卵巢癌抗原CA125

CA125是1981年报告的一种新的卵巢癌抗原,与茁勒氏管分化有关,组织分布广泛,对妇科恶性肿瘤,尤其是对卵巢上皮性癌的特异性较高,可望用于卵巢癌的早期诊断。测定卵熊癌患者血清中的 CA125水平,可监测肿瘤的发展,判定术后化疗疗效,特别是当其水平再度升高时,可预测肿瘤复发和二次探查阳性。本文介绍了该抗原研究现状。     

血清CA125、HE4以及ROMA指数在卵巢癌早期诊断中的应用价值

目的:探讨人附睾蛋白4(HE4)、糖类抗原125(CA_(125))及卵巢癌风险预测模型(ROMA)在卵巢癌早期诊断中的应用价值。方法:采用酶联免疫吸附试验及化学发光法检测53例国际妇产科联合会(FIGO)2014年卵巢癌分期Ⅰ、Ⅱ期卵巢癌患者及54例卵巢良性肿瘤患者血清HE4及CA_(125)水平,根据受试者绝经情况,通过计算ROMA指数,绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC)。结果:卵巢癌检测HE4、CA_(125)水平及ROMA指数分别为416.19±134.04 pmol/L、895.97±252.16 U/ml及(59.10±4.49)%;卵巢良性肿瘤组分别为33.61±3.07 pmol/L、33.98±4.99 U/ml及(20.08±5.07)%,卵巢癌组血清HE4、CA_(125)水平及ROMA指数高于卵巢良性肿瘤组,差异有统计学意义(P0.05)。血清HE4、CA_(125)水平和ROMA指数对卵巢癌诊断的敏感度分别为92.45%、69.81%、96.23%,特异度分别为79.63%、70.37%、81.48%,ROC-AUC分别为0.943、0.803、0.975。结论:联合检测HE4和CA_(125)计算ROMA指数对卵巢癌早期诊断敏感度和特异度较高。     

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.     

血清CA199、CA125、HE4水平表达与卵巢癌的相关性分析

目的 探究血清糖类抗原199(CA199)、糖类抗原125(CA125)、人附睾蛋白4(HE4)水平表达与卵巢癌的相关性。方法 选取60例卵巢癌患者纳入研究组;另选取同期健康体检者60例纳入对照组。两组均采用全自动化学发光免疫分析仪测定血清CA199、CA125、HE4水平以及卵巢癌不同分期患者的血清水平,并分析血清CA199、CA125、HE4水平与卵巢癌的相关性。结果 研究组血清CA199、CA125、HE4水平高于对照组（P<0.05）。研究组卵巢癌Ⅲ～Ⅳ期患者的血清CA199、CA125、HE4水平高于Ⅰ～Ⅱ期患者（P<0.05）。血清CA199、CA125、HE4水平与卵巢癌成正相关（r=0.387、0.379、0.383,P<0.05）。结论 血清CA199、CA125、HE4水平高表达与卵巢癌发病及进展有关,可作为临床预测、诊断、评估病情的关键指标。     

血清CA125及HE4诊断卵巢癌的研究进展

目前临床用于卵巢癌早期诊断的主要肿瘤标记物是血清糖链抗原125(CA125),CA125诊断卵巢癌的敏感性及特异性低。血清人附睾蛋白4(HE4)在卵巢癌中呈高表达,尤其是浆液性卵巢癌,其与CA125联合检测可有效提高卵巢癌的早期诊断率。本文就血清CA125和HE4单独及联合检测诊断卵巢癌的研究进展做一综述。     

CA125对判断卵巢癌化疗疗效和预后的临床价值

近年来采用ＣＡ１２５值变化的绝对值，相对值，半衰期及ＣＡ１２５回归曲线的方法，探讨其与化疗疗效及预后的关系，并对ＣＡ１２５在随诊中的价值进行了客观分析，强调ＣＡ１２５值的动态观察不能代替二次探查术。     

