卵巢癌新辅助化疗患者CA125水平对临床结局的预测分析

目的:探讨行新辅助化疗的卵巢癌患者CA125水平与间歇性肿瘤细胞减灭术的减灭程度及预后的关系。方法:回顾分析青岛大学附属医院行3个周期新辅助化疗并手术的60例卵巢癌患者的临床病例资料,分析初始治疗前CA125水平、新辅助化疗期间CA125的下降率、术前CA125水平与手术理想减灭程度及预后的关系。结果:多自变量logistic回归分析提示,3个周期新辅助化疗后,血CA125下降率及术前CA125水平影响患者手术的切净率。术前CA125≤100U/ml组与>100U/ml组的生存率比较,差异有统计学意义(P<0.05)。结论:3个周期新辅助化疗后,血CA125的下降率及术前CA125水平可预测患者手术的切净率,术前血清CA125是否≤100U/ml可用于初步判断患者的预后。     

CA125动力学变化预测新辅助化疗晚期卵巢癌患者满意减瘤临床分析

目的:通过比较晚期卵巢癌患者新辅助化疗(NACT)期间多种CA125的动力学变化,分析其对中间型肿瘤细胞减灭术减瘤满意程度的预测价值。方法:搜集2018年1月1日至2021年12月31日在中国科学技术大学附属第一医院(安徽省立医院)接受新辅助化疗及中间型肿瘤细胞减瘤灭术的晚期卵巢癌患者的临床信息,获得人口统计学资料、治疗期间血清CA125水平,影像学资料、术后病理、治疗情况等信息,统计CA125的各项动力学变化,并分析其对预测满意减瘤可能性的预测价值。结果:共纳入66例患者,其中49例(74.24%)患者手术后无肉眼病灶残留(R0),17例(25.76%)存在病灶残留(R1/RX)。单因素分析中,NACT前、第一次NACT后、第三次NACT后CA125水平以及第一次NACT后CA125下降百分比在两组中存在差异(P分别为0.001、0.035、0.032、0.018)。多因素分析中,第三次NACT后CA125水平以及第一次NACT后CA125下降百分比为满意减瘤的显著预测因子(P=0.026,P=0.027)。根据ROC曲线,第三次NACT后CA125水平<33.34U/mL预测...     

影响卵巢透明细胞癌预后的相关临床因素分析

目的探讨卵巢透明细胞癌（ovarian clear cell carcinoma,OCCC）的临床特点及其预后的相关因素。方法对2001年1月至2014年6月北京市朝阳医院妇产科收治的41例OCCC患者行回顾性研究,分析可能影响其预后的相关因素。结果 FIGO分期,术前CA125及CA199水平、淋巴结转移、残留肿瘤大小、化疗疗程与卵巢透明细胞癌的预后相关。结论卵巢透明细胞癌的预后存在两极化,FIGO早期、术前CA125〈200U/ml、CA199〈37U/ml、无淋巴结转移、残留肿瘤〈1cm、化疗疗程≥6个疗程者预后良好,相反则预后差。     

