血清癌胚抗原、糖类抗原125及调节性T细胞比率联合检测对卵巢癌化学治疗患者临床转归的预测价值  

Value of combined detection of serum carcinoembryonic antigen,cancer antigen 125 and the regulatory T cell ratio for predicting the clinical outcomes of patients with ovarian cancer receiving chemotherapy

作　　者：张瀚翔 赵莉 郝群 ZHANG Hanxiang;ZHAO Li;HAO Qun(Department of Obstetrics and Gynecology,the Fourth Affiliated Hospital of Nanjing Medical University,Nanjing 210000,Jiangsu Province,China)

机构地区：[1]南京医科大学第四附属医院妇产科,江苏南京210000

出　　处：《新乡医学院学报》2025年第4期315-319,326,共6页Journal of Xinxiang Medical University

摘　　要：目的探讨血清癌胚抗原(CEA)、糖类抗原125(CA125)及调节性T细胞(Treg)比率联合检测对卵巢癌化学治疗患者临床转归的预测价值。方法选择2021年8月至2023年8月于南京医科大学第四附属医院就诊并接受化学治疗的106例卵巢癌患者为卵巢癌组,另选择同期于本院体检的年龄匹配的108例健康女性为对照组。收集所有卵巢癌患者年龄、体质量指数(BMI)、分化程度、是否肿瘤侵犯子宫肌层、肿瘤大小、TNM分期、淋巴结转移等临床资料。化学治疗方案为注射用卡铂300~400 mg·m^(-2),静脉滴注60 min;紫杉醇注射液135 mg·m^(-2),静脉滴注3 h;每21 d为1个疗程,共6个疗程。采用酶联免疫吸附法检测化学治疗前后卵巢癌患者血清CEA和CA125水平,采用流式细胞仪检测化学治疗前后Treg比率。化学治疗结束后根据患者临床结局将患者分为有效组(n=57)和无效组(n=49)。比较2组患者的临床资料,采用多因素logistic回归模型分析卵巢癌患者化学治疗无效的危险因素,受试者操作特征(ROC)曲线分析血清CEA、CA125及Treg比率单独及三者联合检测对卵巢癌化学治疗患者临床结局的预测价值。结果卵巢癌组患者化学治疗前、后血清CEA、CA125及Treg比率均显著高于对照组(P<0.05);卵巢癌组患者化学治疗后血清CEA、CA125水平及Treg比率均显著低于治疗前(P<0.05)。无效组患者治疗前血清CEA、CA125及Treg比率显著高于有效组(P<0.05);有效组与无效组患者的年龄、BMI、分化程度、是否肿瘤侵犯子宫肌层、肿瘤大小比较差异无统计学意义(P>0.05);无效组患者TNM分期Ⅲ+Ⅳ期占比、淋巴结转移占比显著高于有效组(P<0.05)。多因素logistic回归分析结果显示,高CEA、CA125、Treg比率是卵巢癌患者化学治疗无效的危险因素(P<0.05)。ROC结果显示,CEA、CA125、Treg比率单独及三者联合预测卵巢癌患者化学治疗临床转归的曲线下面积(AUC)为0.876、0.737�Objective To explore the value of combined detection of serum carcinoembryonic antigen(CEA),cancer antigen 125(CA125),and the regulatory T cell(Treg)ratio for predicting the clinical outcomes of ovarian cancer patients undergoing chemotherapy.Methods A total of 106 ovarian cancer patients who received chemotherapy at the Fourth Affiliated Hospital of Nanjing Medical University from August 2021 to August 2023 were included as the ovarian cancer group.Additionally,108 age-matched healthy females who underwent physical examinations at the same hospital during the same period were selected as the control group.The clinical data of all ovarian cancer patients,including age,body mass index(BMI),differentiation grade,tumor invasion into the myometrium,tumor size,TNM stage,and lymph node metastasis,were collected.The chemotherapy regimen consisted of intravenous infusion of carboplatin(300-400 mg·m^(2))over 60 minutes and paclitaxel(135 mg·m^(-2))over 3 hours.Each cycle lasted 21 days,and a total of 6 cycles were administered.Serum levels of CEA and CA125 in ovarian cancer patients before and after chemotherapy were detected using enzyme-linked immunosorbent assay,and the Treg ratio was measured by flow cytometry.After chemotherapy,patients were divided into effective(n=57)and ineffective groups(n=49)based on clinical outcomes.The clinical data between the two groups were compared,and multivariate logistic regression models were used to analyze the risk factors for ineffective chemotherapy outcomes in ovarian cancer patients.The value of the use of serum CEA,CA125,and the Treg ratio alone and their combined use for predicting the clinical outcomes of ovarian cancer patients receiving chemotherapy was assessed using the receiver operating characteristic(ROC)curve analysis.Results The serum CEA and CA125 levels and the Treg ratio of patients before and after chemotherapy in the ovarian cancer group were significantly higher than those in the control group(P<0.05).The serum CEA and CA125 levels and the Treg ratio after ch

关 键 词：癌胚抗原 糖类抗原125 调节性T细胞比率 卵巢癌 化学治疗 临床转归 

分 类 号：R737.31[医药卫生—肿瘤]