阴道超声联合血清CA125、CA199和CEA在卵巢癌筛查中的应用

卵巢恶性肿瘤早期诊断困难,症状出现时多数已属晚期,预后不良,死亡率居妇科恶性肿瘤之首。因此,研究敏感的无创方法以提高卵巢肿瘤诊断的准确性极为重要。本文采用血清CA125、CA199和CEA联合阴道超声方法用于诊断早期卵巢癌,现报道如下。     

血清CA125与卵巢癌相关研究进展

血清CA125检测在卵巢癌筛查、诊断、病程监测及预测预后方面已广泛应用.血清CA125联合多种肿瘤标记物及其他器械检查,能极大提高对卵巢癌的诊断与鉴别诊断;化疗期间使用CA125的半衰期能较好预测治疗反应和监测疾病;术前血清CA125水平对估计肿瘤细胞减灭术的质量有一定的帮助.综述CA125检测方面的一些进展,以期能更好地利用CA125.     

CA125、D-二聚体在卵巢癌中的应用价值

卵巢癌发病率在妇科恶性肿瘤中居第3位,而病死率却居首位。卵巢癌起病隐匿,早期缺乏典型临床表现,易发生腹腔内播散转移,70%的患者就诊时已属晚期。虽然目前卵巢癌可经肿瘤细胞减灭术辅以化疗得到有效治疗,但因其复发率较高,晚期患者5年存活率仅为30%左右。早期诊断、有效治疗、降低复发对卵巢癌的预后有重要影响。研究者致力于寻找指标,如CA125、D-二聚体,以应用于卵巢癌的早期诊断、疗效观察及预后评估。综述CA125、D-二聚体在卵巢癌中的应用价值。     

卵巢癌首次化疗后CA125是否一过性上升

CA125广泛用于卵巢上皮性癌诊断、监测和随访的肿瘤标志。约90％的卵巢浆液性腺癌CA125升高值（〉35U／mL），该值与肿瘤细胞的数量相关。肿瘤消退，CA125值下降：肿瘤复发或进展，CA125值上升。众所周知，滋养细胞肿瘤首次化疗后数日内由于肿瘤细胞死亡引起hCG值上升。同样在乳腺癌中，CEA，CA125和CA15-3也有类似的反应。那么卵巢癌在化疗后一定时间内CA125是否也能由于肿瘤细胞死亡引起上升，这种CA125的高峰是否可以作为早期的预后参数？为确定卵巢癌首次化疗后的数日内是否有CA125上升进行研究。     

CA125 parameters in survivors and non-survivors with epithelial ovarian cancer

Abstract. Cruickshank DJ. CA125 parameters in survivors and non-survivors with epithelial ovarian cancer. Int J Gynecol Cancer 1991; 1 : 279–284.
The relationship between different CA125 parameters and survival in patients with epithelial ovarian cancer was investigated in a prospective study. This involved 161 patients of whom 64 died and 97 remained alive. The established prognostic factors of stage and residual disease were controlled for and the population characteristics (age, follow-up/survival duration, histologic subtype, grade) were comparable in the 'dead' and 'alive' groups. For patients with stage I and II disease preoperative serum CA125, pre-chemotherapy serum CA125, plateau serum CA125 and time to reach the plateau level were all higher in the non-survivors when compared with survivors. In contrast, preoperative serum CA125 and pre-chemotherapy serum CA125 were significantly higher in survivors with stage III and IV disease. A possible explanation for these results includes the suggestion that early- and late-stage ovarian cancer may be different 'diseases' with different natural histories rather than being a continuum. Alternatively, the tumor-associated antigen CA125 being a membrane glycoprotein may have a beneficial, perhaps immunologic role in advanced disease.     

