测定血清CA125水平在卵巢癌的临床意义

目的分析卵巢癌手术前后测定血清CA125水平的临床意义.方法采用回顾性分析方法,1994年1月～2000年8月我院收治的137例卵巢癌患者手术前后血清CA125水平结合病理、分期、分化、手术情况\治疗及预后等临床资料进行分析.结果在卵巢癌,术前血清CA125水平与病理类型及分期相关(P=0.006),术后2～4个月血清CA125水平与手术的癌细胞减灭程度相关(P=0.025),术后5～7个月血清CA125水平与是否坚持化疗相关(P=0.014),且为预测复发及生存时间的重要因素.术后血清CA125水平的升高可预测复发,其敏感性为87.5%,且通常较临床证实复发提前,平均为7.2个月.结论卵巢癌患者术前测定血清CA125水平可初步反映病理类型及分期,术后监测血清CA125水平可反映手术的肿瘤减灭程度,及时预测复发,并可判断预后.     

卵巢癌患者血清中TPS、CA125水平及其临床意义

目的 探讨卵巢癌患者血清TPS、CA125水平的临床应用价值。方法 分别检测15例卵巢良性肿瘤患者（良性对照组）和39例卵巢癌患者（卵巢癌组）初诊、治疗后以及15例卵巢癌复发患者血清TPS、CA125水平，统计结果进行比较。结果卵巢癌组血清TPS、CA125水平显著高于良性对照组（P〈0．01）；TPS对卵巢癌诊断的灵敏度和特异度为71．8％和86，7％，CA125为84．6％和86．7％，两者差异无显著性（P〉0．05）；治疗后患者血清TPS、CA125水平低于治疗前（P〈0．01、P〈0．05），而复发时TPS水平又显著高于治疗后（P〈0．05）。结论 血清TPS检测有助于卵巢癌诊断、疗效观察及预后判断，联合检测CA125可提高其临床应用价值。     

The differential diagnostic value and clinical significance of serum HE4 in ovarian disease with elevated CA125

Archives of Gynecology and Obstetrics - To determine the diagnostic value and clinical significance of serum HE4 levels in differentiating between benign and malignant ovarian disease in patients...     

间皮素与血清CA125联合检测上皮性卵巢癌的临床价值

目的研究间皮素(mesothelin)在上皮性卵巢癌血清及尿液中的表达水平,与血清CA125联合检测上皮性卵巢癌的临床应用价值。方法 2009年4月在郑州大学第一附属医院,采用ELISA法检测41例上皮性卵巢癌、32例卵巢良性肿瘤、30例正常人群血清及尿液间皮素水平和血清CA125水平。结果卵巢癌患者血清及尿液中间皮素水平明显高于卵巢良性肿瘤组和正常对照组,差异有统计学意义(P<0.01),血清及尿液间皮素水平在卵巢良性肿瘤组与正常对照组间差异均无统计学意义(P>0.05)。血清间皮素检测上皮性卵巢癌敏感度、特异度分别为58.5%、83.9%,联合血清CA125检测其敏感度、特异度分别为85.4%、85.5%;尿液间皮素检测上皮性卵巢癌的敏感度、特异度分别68.3%、93.5%,联合血清CA125检测其敏感度、特异度分别为92.7%、96.8%,联合血清间皮素、尿液间皮素和血清CA125检测其灵敏度和特异度为95.1%、96.8%。结论血清及尿液间皮素联合CA125检测将有助于卵巢癌的早期检测。     

