卵巢透明细胞癌患者化疗期间血清CA125的临床价值  

Clinical value of serum CA125 in patients with ovarian clear cell carcinoma during chemotherapy

作　　者：冯绣程 黄奕[2] 戴梦源 时玉颖 苏敏 蔡红兵[1] FENG Xiucheng;HUANG Yi;DAI Mengyuan;SHI Yuying;SU Min;CAI Hongbing(Dept.of Gynecological Oncology,Zhongnan Hospital of Wuhan University/Hubei Cancer Clinical Study Center/&Hubei Key Laboratory of Tumor Biological Behaviors,Wuhan 430071,Hubei,China;Dept.of Gynecological Oncology,Hubei Cancer Hospital,Wuhan 430079,Hubei,China)

机构地区：[1]武汉大学中南医院妇瘤科/湖北省肿瘤医学研究中心/肿瘤生物学行为湖北省重点实验室,湖北武汉430071 [2]湖北省肿瘤医院妇瘤科,湖北武汉430079

出　　处：《武汉大学学报（医学版）》2022年第1期76-80,共5页Medical Journal of Wuhan University

摘　　要：目的:探讨卵巢透明细胞癌(OCCC)患者肿瘤细胞减灭术后化疗期间血清CA125变化和预后的关系。方法:选取2012年1月—2018年12月在武汉大学中南医院进行手术且诊断为OCCC的患者。收集术前血清CA125>35 U/mL的患者的临床资料和血清CA125的变化值。通过ROC曲线分析CA125变化对患者预后的预测价值;Kaplan-Meier模型进行生存分析;Cox单因素和多因素回归模型确定卵巢透明细胞癌患者预后的影响因素。结果:根据预测死亡的最佳截断值19.35 U/mL将卵巢透明细胞癌患者分为两组,即2周期化疗后CA125<19.35 U/mL组和≥19.35 U/mL组,两组患者1年总体生存(OS)率分别为95.8%和82.3%,3年OS率分别为91.0%和43.0%(P<0.05)。根据预测复发的最佳截断值将卵巢透明细胞癌患者分为两组,即1周期化疗后CA125<20.68 U/mL组和≥20.68 U/mL组,两组患者1年无进展生存(PFS)率分别为93.3%和66.5%,3年PFS率分别为93.3%和39.4%(P<0.05)。Cox多因素分析发现FIGO分期、残余瘤和2周期化疗后CA125水平是影响OS的独立预后因素;淋巴结切除是影响PFS的独立预后因素。结论:2周期化疗后CA125降至19.35 U/mL可作为卵巢透明细胞癌患者预后指标。Objective:To investigate the relationship between the changes of CA125 and the prognosis of patients with ovarian clear cell carcinoma(OCCC)during cytoreductive postoperative chemotherapy.Methods:The patients who were diagnosed with OCCC and underwent surgery in Zhongnan Hospital of Wuhan University from January 2012 to December 2018 were selected.The clinical data and changes of serum CA125 of patients with preoperative CA125>35 U/mL were collected.The predictive value of CA125 in patients′prognosis was analyzed by ROC curve.Kaplan-Meier model was used for survival analysis.Cox univariate and multivariate regression models were used to determine the factors affecting the prognosis of patients with ovarian clear cell carcinoma.Results:According to the best cut-off value of 19.35 U/mL for predicting death,patients with OCCC were divided into two groups,namely,the CA125<19.35 U/mL group and≥19.35 U/mL group after 2 cycles of chemotherapy.The 1-year overall survival(OS)rate of the two groups was 95.8%and 82.3%,respectively,and the 3-year OS rate was 91.0%and 43.0%,respectively(P<0.05).According to the best cut-off value for predicting recurrence,patients with OCCC were divided into two groups,namely,the CA125<20.68 U/mL group and≥20.68 U/mL group after 1 cycle of chemotherapy.The 1-year progression free survival(PFS)rate of the two groups was 93.3 and 66.5%,respectively,and the 3-year OS rate was 93.3%and 39.4%,respectively(P<0.05).Cox multivariate analysis showed that FIGO stage,residual tumor,and CA125 level after 2 cycles of chemotherapy were independent prognostic factors for OS;lymphadenectomy was an independent prognostic factor for PFS.Conclusion:The CA125 decreased to 19.35 U/mL after 2 cycles of chemotherapy could be used as a prognostic indicator for patients with ovarian clear cell carcinoma.

关 键 词：卵巢透明细胞癌 CA125 预后 

分 类 号：R737.31[医药卫生—肿瘤]