血清CA125判定子宫内膜癌预后的价值

目的 :研究、探讨血清CA12 5判定子宫内膜癌预后的价值。方法 :189例原发性子宫内膜癌病例 ,检测治疗前、治疗后以及复发、再转移病例的血清CA12 5水平。结果 :1)分别以 35U/ml、17U/ml作为绝经前、后的血清CA12 5阳性诊断标准 ,阳性率分别为 37.5 %、6 4 .4 %。 2 )绝经前、后病例 ,如果治疗前血清CA12 5分别超过 70U/ml、2 5U/ml则 5年生存率低、预后不良(P <0 .0 0 1)。 3)治疗后血清CA12 5仍大于 2 0U/ml,特别是大于 2 8U/ml病例全部死亡。 4 )绝经前、后病例 ,如果治疗前血清CA12 5分别超过 4 0U/ml、30U/ml,则对于预测是否有盆腔淋巴结的转移有意义。 5 ) 82 .6 %的复发、再转移的病例血清CA12 5超过 2 0U/ml;治疗前血清CA12 5阴性病例 ,在发生转移时 6 8.8%血清CA12 5升高。结论 :血清CA12 5对于子宫内膜癌的预后判断和治疗经过的监测具有很高的实用价值 ,对及时诊断、恰当治疗预后不良病例具有重要的指导意义

The Prognostic Value of Serum CA125 Levels in Patients with Endometrial Cancer

Objective: The aim of this study is to examine the prognostic value of serum CA125 levels in patients with endometrial cancer. Methods: 189 patients with endometrial cancer treated at our Hospital between 1996 and 2002 were investigated. Serum CA125 levels were measured before and after treatment, and on recurring metastasis. Results: 1) Serum CA125 levels increased with the surgical stage and were relatively high in the patients with serous adenocarcinoma, adenoacanthoma and low grade endometrioid adenocarcinoma.2) Diagnostic efficiency was the highest at a 70U/ml cut-off level in premenopause and 25U/ml in postmenopause to predict poor prognsins ( P <0.001). 3) All patients with as level higher than 28U/ml after treatment had a poor prognosis. 4) They tended to have metastasis to the pelvic node whose CA125 levels before treatment were higher than 40U/ml before menopause and higher than 30U/ml after menopause. 5) 82.6% of patients with metastasis had high serum CA125 levels (20U/ml) on recurring metastasis, but the patients had recurrence of vagival cuff. Conclusion: It is considered that the serum CA125 level in a patient with endometrial cancer is a predictive factor in distingushing a patient with a poor prognosis from a patient with a good prognosis.