The value of CA 125 determination in the serum of patients with ovarian cancer

The circulating ovarian cancer associated antigen CA 125 was determined in serum of 63 patients with ovarian malignancies by radioimmunometric solid phase assay using the monoclonal antibody OC 125 as catcher and tracer. The results of 41 patients with 43 active tumour situations were compared with the CA 125 serum levels of 27 patients without recurrence after therapy of ovarian cancer and 49 benign ovarian tumours. Significant differences exist between these three groups (p less than 0.001) with elevated values (greater than 35 U/ml) in 84 per cent in ovarian carcinoma, 22 per cent in benign tumours and nought per cent in woman without recurrence in follow-up. The pre-operative sensitivity in ovarian cancer is 93 per cent (in epithelial carcinoma 96 per cent) with a distinct dependence of the CA 125 serum levels on the stage of the disease (stage III and IV versus stage I and II; p less than 0.01). A positive correlation of CA 125 values to clinical status was found in 82 per cent in follow-up. Increasing values of CA 125 can detect the recurrence any months earlier than the clinical examination. Decreasing serum levels in chemotherapy don't reflect the objective tumour remission in every case. Because of elevated values in benign and inflammatory adnexal tumours and the relative low sensitivity in borderline cases (three of seven patients greater than 35 U/ml) the CA 125 assay seems not be suitable for a screening method. However it is a substantial amplification in control of therapeutic success and an early detection of recurrence of ovarian cancer disease.     

Evaluation of serum CA 125 levels in the monitoring of ovarian cancer

Serum CA 125 levels were evaluated in 227 patients with ovarian cancer. CA 125 levels were elevated in 86% of the patients. All histologic types, including mucinous tumors, were associated with raised CA 125 levels. There was a positive correlation with tumor burden and an inverse correlation with degree of differentiation. In patients undergoing radical operation an elevated CA 125 level was a bad prognostic index. Serial CA 125 measurements were assessable in 112 patients undergoing chemotherapy. Rising or falling levels correlated with disease in 92% of the cases. The CA 125 level increased before clinical progression with a median lead time of 3 months. Only patients who showed objective response to chemotherapy had a decrease in antigen levels of greater than or equal to 30% 4 weeks after the first course of chemotherapy and a normalization of CA 125 levels 3 months after initiation of chemotherapy. Rising levels were always associated with progression. These data suggest that CA 125 may aid in early identification of nonresponders. However, a normal CA 125 level does not exclude the presence of disease.     

CA125 expression at clinical diagnosis by ovarian carcinoma not detected through antecedent serum CA125 screening

At the time of clinical presentation with ovarian carcinoma, 85% of women have an elevated serum level of the CA125 antigen, but the duration of the preclinical phase of expression of CA125 is unknown. From the database of The Royal London Hospital ovarian cancer screening project, 19 women were identified who had a serum CA125 level <30 IU ml⁻¹, measured between 2 and 24 months prior to their clinical diagnosis of ovarian cancer. Histological sections of tumor removed from these women were reviewed. In 17 cases tumor tissue was immunocytochemically stained for CA125 expression. Tumor blocks of 40 women presenting clinically with ovarian cancer with known preoperative CA125 levels were also stained for CA125 expression. The serum CA125 level at the time of diagnosis was available in six of the 19 screening study cases, four of which had levels> 30 IU ml⁻¹. In five of the 13 cases with unknown serum CA125 levels, ovarian tumor tissue expressed CA125. Among the 40 controls, 24 tumors expressed CA125 and all 24 had a serum level greater than 47 IU ml⁻¹. An annual screening test using serum levels of CA125 at a cut-off of 30 IU ml⁻¹, cannot detect all cases of ovarian cancer that express the antigen at the time of clinical diagnosis. The development of a panel of complementary tumor markers will be necessary to provide a test with a higher sensitivity for the detection of preclinical ovarian cancer.     

Cancer antigen CA 125 in ovarian cancer

AIM: To estimate the diagnostic and prognostic value, pathological and clinical correlation of cancer antigen 125 (CA125) in ovarian cancer (OC). Retrospective analysis was done of 350 patients who were operated for OC in years 1990-2001 in Gynecology Clinic MU of Gdansk. We analyzed those before primary operation (PO) and second look laparotomy (SLL). Chi 2 and t-Student tests were used. RESULTS: Before PO 18% OC patients had CA125 less than 35 and 43.8% more than 600 U/ml, for benign tumors it was 59.9 and 1.1 respectively (p < 0.001). 56.2% with complete remission and 43.8% with progress disease in SLL had normal values of antigen before the operation. There were 32 patients who had CA125 > 600 before SLL and all of those had progress disease. The positive and negative predictive value of CA125 before SLL were 0.94 and 0.56 respectively. Cytoreduction with no macroscopic disease was achieved in 45% of patients with CA125 < 600 U/ml before PO, and it was 19.2% for those with antigen > 600 (p = 0.001). We looked for differences of CA125 levels depending on clinical and pathological data. According to our results only histology (p = 0.02) and clinical stage (p = 0.02) influenced CA 125 levels. CONCLUSIONS: There is a good correlation between elevated levels of CA125 and state of the disease in SLL, and we consider SLL as obligatory to perform as there is a low negative predictive value of CA125. The CA125 before primary operation has prognostic significance to possibility of optimal cytoreduction.     

