA125 And LDH In Preoperative Diagnosis Of Uterine Sarcoma

Purpose Uterine sarcoma is a rare malignant tumor for women.It has a high degree of malignancy,and no specific clinical manifestations and auxiliary examination methods.So it is hard for preoperative diagnosis.If the uterine sarcoma is misdiagnosed as a benign tumor such as uterine fibroids,laparoscopic surgery is chosen,which may cause the risk of iatrogenic dissemination and metastasis of the tumor,influencing the prognosis of the patients.Therefore,exploring serological tumor markers specific for preoperative diagnosis of uterine sarcoma has been a hot topic for scholars at home and abroad.In this paper,the clinical significance of serum CA125 and LDH levels in preoperative diagnosis of uterine sarcoma was studied by analyzing the serum levels of CA125 and LDH in 180 patients.Methods (1)Retrospectively analyzed the levels of serum CA125 and LDH for patients treated in Anhui Provincial Hospital from Oct.2016 to June 2017,including 25 cases of uterine sarcoma,150 cases of uterine leiomyoma and 5 cases of smooth muscle tumors of uncertain malignant potential,who were confirmed by pathological examination.The clinical characteristics of each group and the differences of serum CA125 and LDH levels between above groups were analyzed.(2)The serum CA125 value of patients was detected by electrochemiluminescence immunoassay(ECLIA)using Abbott i2000 SR chemiluminescence immunoassay.The reference value was 0~35U/ml,CA125>35U/ml was positive,and CA125<35U/ml was negative.Serum LDH values were measured by rate method using Siemens ADVIA-2400 biochemical detector.The reference value was 90 ~ 180 U / L,serum LDH > 180 U / L was positive,and 90 ~ 180 U / L(including 90,180)was negative.(3)Using SPSS19.0 statistical software,the number of measurement data was expressed as median(P25,P75).The measurement data of each group were compared by Kruskal-Wallis test.The comparison between the two groups was analyzed by Bonferron test.Using chi-square test to analyze counting data.The specificity and sensitivity of serum CA125 and LDH for the diagnosis of uterine sarcoma were calculated by the receiver operating characteristic curve(ROC curve),and the area under the curve(AUC)and the 95% confidence interval were calculated.P < 0.05 was considered statistically significant.Results The age of patients in the uterine sarcoma group was significantly higher than that in the uterine fibroids group(P < 0.001).The proportion of patients with uterine sarcoma and uterine fibroids in menopausal and abdominal pain was statistically significant(P value was less than 0.05),and the proportion of vaginal bleeding between above groups has no statistical significances,the P value was 0.171.The tumor size and tumor singleness were compared among uterine sarcoma group,uterine fibroids group and the smooth muscle tumors of uncertain malignant potential group,the differences were not statistically significant,P values were all greater than 0.05.The expression of serum CA125 in uterine sarcoma group showed no significant difference compared with other groups(P>0.05).The level of serum LDH in uterine sarcoma group [201.00(150.50,238.00)U/ L] was significantly higher than that in uterine leiomyoma group[149.00(135.00,160.00)U/ L](P<0.001).The level of serum LDH detected in the uterine sarcoma group was higher than that in the smooth muscle tumors of uncertain malignant potential group [172.00(147.00,175.00)U/ L],with no significant differences(P =0.229).The ROC-AUC of CA125 in patients with uterine sarcom was 0.546 while the ROC-AUC of LDH was 0.757.The cut-off value of serum LDH to diagnose uterine sarcoma was 199U/ L,with a sensitivity of 61.9 % and a specificity of 96.4%.Conclusion Preoperative diagnosis of uterine sarcoma by serum CA125 has not found any guiding significances.The level of serum LDH can be used to assist preoperative diagnosis of uterine sarcoma,and have some guiding significances for choosing the clinical programs.Serum CA125 has not found any guiding significance for the preoperative diagnosis of uterine sarcoma.Serum LDH detection level can be used to assist the preoperative diagnosis of uterine sarcoma,and has certain guiding significances for the choice of clinical treatment.