术前癌抗原125水平预测卵巢上皮癌的价值研究  

Preoperative CA125 levels as an independent prognostic factor for epithelial ovarian cancer

作　　者：余文辉[1] 周小梅[1] 李卓华[2] 杜映纯 陈春娟[3] 陈佩莹[3] 温怡仙 

机构地区：[1]广东省深圳市中医院检验科,518033 [2]广东省汕头市第二人民医院妇产科,515011 [3]广东省汕头市第二人民医院检验科,515011

出　　处：《国外医学（临床生物化学与检验学分册）》2005年第5期257-260,共4页Foreign Medical Sciences(section of Clinical Biochemistry and Laboratory Medicine

摘　　要：目的评估术前癌抗原125(CA125)水平与原发性卵巢癌患者预后的关系。方法对142例术前行血清CA125测定的卵巢上皮癌患者进行回顾性分析,评估CA125水平与术前、术后各种变量的关系。用电化学发光免疫分析法(ECLIA)测定CA125水平。结果所有患者CA125中位数为582kU/L(7～52930kU/L),术前CA125水平与年龄差异不存在相关性(P=0.40)。但术前CA125中位数在浆液组织及其他组织类型(870kU/Lvs334kU/L,P=0.02),肿瘤分期高(Ⅲ.MⅣ)与低(Ⅰ/Ⅱ)(893kU/Lvs174kU/L,P<0.01)、肿瘤病理分级高(G3)与低(G1、G2)(928kU/Lvs323kU/L,P<0.01)、出现腹水有无(893kU/Lvs220kU/L,P<0.01)等方面,差异具有非常显著性意义。次优化肿瘤细胞减灭术(肿瘤残端>1cm)者CA125明显高于最优化肿瘤细胞减灭术(1067kU/Lvs399kU/L,P<0.01)。最优化肿瘤细胞减灭术患者术前CA125<500kU/L者,阳性预测值为82%,阴性预测值为48%,校正协变量后,CA125水平与规定疾病存活率密切相关。术前CA125水平升高(最高者除外)患者,其死亡危险性升高。结论术前CA125水平为卵巢上皮癌的一种独立预测因子,但不是最优化肿瘤细胞减灭术的可靠预测因子。Objective To estimate the association of preoperative cancer antigen 125(CA125) levels with outcome in primary ovarian cancer patients.Methods 142 patients with epithelial ovarian cancer,who had a serum CA125 level drawn before surgery,were retrospectively evaluated.The relationship of preoperative CA125 levels and various preoperative and postoperative variables was evaluated.CA125 levels were measured using electrochemiluminescence immunoassay (ECLIA).Results The median CA125 value for all patients was 582 kU/L (range 7～52 930 kU/L).Preoperative CA125 values did not correlate with increasing age (P=0.40),but were found to be significantly associated with histology compared with other histology (median CA125 of 870 vs 334 kU/L, P=0.02),high-stage (Ⅲ∕Ⅳ)compared with low-stage(Ⅰ/Ⅱ)(median CA125 of 893 vs 174 kU/L,P<0.01),high tumor grade (G3)compared with low-grade(G1,G2)(median CA125 of 928 vs 323 kU/L,P<0.01),and the presence of ascites compared with absence of ascites(median CA125 of 893 vs 220 kU/L,P<0.01).Suboptimal cytoreductive surgery (more than 1 cm residual)was associated with significantly higher CA125 levels compared with individuals with optimal cytoreductive surgery(1 067 vs 399 kU/L,P<0.01).Preoperative CA125 levels less than 500 kU/L had a positive predictive value for optimal cytoreductive surgery of 82%,but a poor negative predictive value of 48%.After adjusting for covariates,there was a significant association between CA125 levels and disease-specific survival.As preoperative CA125 levels increased,the risk of death increased except at the highest value of CA125.Conclusion Preoperative CA125 is an independent risk factor for death due to disease in ovarian cancer,but not a reliable predictor of optimal cytoreductive surgery.

关 键 词：术前 癌抗原125 预测 卵巢上皮癌 电化学发光免疫分析法 

分 类 号：R737.31[医药卫生—肿瘤]