晚期卵巢上皮性癌患者初次治疗过程中血清CA125水平变化与其预后的关系

目的 探讨晚期(Ⅲ～Ⅳ期)卵巢上皮性癌(卵巢癌)患者初次治疗过程中血清CA125水平变化与其预后的关系.方法 选择1998年1月-2003年12月间中山大学肿瘤防治中心妇瘤科收治的142例晚期卵巢癌患者,回顾性分析其初次治疗过程中血清CA125水平的变化,采用Kaplan-Meier法计算其累积生存率,并采用Cox风险比例回归模型分析血清CA125水平的变化对患者预后的影响.结果 根据患者治疗前血清CA125水平不同分为≤500、>500～1500和>1500 kU/L,其3年累积生存率(分别为64%、71%及64%)比较,差异无统计学意义(P>0.05).术后接受3个疗程化疗后,血清CA125水平降至正常(0～35 kU/L)的77例患者的3年及5年累积生存率分别为84%及56%,明显高于血清CA125水平仍为异常的48例患者(分别为42%、15%,P<0.01).多因素分析表明,残留灶直径(P<0.01)及3个疗程化疗后血清CA125水平(P<0.01)是影响晚期卵巢癌患者预后的独立的因素.进一步分层分析表明,接受了满意的肿瘤细胞减灭术(残留灶直径≤1 cm)的患者中,3个疗程化疗后血清CA125水平降至正常者的3年及5年累积生存率分别为88%、64%,明显高于化疗后血清CA125笛水平仍为异常者(分别为52%、18%,P<0.01);同样,接受了不满意的肿瘤细胞减灭术(残留灶直径>1 cm)的患者中,3个疗程化疗后血清CA125水平降至正常者的3年和5年累积生存率分别为74%、32%,明显高于化疗后血清CA125水平仍为异常者的33%、13%(P<0.01).结论 3个疗程化疗后血清CA125水平正常与否可预测晚期卵巢癌患者的预后,且无论初次手术是否为满意的肿瘤细胞减灭术,3个疗程化疗后血清CA125水平降至正常者较未降至正常者预后好.     

血清和腹腔液CA125测定与子宫内膜异位症诊断的相关分析

目的:探讨不孕症患者术前血清及术中腹腔液CA125浓度与诊断子宫内膜异位症(EM)的关系。方法:对129例因疑输卵管性不孕而行腹腔镜或宫腹腔镜联合手术的患者,于术前抽取血清,术中抽取腹腔液测CA125浓度。根据血清CA125值分为<10U/ml、10-15U/ml、16-34U/ml和≥35U/ml4组,分析各组血清和腹腔液中CA125浓度与EM诊断的相关性。结果:血清CA125水平<10U/ml和≥16U/ml时,EM的诊断符合率分别为9.09%和89.55%,两组比较有显著差异(P<0.01)。腹腔液<800U/ml和≥800U/ml的EM诊断符合率分别为19.23%和94.80%,两组比较有显著差异(P<0.01)。血清CA125≥10U/ml结合腹腔液CA125≥800U/ml的诊断符合率为93.42%。结论:血清CA125≥10U/ml结合腹腔液CA125≥800U/ml对EM的诊断有重要参考价值。     

血清CA125用于预测上皮性卵巢癌、输卵管癌及腹膜癌化疗反应性的研究

目的:探讨上皮性卵巢癌、输卵管癌及腹膜癌对铂类+紫杉醇类化疗敏感性与CA125变化的关系。方法:选取2009年1月至2011年5月上海市第一妇婴保健院手术及化疗的71例上皮性卵巢癌、6例输卵管癌和1例腹膜癌患者,以3次化疗后血清CA125能否降至正常(<35kU/L),术后前3次化疗后每次CA125同上次比较能否降低50%作为判断铂类敏感的指标,比较分析化疗敏感型患者CA125数值变化规律。结果:(1)术前CA125数值对于判断患者第2次及第3次化疗后血清CA125能否下降50%以上具有统计学意义(P<0.01);(2)术后首次CA125数值对于判断患者第2次(P=0.028),第3次(P<0.01)化疗后血清CA125能否下降50%,以及3次化疗后血清CA125能否降至正常(P=0.046)具有统计学意义;(3)较早FIGO分期(FIGOⅠ～Ⅱ期),无腹水,满意的肿瘤灭减术也是决定患者化疗敏感性的临床指标。结论:术前和术后血清CA125水平、较早的FIGO分期、无腹水、满意的肿瘤减灭术是影响卵巢癌、输卵管癌、腹膜癌患者化疗敏感性的有意义的临床指标。     

