| Objective:To investigate the clinical value of serum CA125in the diagnosis of adenomyosis(AM),therapeutic response after uterine artery embolization(UAE) and predicting laterecurrence.Materials and Methods:1.In this study, radioimmunoassay (RIA) to detect the serum CAl25level for the62cases ofpure adenomyosis patients confirmed by clinical data of the First Hospital of Shanxi MedicalUniversity during Jan,2010Nov,2011and35healthy human Group C.2. Group A32patients with AM were treated by uterine artery embolization.After partialanethesia, biteral puncture was performed by using seldinger’s technique.4~5F Cobra catheterwas placed into the contralateral internal iliac artery.After that digital subtraction angiography(DSA) of the contralateral internal iliac artery was detected, the uterine artery was selected thecatheterization and bilateral graded embolized with polyvinyl alcohol (PVA) particles(350~700m)+fresh gelfoam particles (1~2mm).Using a loop technology the other side uterinearterial was treated in the same method. Embolic agent dosage based on uterine adenomyosisblood for the rational allocation.3. Group B30cases of uterine adenomyosis underwent surgery,11cases of abdominalhysterectomy,19cases of vaginal hysterectomy.4.The uterine volume, hemoglobin concentration, degree of dysmennorrhea and serumCA125were investigated before operation and follow up was done at1month,3months,6months after operation; recurrence of symptoms was treated at any time.Results:1. The CA125of group A,group B and group C were (115.2±55.6) U/ml,(120.6±53.4)U/ml,(23.1±8.1)U/ml, the positive rate was87.5%,93.3%,8.6%. The difference of serumCA125was statistically significant between A and B group; In62cases of uterineadenomyosis,there were43cases of diffuse type and serum CA125was (139.4±51.9)U/ml,significantly higher than the limitations of type patients (93.7±28.6)U/ml (t=4.9827, P <0.01);Forgroup C, the differences of serum CA125were statistically significant with A and B group (P <0.01).2.Group A the patients were treated by UAE, technical success rate was100%, no seriouscomplications. Follow12months, the clinical remission rate of93.8%. All the patients hadsymptoms of dysmenorrheal,the symptoms alleviated or disappeared after UAE during112months.From preoperative (87.4±11.4) to postoperative at6months (13.4±5.1), the differencehad statistically significant (<0.01). After UAE the uterine volume had been reduced gradually,at6months narrowed from preoperative (247.5±39.2) mm3and postoperative (112.7±32.6) mm3(P <0.01). Hemoglobin concentration of all patients with hemoglobin increased in varyingdegrees, from the preoperative (73.5±14.3) g/L return to (132±7.6)g/L at6months (P<0.01).After UAE, the serum CA125decreased significantly (29.6±19.9)U/ml(P<0.01) at6months.Thereduction compared with both the uterine volume reduction and the hemoglobin increase hadgood correlation r=0.8745P <0.01and r=0.7985P<0.01),Two cases relapsed and had tohave hysterectomy.3. Patients in group B underwent hysterectomy, dysmenorrhea disappeared after operative,hemoglobin increased gradually and restored from the preoperative (72.4±16.5)g/L to (127±11.6)g/L (P<0.01) in six months;CA125levels returned to normal after1month (27.3±15.9) U/ml,and there was no upward trend followed up in twelve months.4.In group A,two cases of clinical remission after treatment, relapsed respectively on9and11months.The serum and the uterine volume CA125were similar to before operation.Conclusions:1.Preoperative serum CA125increases in adenomyosis have important diagnostic value,the sensitivity was90.3the specificity was85.7%2.UAE for treatment of adenomyosis can make symptoms of dysmenorrhea improved,uterine volume reduced, and anemia to be corrected, is a safe, effective, simple, with fewcomplications, minimally invasive method.3.The serum CA125of adenomyosis with dynamic monitoring has important guidingsignificance for UAE clinical efficacy and relapse prediction. |
