>
网站首页期刊介绍通知公告编 委 会投稿须知电子期刊广告合作联系我们
最新消息:
围手术期CA125水平对高级别浆液性卵巢癌的预后价值研究
作者:李玮1  李然2  朱根海1  吴秀荣1  王圣坦1 
单位:1. 海南省人民医院, 海南 海口 570000;
2. 广东医学院附属医院, 广东 湛江 524001
关键词:高级别浆液性性卵巢癌 癌胚抗原125 预后 
分类号:R737.31
出版年·卷·期(页码):2019·38·第五期(877-880)
摘要:

目的:探索围手术期癌胚抗原125(CA125)变化对高级别浆液性卵巢癌(HGSC)的预后价值。方法:回顾性研究海南省人民医院2005年1月至2015年1月诊断为HGSC并接受手术治疗的患者,收集患者临床数据及就诊时和手术后CA125数据。采用R软件的Maxstat函数包确定区分CA125水平分级的最佳界值,并进行Cox回归分析。结果:共纳入243例HGSC患者,基线CA125最佳界值为165.3 U·ml-1,术前/术后CA125值大于6.3为预后良好指标。基线CA125水平降低和术前/术后CA125值增加与患者高总生存率有关(风险比分别为:HR=0.42,95% CI 0.25~0.70,P<0.001;HR=0.46, 95% CI 0.29~0.75, P<0.001)。结论:围手术期CA125水平对HGSC具有重要预后价值,就诊时低于165.3 U·ml-1或术前/术后CA125值大于6.3提示更好的预后。

Objective: To explore the prognostic value of perioperative CA125 changes in high-grade serous ovarian cancer (HGSC) patients. Methods: A retrospective study was performed on patients diagnosed as HGSC undergoing surgery from January 2005 to January 2015. The clinical data, CA125 data at diagnosis and following surgery were collected. The Maxstat function package of the R software was used to determine the optimum CA125 level cutoff value. Cox regression analysis was performed to evaluate mortality based on the CA125 level. Results: A total of 243 HGSC patients were enrolled. The optimum CA125 level cutoff value was 165.3 U·ml-1. Pre-operative/postoperative ratio higher than 6.3 was a good indicator of prognosis. The decrease of CA125 level at diagnosis and the pre-operative/post-operative CA125 ratio were associated with improved overall survival (Hazard ratios:HR=0.42, 95% CI 0.25-0.70, P<0.001; HR=0.46, 95% CI 0.29-0.75, P<0.001, respectively). Conclusion: Per-operative CA125 levels have an important prognostic value for HGSC, with a low pre-operative CA125 value or high pre-operative/post-operative CA125 ratio greater than 6.3 suggesting a better prognosis.

参考文献:

[1] SIEGEL R,MILLER K D,JEMAL A.Cancer statistics,2018[J].CA Cancer J Clin,2018,68(1):7-30.
[2] BAST R C Jr,HENNESSY B,MILLS G B.The biology of ovarian cancer:New opportunities for translation[J].Nat Rev Cancer,2009,9(6):415-428.
[3] VAUGHAN S,COWARD J I,BAST R C Jr,et al.Rethinking ovarian cancer:Recommendations for improving outcomes[J].Nat Rev Cancer,2011,11(10):719-725.
[4] BAST R C Jr,KLUG T L,ST JOHN E,et al.A radioimmunoassay using a monoclonal antibody to monitor the course of epithelial ovarian cancer[J].N Engl J Med,1983,309(15):883-887.
[5] 张曦匀,帕提曼·米吉提,古扎丽努尔·阿不力孜.常用肿瘤标志物在上皮性卵巢癌诊断中的临床价值[J].中国现代医学杂志,2017,27(15):62-67.
[6] 唐洁,王蕾.术后CA125值变化对上皮性卵巢癌预后判断的价值[J].中国现代医学杂志,2012,22(7):39-43.
[7] ROSSI A C,DI VAGNO G,CORMIO G,et al.A retrospective study of preoperative CA 125 levels in 82 patients with ovarian cancer[J].Arch Gynecol Obstet,2004,269(4):263-265.
[8] SEVELDA P,SCHEMPER M,SPONA J.CA 125 as an independent prognostic factor for survival in patients with epithelial ovarian cancer[J].Am J Obstet Gynecol,1989,161(5):1213-1216.
[9] HOGDALL E V,CHRISTENSEN L,KJAER S K,et al.CA125 expression pattern,prognosis and correlation with serum CA125 in ovarian tumor patients.From The Danish "MALOVA" Ovarian Cancer Study[J].Gynecol Oncol,2007,104(3):508-515.
[10] GADDUCCI A,ZOLA P,LANDONI F,et al.Serum half-life of CA 125 during early chemotherapy as an independent prognostic variable for patients with advanced epithelial ovarian cancer:Results of a multicentric Italian study[J].Gynecol Oncol,1995,58(1):42-47.
[11] GEISLER J P,MILLER G A,LEE T H,et al.Relationship of preoperative serum CA-125 to survival in epithelial ovarian carcinoma[J].J Reprod Med,1996,41(3):140-142.
[12] NAGELE F,PETRU E,MEDL M,et al.Preoperative CA 125:An independent prognostic factor in patients with stage Ⅰ epithelial ovarian cancer[J].Obstet Gynecol,1995,86(2):259-264.
[13] 邱建,傅云峰,周彩云,等.上皮性卵巢癌组织CK2β和p53蛋白表达临床意义分析[J].中华肿瘤防治杂志,2015,22(6):451-456.
[14] CHAN J K,CHEUNG M K,HUSAIN A,et al.Patterns and progress in ovarian cancer over 14 years[J].Obstet Gynecol,2006,108(3 Pt 1):521-528.
[15] MAY T,STEWART J M,BERNARDINI M Q,et al..The prognostic value of perioperative,pre-systemic therapy CA125 levels in patients with high-grade serous ovarian cancer[J].Int J Gynecol Obstet,2018,140(2):247-252.
[16] 秦雪,刘鑫丽,王欣彦,等.血清CA125变化与上皮性卵巢癌预后及复发关系研究[J].中国实用妇科与产科杂志,2016,32(5):473-476.

服务与反馈:
文章下载】【发表评论】【查看评论】【加入收藏
提示:您还未登录,请登录!点此登录
您是第 405679 位访问者


copyright ©《东南大学学报(医学版)》编辑部
联系电话:025-83272481 83272483
电子邮件:
bjb@pub.seu.edu.cn

苏ICP备09058364