晚期上皮性卵巢癌患者“间歇性肿瘤细胞减灭术”手术适应证的探讨

目的:探讨间歇性肿瘤细胞减灭术(IDS)的适应证。方法:采用回顾性病例对照研究,分析2000年1月至2009年12月间71例初次肿瘤细胞减灭术不满意的ⅢC～Ⅳ期卵巢上皮癌(包括原发性腹膜癌,原发性输卵管癌)患者的资料。A组(n=41)初次减灭术后单纯化疗6～8疗程;B组(n=30)经3～4个疗程化疗后行间歇性肿瘤细胞减灭术,然后继续化疗4～6疗程。化疗方案均为铂类为基础的联合化疗。两组患者的化疗方案和疗程无差异。通过比较两组患者的临床特征、手术及生存情况,以及B组患者IDS术前CA125、B超检查与术后病理结果的对应关系,总结IDS的适应证。结果:B组30例患者中23例(76.7%)最终达到满意减瘤,共有11例术后病理结果为阴性,术前CA125或B超对病理结果阳性预测的敏感度差,CA125的特异性达100%。CA125联合B超的预测准确率为70%。A、B组的五年生存率(P=0.790)、OS(P=0.254)和PFS(P=0.289)均无显著性差异。B组中无肉眼残留病灶患者的PFS和OS较A组有明显延长的趋势。结论:间歇性肿瘤细胞减灭术主要适应证是:初次肿瘤细胞减灭术采用"基本术式",3个疗程化疗后部分缓解,CA125仍异常;或CA125恢复正常,最好经PET-CT或增强CT明确有残留病灶。残留病灶有可能通过再次手术切除干净,达到无肉眼残留,这部分患者有可能生存获益。     

sTWEAK在上皮性卵巢癌患者血清中的表达及其意义

目的:检测卵巢上皮性癌(EOC)患者外周血可溶性肿瘤坏死因子样凋亡微弱诱导剂(sTWEAK)的表达水平,并分析其临床意义。方法:选取2010年1月至2014年2月在上海交通大学附属仁济医院住院行手术的上皮性卵巢癌(EOC)患者和良性上皮性卵巢肿瘤患者共43例,采用ELISA法检测外周血血清中sTWEAK的表达水平。结果:(1)与良性上皮性卵巢肿瘤组相比,EOC组的sTWEAK的表达水平明显升高(P0.05)。两组患者中sTWEAK的表达与CA125呈正相关(r=0.42,P0.05),其中CA125500U/ml者的sTWEAK表达水平明显低于CA125500U/ml者(P0.05)。(2)EOC患者血清中,sTWEAK的表达水平与其临床分期、病理分级、组织类型以及腹水有无肿瘤细胞均无相关性(P0.05)。(3)EOC组中,CA125500U/ml者行满意肿瘤细胞减灭术的比例显著高于CA125500U/ml者(P0.05)。结论:sTWEAK虽不能反映EOC患者的肿瘤进展,但其与EOC的发生密切相关,sTWEAK可能成为判断卵巢肿瘤良恶性的新型血清学标记,在EOC诊断及预后预测中具有一定的应用前景。     

血清sCD44v6/CA125检测在卵巢癌患者中的临床应用

目的探讨血清sCD44v6和CA125的检测在卵巢癌诊断和治疗中的临床意义.方法对80例卵巢癌患者、50例良性卵巢瘤患者和130例正常健康人群的血清样本采用ELISA和放免法定量检测sCD44v6和CA125浓度.结果卵巢癌患者术前血清sCD44v6浓度为209.4±50.2 ng/ml,显著高于良性患者的153.3±47.6 ng/ml (P＜0.01)和正常人群的132.6±33.9 ng/ml (P＜0.01);卵巢癌术前血清CA125平均浓度为38.2±9.7 U/ml,高于良性组16.7±5.8 U/ml(P＜0.01)和正常组11.5±5.1 U/ml(P＜0.01).行卵巢癌肿瘤细胞减灭术后患者血清sCD44v6较术前明显下降(P＜0.01).sCD44v6和 CA125随着病程进展、癌细胞恶性程度的增高、淋巴结转移和浸润的深入而升高.生存分析sCD44v6的异常升高对患者的预后有影响,sCC(sCD44v6和CA125联合)与卵巢癌患者的预后有关(RR=3.158,P＝0.003 2).结论血清sCD44v6和CA125的检测在卵巢癌的辅助诊断、手术疗效、转移程度的判断以及预后评估等方面有重要价值.     