The CA 125 assay as a predictor of clinical recurrence in epithelial ovarian cancer

Serum CA 125 levels were obtained from 55 women with epithelial ovarian cancer before a second-look surgical procedure and serially thereafter. All patients were clinically and radiographically free of tumor at the time of the second-look operation and were followed to clinical recurrence. Median follow-up was 12 months. CA 125 levels obtained at the second-look operation had a sensitivity and specificity for predicting clinical recurrence of 94% and 88%, respectively. Patients with an elevated CA 125 level (greater than or equal to 35 U/ml) had a 60% chance of clinical recurrence within 4 months, while patients with levels less than 35 U/ml had a 5% chance of clinical recurrence over the same time period. Serial CA 125 levels obtained after second-look operations were strong predictors of clinical outcome, and distinctly different monitoring profiles were observed among those patients remaining clinically free of tumor and those suffering clinical recurrence. The CA 125 assay became elevated (greater than or equal to 35 U/ml) before clinical recurrence in 94% of 35 cases with a median lead time of 3 months. The CA 125 assay identifies patients destined to suffer a clinical recurrence and provides a warning measurable in months. This may have important implications for therapy.     

Normal serum CA125 half-life and normal serum nadir CA125 level in patients with ovarian cancers

The normal serum CA125 half-life and distribution of the normal serum nadir CA125 value in patients with epithelial ovarian carcinoma (EOC) have not been determined yet. Among patients with EOC, 41 patients met the inclusion criteria of the present study: the patients that underwent complete cytoreductive surgery and six cycles of platinum-containing chemotherapy, and who had no recurrent disease more than five years. Serum CA125 half-life (T1/2) during primary surgery and primary chemotherapy was calculated and serum nadir CA125 level was evaluated by logarithmic-transformed serum CA125. Median value of nadir CA125 was 7 U/ml (range 3-20 U/ml), and the mean ln (serum nadir CA125) was 1.96 +/- 0.45. Mean T1/2 was 10.4 days in all patients, and T1/2 value was associated with the preoperative serum levels of CA125. Predicted slope of CA125 regression curve was also influenced by the preoperative CA125 value. The present study provides fundamental information with regard to normal half-life time and normal nadir of CA125 in EOC patients.     

CA 125 serum levels correlated with second-look operations among ovarian cancer patients

CA 125, which is an antigenic determinant expressed by many epithelial ovarian cancers, is measured in serum using a solid phase immunoradiometric assay. Sera from 55 patients who were in clinical remission and underwent a second-look operation to assess disease status after chemotherapy were studied prospectively. All patients had the CA 125 assay performed within one week before their second-look operation. Twenty-four patients (44%) had no histologic or cytologic evidence of disease, seven patients (13%) had microscopic disease, 13 patients (24%) had disease measuring 1 mm to 1.5 cm, and ten patients (18%) had disease greater than or equal to 1.5 cm in maximum tumor dimension. None of the 24 patients with a negative second-look operation had a positive CA 125 antigen level (greater than or equal to 35 U/mL), compared with six of 20 patients (30%) with less than 1.5 cm disease, and six of ten (60%) with greater than or equal to 1.5 cm disease (P less than .0001). All 12 patients with an elevated CA 125 antigen level (greater than or equal to 35 U/mL) had disease discovered at their second-look operation. Thus, in this setting the predictive value of a positive CA 125 titer (greater than or equal to 35 U/mL) was 100%. The predictive value of a negative CA 125 antigen level (less than 35 U/mL) was 56%, ie, the test did not exclude the presence of disease in 44% of patients with a positive second look. The maximum tumor size associated with at least one prior negative antigen level was 1.9 cm.(ABSTRACT TRUNCATED AT 250 WORDS)