卵巢上皮性癌新辅助化疗后血清CA125水平下降至一半所需的时间与手术切净率及预后的关系

目的 探讨卵巢上皮性癌新辅助化疗后血清CA125,水平下降至一半所需的时间（即CA15的T1/2）与手术切净率及预后的关系。方法 回顾性分析39例行新辅助化疗的卵巢上皮性癌患者,以化疗后CA125的T1/2长短分组,分为T1/2〈20d组和T1/2≥20d组,比较两组间的手术切净率及预后。结果 新辅助化疗后T1/2≥120d组的手术切净率明显低于T1/2〈20d组（分别为29％和80％,P〈0．01）。T1/2≥20d组的中位生存时间为21.2个月,明显低于T1/2〈20d组的37．6个月（P〈0．05）;两组累计生存率比较,差异有统计学意义（P〈0．01）。多因素分析提示,血清CA125的T1/2及术后残留灶直径是卵巢上皮性癌患者新辅助化疗后影响其预后的独立因素。结论 卵巢上皮性癌新辅助化疗后,血清CA125的T1/2长短有助于术前判断手术切净情况,并且是影响此类患者预后的独立因素。

Relationship between CA125 half life during neoadjuvant chemotherapy and the optimal operation rate and prognosis in patients with advanced epithelial ovarian carcinoma

OBJECTIVE: To investigate the relationship between the serum half life of CA(125) and the optimal operation rate and prognosis in patients with advanced epithelial ovarian carcinoma treated with neoadjuvant chemotherapy. METHODS: Clinical data of 39 patients who had undergone neoadjuvant chemotherapy were analyzed retrospectively. Patients were divided into two groups according to the serum half-life of CA(125), and the optimal operation rate and prognosis were compared. RESULTS: The optimal operation rate in patients with serum half-life >or= 20 days was significantly lower than that in patients with serum half-life < 20 days (29% vs 80%, P < 0.01). Cumulative survival was higher in patients with serum half-life < 20 days (P < 0.01). Serum half-life of CA(125) and tumor residual after operation were independent prognostic factors by COX model analysis. CONCLUSION: Serum half-life of CA(125) may indicate optimal debulking operation, and it is an independent prognostic factor in ovarian carcinoma patients treated with neoadjuvant chemotherapy.