血清CA125检测在子宫内膜癌中的价值

目的探讨血清CA125在子宫内膜癌中的价值.方法选取1992年3月～2002年3月在北京大学第一附属医院、北京大学人民医院住院经手术治疗的子宫内膜癌患者141例,术前及随访中用放射免疫法测定血清CA125水平,CA125≥35 U/ml 为阳性结果.对其中14例行子宫内膜癌组织CA125免疫组化方法检测.收集患者的临床病理资料,分析CA125与这些资料的关系以及复发患者复发前后CA125变化.结果 CA125免疫组化检测14例均呈阳性,阳性细胞着色率与血清CA125之间无明显相关.141例患者术前血清CA125阳性32例(22.7%), Ⅰ、Ⅱ、Ⅲ和Ⅳ期患者血清CA125阳性(阳性率)分别为11例(12.1%)、6例(31.6%)、12例(46.2%)和3例(60.0%). 血清CA125阳性率随子宫内膜癌期别的增加而升高.深肌层浸润、宫颈受累、附件转移、腹腔洗液细胞学阳性、盆腔淋巴结转移及宫内肿瘤病灶≥2 cm者,血清CA125阳性率增加.随访中13例复发,其中9例术前血清CA125＞35 U/ml者复发时均伴血清CA125水平升高,而另4例术前血清CA125正常者,复发后血清CA125水平仍正常.结论子宫内膜癌患者术前血清CA125的测量有助于了解肿瘤的侵犯范围.术前血清CA125水平异常的子宫内膜癌患者,术后定期复查血清CA125水平,将有助于子宫内膜癌病情的监测.     

Can optimal primary cytoreduction be predicted in advanced stage epithelial ovarian cancer? Role of preoperative serum CA-125 level

The aim of this study was to determine the ability of preoperative serum CA-125 levels to predict optimal cytoreduction in patients with stage III epithelial ovarian cancer. A retrospective review was made of the records of 40 patients with FIGO stage III ovarian carcinoma who underwent primary cytoreductive surgery. A receiver operating characteristic (ROC) curve was used to determine the most useful CA-125 level in predicting optimal versus suboptimal tumour cytoreduction. Twenty-two (55%) patients were optimally cytoreduced (residual disease 500 U/ml. At this threshold, preoperative serum CA-125 level was able to predict optimal versus suboptimal cytoreduction with a sensitivity of 72%, specificity of 73%, positive predictive value of 68%, and negative predictive value of 76%. In the management of patients with advanced epithelial ovarian carcinoma, preoperative serum CA-125 level may help to predict optimal primary cytoreduction and to identify candidates for alternative approaches other than traditional primary cytoreductive surgery, such as neoadjuvant chemotherapy.     

Preoperative CA-125 levels in patients with hereditary compared to sporadic epithelial ovarian carcinoma