The utility of presurgical CA125 to predict optimal tumor cytoreduction of epithelial ovarian cancer

The objective of this study was to evaluate the ability of a preoperative serum CA125 to predict whether optimal debulking (OD) could be achieved for patients with stage III and IV epithelial ovarian cancer (EOC). The records of consecutive patients who underwent primary surgery for EOC at Indiana University Hospital between January 1997 and January 2003 were reviewed. Eligibility criteria included FIGO stage III/IV disease, surgery by gynecologic oncology faculty, preoperative CA125, and an operative note clearly defining volume of residual disease. The Medcalc software statistical package was used to generate a receiver-operating characteristic (ROC) curve. Two hundred and eighty-nine cases of stage III/IV EOC were identified, of which 164 met the eligibility criteria. Serum CA125 /=75% of the time. Conversely, OD was achieved in /=4500. The area under the ROC curve for CA125 was .670. The OD rate for those with and without ascites was 49% and 79%, respectively (P < 0.001). In a multivariate analysis using CA125, age, and ascites, the area under the curve was 0.686. We conclude that preoperative serum CA125 did not reliably predict OD in patients with stage III-IV EOC.     

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.     

Whole-body positron emission tomography and tumor marker CA125 for detection of recurrence in epithelial ovarian cancer

Abstract.   Murakami M, Miyamoto T, Iida T, Tsukada H, Watanabe M, Shida M, Maeda H, Nasu S, Yasuda S, Yasuda M, Ide M. Whole-body positron emission tomography and tumor marker CA125 for detection of recurrence in epithelial ovarian cancer. Int J Gynecol Cancer 2006; 16(Suppl. 1): 99–107.
We evaluated the clinical role of the combination of positron emission tomography (PET) with F-18 fluorodeoxyglucose (FDG) and tumor marker CA125, in the detection of recurrence after initial therapy for epithelial ovarian cancer. The indication is the cases that cannot be confirmed the recurrence by conventional imaging modalities. Ninety patients underwent PET and computed tomography, including the measurement of specific tumor markers. FDG-PET confirmed recurrence in 46 patients (51%), and the recurrent site was confirmed by PET alone in 17 (37%). PET had high sensitivity for detecting both intraperitoneal and retroperitoneal metastases (93.9 and 92.9%, respectively). PET imaging was able to detect normal-sized metastases in the lymph nodes in 14 (50%) of the 28 patients with retroperitoneal metastasis. PET could show 87.5% positive rate of recurrent patients with asymptomatic rise of CA125 who had no sign of recurrence by conventional imaging methods. Of the 46 recurrent patients, 41 (89%) had specific elevated titers of CA125 at the first treatment. PET imaging was able to detect recurrence at relatively low titers (a median 68 U/mL) of CA125. In 8 (19.5%) of these 41 patients, recurrence with normal CA125 levels could be confirmed only by PET. The sensitivity of the combination of PET and CA125 was 97.8% with only one false-negative case. The combination of FDG-PET and CA125 titer is useful for the accurate detection of recurrence.     

CA125测定联合B超检查对卵巢上皮癌的诊断和预后的价值分析

目的　探讨CA1 2 5检测联合B超检查在卵巢上皮癌的诊断及预后的价值。方法　卵巢上皮癌、卵巢良性肿瘤术前进行CA1 2 5测定和B超检查 ,卵巢上皮癌者术后 1周及每次化疗前复查CA1 2 5和B超。结果　术前卵巢上皮癌的CA1 2 5明显高于卵巢上皮癌术后组及卵巢良性肿瘤组 ,Ⅲ、Ⅳ期卵巢上皮癌的CA1 2 5明显高于Ⅰ、Ⅱ期 ;2 7%的CA1 2 5>6 0 0U/ml患者能施行理想的肿瘤细胞减灭术。CA1 2 5联合B超使卵巢上皮癌的诊断阳性率提高达 95 %。结论　CA1 2 5是卵巢上皮癌诊断和判断预后的特异性指标 ,CA1 2 5联合B超检查可提高卵巢上皮癌的诊断率。     

Stage- and CA125–related survival in patients with epithelial ovarian cancer treated at a cancer center

