上皮性卵巢癌CA125半衰期与器官转移聚类的相关性分析

目的:分析上皮性卵巢癌患者术后辅助化疗期间CA125的半衰期及其影响因素,以及CA125半衰期与肿瘤转移器官的部位及个数的相关性。方法:回顾分析2017年12月至2019年5月在中国科学技术大学附属第一医院行手术治疗的59例上皮卵巢癌初次满意减瘤术患者的临床资料。通过公式t 1/2=dt/2×lg(CA 1/CA 2)]计算CA125半衰期;CA 1为CA125手术前数值;CA 2为CA125化疗期间第一次降到正常范围(35U/ml)的值(或化疗的3个月内降至最低的值);dt是CA 1及CA 2之间的时间。结果:16例患者的术前CA125低于200U/ml,平均年龄(56.00±11.74)岁:其CA125半衰期难以反映实际CA125化疗期间下降情况。43例患者术前CA125大于200U/ml,平均年龄(53.28±9.73)岁。Pearson分析显示,CA125半衰期与年龄、分期、病理类型、病理分级、血栓形成无明显相关(P分别为0.818、0.180、0.252、0.795、0.339);而与手术后第一次化疗时间间歇密切相关(r=0.345,P=0.024)。分析CA125半衰期与盆腔以外常见转移器官包括肠管(特指累及肠管肌层,需切除肠管)、网膜、腹膜、淋巴结]数目的差别,发现累及器官数越多,CA125半衰期越长,转移3个及4个器官的CA125半衰期均长于2个器官(P=0.001和P=0.005)及1个器官的半衰期(P=0.033和P=0.035)。结论:CA125半衰期适于用大于200U/ml的上皮性卵巢癌;其时间与术后第一次化疗间歇期时间及转移器官数正相关;临床上推荐上皮性卵巢癌患者术后宜尽早化疗。

Analysis of the relationship between the half-life of CA125 and the cluster of metastatic organs in epithelial ovarian carcinoma

Objective:To analyze the half-life of CA125 in the patients with epithelial ovarian carcinoma during postoperative adjuvant chemotherapy and its related factors,and the correlations with the locations and numbers of the metastatic organs.Methods:We retrospectively analyzed the clinical data of the 59 epithelial ovarian cancer patients treated with primary cytoreductive surgery in the First Affiliated Hospital of University of Science and Technology of China from Dec.2017 to May 2019.The formula of the CA125 half-life was dt/2×lg(CA 1/CA 2)].We set CA 1 as the level of CA125 before primary cytoreductive surgery(PCS)and CA 2 as the first CA125 level<35U/ml(or the lowest CA125 level during the chemotherapy within 3 months after operation).dt as the interval days of CA 1 and CA 2.Results:The average age was(53.38±9.82)years old for the 16 patients with the preoperative CA125 less than 200U/ml;and the calculated CA125 half-life was unable to reflect the actual decline of CA125 level during chemotherapy.The average age was 53.28±9.73 day for the 43 patients with the preoperative CA125 more than 200U/ml.Pearson analysis showed that the CA125 half-life had no significant correlation with age,FIGO stage,pathological type,pathological grade,or thrombosis(P values were 0.818、0.180、0.252、0.795、0.339,respectively).The CA125 half-life was closely related to the interval of the first chemotherapy after surgery(r=0.345,P=0.024).Through analyzing the correlation between the CA125 half-life and the numbers of the common tumor metastasis sites outside the pelvic cavityincluding the bowels(specifically involved with muscle layers to be resected),the omentum,the peritoneum,and the lymph nodes],we found that the more organ involved,the longer CA125 half-life would be.The half-life of CA125 in patients with 3 and 4 metastatic organs was longer than that with 2 organs(P=0.001 and P=0.005)and 1 metastatic organ(P=0.033 and P=0.035).Conclusion:The half-life of CA125 was suitable for epithelial ovarian carcinoma with preoperative CA125 level more than 200U/ml,which was positively correlated with the interval of the postoperative first chemotherapy and the numbers of metastatic organs.Therefore,early chemotherapy was recommended for patients with epithelial ovarian cancer after operation.