OBJECTIVE: The aim of this study was to determine whether a significant difference in preoperative CA-125 levels exists between patients with BRCA-associated hereditary ovarian carcinoma and those with sporadic ovarian carcinoma and whether the CA-125 level predicts the probability of optimal cytoreductive surgery. METHODS: From a retrospective cohort of 189 consecutive ovarian cancer patients genotyped for BRCA mutation status, data on preoperative CA-125 levels were available for 49/88 (56%) hereditary cases and 43/101 (43%) sporadic cases. Data on the extent of surgical cytoreduction were obtained for all 92 patients with available CA-125 data. Comparison of preoperative CA-125 levels between hereditary and sporadic groups was assessed using the Kruskal-Wallis chi(2) test. Correlation of surgical cytoreduction with preoperative CA-125 level was assessed using Fisher's exact test. RESULTS: Mean preoperative CA-125 levels were not significantly different among BRCA1 (2289 U/ml), BRCA2 (2586 U/ml), and sporadic (3307 U/ml) cases (P = 0.5). For hereditary cases, optimal cytoreduction was achieved in 59% of patients with preoperative CA-125 levels of <500 U/ml and in 52% of patients with preoperative levels >500 U/ml. For sporadic cases, optimal cytoreduction was achieved in 62% of patients with CA-125 levels of <500 U/ml and in 20% of patients with levels >500 U/ml (P = 0.01). CONCLUSIONS: Preoperative CA-125 levels are not significantly different for patients with hereditary compared to sporadic ovarian carcinoma. The probability of optimal cytoreduction is independent of the preoperative CA-125 level for hereditary cases, but optimal cytoreduction is significantly less likely for sporadic cases with CA-125 levels of >500 U/ml.     

Can serum CA-125 levels predict the optimal primary cytoreduction in patients with advanced ovarian carcinoma?

OBJECTIVE: The aim of this study was to investigate the predictive value of serum CA-125 levels to ability of optimal primary cytoreduction in patients with advanced epithelial ovarian carcinoma. METHODS: Preoperative serum CA-125 levels were determined by a commercial enzyme immunoassay kit in a series of 92 patients with stage IIIC epithelial ovarian carcinoma. The abilities of various cutoff value of CA-125 to predict suboptimal cytoreductive surgery were determined. A receiver operating characteristic curve was used to find the most clinically useful CA-125 cutoff value. RESULTS: Optimal cytoreduction was obtained in 48 patients (52%) using the diameter of the largest residual tumor nodule less than 1 cm. Receiver operating characteristic curve showed that the most clinically suitable CA-125 cutoff value was 500 U/ml. Forty-seven patients (51%) had preoperative serum CA-125 levels below 500 U/ml. Of these patients, optimal cytoreductive surgery was performed in 36 (77%). Of the 45 patients with serum CA-125 levels greater than 500 U/ml, optimal cytoreductive surgery was achieved in 12 (27%). True- and false-positive rates were 73 and 23%, respectively. CONCLUSIONS: Although our results showed that preoperative serum CA-125 levels might predict the optimal resectable patients, larger prospective studies are needed to prove its predictivity. Gynecologic oncologists should evaluate the sum of all criteria until more data are available.     

A retrospective study of preoperative CA 125 levels in 82 patients with ovarian cancer

Introduction. The aim of our study was to investigate preoperative serum CA 125 as a prognostic factor in patients with ovarian carcinoma.Methods. A retrospective analysis was conducted on 82 patients with ovarian carcinoma treated at our Unit between 1998 and 2000 who had a serum CA 125, evaluated by a commercially available radioimmunoassay, prior to cytoreductive surgery. We looked for an association between preoperative CA 125 and known prognostic factors of ovarian cancer. We compared outcomes of patients with preoperative CA 125 at or below to 500 U/ml with outcomes of patients with preoperative CA 125 above 500 U/ml.Results. A significant (p<0.002) correlation between stage and CA 125 serum levels was found as 16 out of 18 stage I–II patients (89%) had CA 125 level 500 U/ml and 36 out of 64 stage III–IV patients (56%) had CA 125 level >500 U/ml. Among stage III and IV patients there was nonstatistically significant relation between serum CA 125 and histologic grade (G1+G2 vs. G3) and residual disease (<1 cm vs. >1 cm) after primary cytoreductive surgery. Preoperative serum CA-125 level did not predict either recurrences or disease free interval.Conclusion. Preoperative CA 125 correlated well with FIGO stage but not with age, grade, residual disease after primary surgery, relapse and disease free interval.     