Abstract.   Board RE, Bruijns CTPH, Pronk AE, Ryder WDJ, Wilkinson PM, Welch R, Shanks JH, Connolly G, Slade RJ, Reynolds K, Kitchener HC, Jayson GC. Stage- and CA125–related survival in patients with epithelial ovarian cancer treated at a cancer center. Int J Gynecol Cancer 2006; 16(Suppl. 1): 18–24.
Current accepted prognostic indicators in ovarian cancer include performance status, surgical (FIGO) staging, and residual disease after operation. Here we present data from a prospective analysis of patients with ovarian cancer treated at the Christie Hospital. We confirm the independent prognostic effects of FIGO staging, performance status, and residual disease in our group of patients and furthermore show that CA125 levels at presentation to the oncology service are of independent prognostic significance ( P = 0.02). We present survival data and show that the 3-year, cancer-specific survival for stage I disease is 90%. We postulate that this good survival may in part be due to the use of computed tomography scanning at presentation to allow accurate staging. Further clinical trials are needed to test whether combinations of surgical, histologic, biochemical, and radiologic parameters can be used to identify a population with such a good prognosis that adjuvant therapy is not required.     

Prognostic significance of CA 125 and TPS levels after 3 chemotherapy courses in ovarian cancer patients

OBJECTIVE: To evaluate the prognostic significance of and predictive value for survival of CA 125 and TPS levels after three chemotherapy courses in ovarian cancer patients. METHODS: We analyzed in a prospective multicenter study the 1- and 2-year overall survival (OS) in ovarian carcinoma patients. The prognostic significance of CA 125 and TPS levels above the discrimination value (25 kU/L and 100 U/L, respectively) was examined by univariate and multivariate analyses. RESULTS: Of the 213 cases included, 64 patients were staged as FIGO I + II and 149 patients were staged as FIGO III + IV. Tumor marker levels in stage I + II were not correlated with survival. However, stage III and IV patients with elevated levels of CA 125 or TPS after three chemotherapy courses had a worse 2-year OS (69% vs 26%, P < 0.0001 and 57% vs 20%, P < 0.0001, respectively) than patients with normal levels of the markers. In univariate analysis the result of operation (staging laparatomy and partial debulking) and advanced FIGO stage (IV) were also adverse prognostic factors. Independent factors predictive of low 2-year OS by multivariate analysis were staging laparotomy, TPS elevated, and CA 125 elevated. The only factors predictive of low 1-year OS were TPS elevated and staging laparotomy. CONCLUSIONS: Ovarian cancer patients with elevated CA 125 levels after three chemotherapy courses have a poor prognosis. However, the prognostic accuracy can be significantly increased by the parallel determination of serum TPS.     

Screening for ovarian cancer using serum CA125 and vaginal examination: report on 2550 females

This study was undertaken to assess the effectiveness of using serum CA125 and vaginal examination as a screening test for ovarian cancer in apparently healthy females. Two thousand five hundred and fifty healthy females aged 40 and over were recruited to participate in a screening study involving a questionnaire, serum CA125 measurement and vaginal examination. Females with either an elevated CA125 level or abnormal vaginal examination had a pelvic ultrasound performed as a secondary procedure. The positive predictive values of an elevated serum CA125 level, and a combination of CA125 level measurement and vaginal examination for ovarian cancer, were 1/100 and 1/3, respectively. The specificities of serum CA125 levels, vaginal examination and both in combination were 96.1%, 98.5% and 99.9%, respectively. In postmenopausal females the positive predictive values were improved with CA125 measurement alone, giving a positive predictive value of 1/24. Seventeen females underwent operative procedure as a result of the screening—only one of these was for an ovarian cancer. The combination of serum CA125 measurement and vaginal examination is not an effective screening test in the general population, although in postmenopausal females it does achieve acceptable specificities and positive predictive values.     

Tumor tissue CA125 in ovarian carcinoma patients with normal serum levels

A good correlation between elevated serum CA125 and its immunolocalization in ovarian tumor tissue has been reported. This study was undertaken in order to assess the presence of CA125 in tumor tissue obtained from ovarian carcinoma patients with normal serum levels. Eleven such ovarian carcinoma patients (nine of them serous) were identified. In seven the level was normal prior to the initial operation, and in four, prior to a positive second-look operation. Immunohistochemical staining of paraffin sections for CA125 was positive in seven of the tumor tissue samples. Tumor tissue of most ovarian carcinoma patients with a preoperative normal serum CA125 contains the antigen, but an undetermined mechanism prevents elevated serum levels.