血清CA125变化与上皮性卵巢癌预后及复发关系研究  

Clinical significance of serum CA125 in prognosis evaluation and recurrence monitoring of epithelial ovarian cancer

作　　者：秦雪[1] 刘鑫丽[2] 王欣彦[1] 李秀琴[1] 

机构地区：[1]中国医科大学附属盛京医院妇产科,辽宁沈阳110022 [2]北京军区总医院263临床部妇产科,北京101149

出　　处：《中国实用妇科与产科杂志》2016年第5期473-476,共4页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨上皮性卵巢癌初始治疗后CA125最低值及其动态变化与预后的关系。方法选择2008年1月至2013年1月中国医科大学附属盛京医院初始治疗达到完全缓解,术前CA125高于35 k U/L的上皮性卵巢癌复发患者120例。我们将卵巢癌复发的CA125参考值设为15 k U/L,其中33例CA125≥15 k U/L,87例CA125<15 k U/L。比较两组的无进展生存期、总生存期。结果 CA125<15 k U/L组的无进展生存期[(17.58±1.23)个月]、总生存期[(22.38±2.41)个月]均显著高于CA125≥15 k U/L组[(10.88±3.01)个月及(11.42±4.21)个月](P<0.05)。COX比例风险模型分析初始治疗后CA125最低值≥15 k U/L预示卵巢癌早期复发。同时CA125在正常范围内连续3次升高出现的时间[(15.22±10.8)个月]早于影像学诊断肿瘤复发[(22.59±17.22)个月]7个月。结论初始治疗后CA125降至15 k U/L以下的患者预后相对较好。动态监测CA125水平,如果在35 k U/L内连续3次升高,应及时进行影像学评价,可能对部分患者早期诊断复发有意义。Objective To explore the relationship of the minimum CA 125 level and its dynamic changes with the prog- nosis of ovarian cancer after initial treatment for epithelial ovarian cancer. Methods The study enrolled 120 patients di- agnosed with epithelial ovarian cancer from Jan.2008 to Jan. 2013 at Shengjing Hospital of China Medical University, who underwent ovarian cancer staging surgery or cytoreductive surgery with CA 125≥35kU/L. Enrolled patients achieved complete remission. The preoperative CA125 level ≥15 kU/L was set as the recurrence value.There were 33 cases of CA125 〉115 kU/L and 87 cases of CA125 〈 15 kU/L.Compare progression-free survival and overall survival between the two groups.Results In patients who had minimum serum CA 125 level of 〈 15 kU/L, the PFS was （17.58± 1.23）months and OS （22.38±2.41）months.Patients who had minimum serum CA125 level≥15 kU/L had the PFS of （10.88±3.01） months and OS of （11.42±4.21 ）months.There was a statistically significant difference between the two groups （P 〈 0.05）.By COX proportional hazards regression model analysis, the minimum level of serum CA 125 ≥15 kU/L after first- line therapy （P 〈 0.05） was significantly associated with the recurrence of ovarian cancer. For patients with progressive increases in serum CA 125 levels within 35 kU/L, the time interval of serum CA 125 increase was （15.22± 10.8）months, which was 7 months earlier than the time interval of imaging diagnosis of recurrence （22.59±17.22）months.Conclusions Patients with the minimum level of serum CA125 〈 15 kU/L after initial treatment have better prognosis. If patients have progressive increase in serum CA 125 levels within 35 kU/L, we suggest imaging examinations, which might be an important to early diagnosis of epithelial ovarian cancer.

关 键 词：上皮性卵巢癌 癌抗原125 复发监测 

分 类 号：R737.31[医药卫生—肿瘤]