The ability of preoperative serum CA-125 to predict optimal primary tumor cytoreduction in stage III epithelial ovarian carcinoma

PURPOSE: The aim of this study was to determine the ability of preoperative serum CA-125 to predict optimal primary tumor cytoreduction in patients with Stage III epithelial ovarian carcinoma. METHODS: We performed a retrospective chart review of 100 consecutive patients with Stage III ovarian carcinoma who had a serum CA-125 drawn prior to primary cytoreductive surgery. We used a receiver operating characteristic curve to determine the CA-125 level with the maximal prognostic power in predicting optimal versus suboptimal cytoreduction. RESULTS: The median CA-125 level for the 100 patients was 819 U/ml (range 5.6-26,200 U/ml). Optimal cytoreduction (diameter of largest residual tumor nodule < or =1 cm) was obtained in 45 cases (45%). The probability of performing optimal cytoreduction decreased with increasing CA-125 levels. A preoperative CA-125 level of 500 U/ml was identified as the value with the most predictive power. Optimal cytoreduction was achieved in 33 of the 45 cases (73%) with a CA-125 less than 500 U/ml compared to only 12 of the 55 cases (22%) with a CA-125 greater than 500 U/ml. Using a threshold level of 500 U/ml, the preoperative serum CA-125 level was able to predict optimal versus suboptimal cytoreduction with a sensitivity of 78%, specificity of 73%, positive predictive value of 78%, and negative predictive value of 73%. CONCLUSION: The probability of performing optimal cytoreduction in patients with Stage III ovarian carcinoma and a preoperative CA-125 greater than 500 U/ml was approximately one in five. These patients may be candidates for initial laparoscopic evaluation to obtain a confirmatory tissue diagnosis and to determine resectability.     

Preoperative CA 125 levels: an independent prognostic factor for epithelial ovarian cancer

OBJECTIVE:To estimate the association of preoperative CA 125 levels with outcome in primary ovarian cancer patients.METHODS:One hundred forty-two patients with epithelial ovarian cancer, who had a serum CA 125 level drawn before surgery, were retrospectively evaluated. The relationship of preoperative CA 125 levels and various preoperative and postoperative variables was evaluated. CA 125 levels were determined using a solid-phase immunoassay.RESULTS:The median CA 125 value for all patients was 582 U/mL (range 7-52,930 U/mL). Preoperative CA 125 values did not correlate with increasing age (P =.40), but were found to be significantly associated with serous histology compared with other histology (median CA 125 of 870 versus 334 U/mL, P =.02), high-stage (III/IV) compared with low-stage (median CA 125 of 893 versus 174 U/mL, P <.001), high tumor grade (3) compared with grade 1 or 2 (median CA 125 of 928 versus 323 U/mL, P <.001), and the presence of ascites compared with absence of ascites (median CA 125 of 893 versus 220 U/mL, P <.001). Suboptimal cytoreduction (more than 1 cm residual) was associated with significantly higher CA 125 levels (1067 U/mL) compared with individuals with optimal cytoreduction (399 U/mL, P <.001). Preoperative CA 125 values less than 500 U/mL had a positive predictive value for optimal cytoreduction of 82%, but a poor negative predictive value of 48%. After adjusting for covariates, there was a significant association between CA 125 levels and disease-specific survival. As preoperative CA 125 levels increased, the risk of death increased except at the highest values of CA 125.CONCLUSION:Preoperative CA 125 is an independent risk factor for death due to disease in ovarian cancer, but not a reliable predictor of optimal cytoreduction.     

Can a preoperative CA 125 level be a criterion for full pelvic lymphadenectomy in surgical staging of endometrial cancer?

OBJECTIVE: The aim of the present study was to evaluate whether a preoperative serum level of CA 125 in patients with endometrial cancer can provide additional information in determining the extent of lymphadenectomy required in the surgical staging and which cutoff value is optimal in this respect. METHODS: CA 125 was measured in 124 patients diagnosed with endometrial carcinoma who underwent surgery at our institution between January 1995 and May 2000. Statistic analysis was performed using the Mann-Whitney U test and Kruskal-Wallis test to evaluate the association of preoperative CA 125 levels with various factors. The chi(2)/Fisher's exact test and a logistic regression model were employed to examine the effects of clinicopathological factors on serum CA 125 levels. Furthermore, a receiver operating characteristic curve was used to determine which cutoff value of the preoperative CA 125 was the optimal one. RESULTS: Univariate analyses showed that elevated CA 125 levels were significantly correlated with an advanced stage, larger tumor size, increasing depth of the myometrial invasion, cervical invasion, positive cytology, and lymph node metastases (P < 0.05). Multivariate analyses using a logistic regression model showed lymph node metastases had the most significant effect on the elevation of CA 125 levels. The ROC curve determined that the best cutoff value was 40 U/ml; the sensitivity and specificity for screening lymph node metastases were found to be 77.8 and 81.0%, respectively. CONCLUSION: Our data provide evidence indicating that a preoperative CA 125 level greater than 40 U/ml can be considered a criterion for full pelvic lymphadenectomy in the surgical staging of endometrial cancer.     

Changes in CA125 concentration in ovarian cancer patients during the remission state--mean attenuating curve and the effectiveness of surgery and chemotherapy

We have periodically monitored CA125 in 21 primary ovarian cancer patients who were clinically diagnosed as in the remission state after cytoreductive surgery and a combination chemotherapy 200 days after surgery. In this monitoring, the mean attenuating curve (exponential curve) of CA125 within 75 days after surgery was obtained, Y = 2.4831 exp (-0.11281 x 10-1X) [Y:log10 (CA125), X:days from the surgery]. According to this formula, the half life of CA125 is 11.5 days and CA125 is supposed to decrease to under 35U/ml in 42.1 days. In the patients whose preoperative CA125 was over 1,000U/ml (n = 8), the half life was 6.8 days and CA125 fell below 35U/ml within 45.8 days. In the rest of the patients, (35U/ml less than preoperative CA125 less than 1,000U/ml), these figures were 16.3 days and 38.2 days, respectively. Then in the patients whose tumors were completely resected (n = 13), the mean attenuating curve was Y = 2.3655 exp (-0.99935 x 10(-2)X), the half life was 13.6 days, and CA125 decreased to under 35U/ml in 42.7 days. After primary surgery, CA125 decreased to 50.0 +/- 54.2% of the preoperative concentration. Among 16 patients (without 5 P-MFC chemotherapy) 13 (13/16, 81.3%) showed CA125 under 35U/ml after 2 courses of chemotherapy. Thus, it became clear that CA125 decreases in the remission state of ovarian cancer.     

An initial analysis of preoperative serum CA 125 levels in patients with early stage ovarian carcinoma

Preoperative serum CA 125 levels were determined for 36 patients with Stage I and II ovarian carcinoma. Levels ranged from 9 to 1962 U/ml with a mean of 216 U/ml. In Stage I patients, CA 125 levels averaged 133 U/ml and in Stage II patients 382 U/ml. Nine of 24 Stage I (38%) and 9 of 12 Stage II patients (75%) had CA 125 levels in excess of 65 U/ml in a population somewhat overrepresented in mucinous tumors. Patients with non-mucinous neoplasms had CA 125 elevations more often--in 75% of the cases--than those with mucinous tumors. A larger study will be required to more precisely estimate the fraction of early stage patients with elevated preoperative serum CA 125 levels; however, this investigation demonstrates an assay sensitivity minimally adequate to initiate a pilot evaluation of serum CA 125 levels in a population at risk for ovarian carcinoma.     

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.