腹水糖链抗原125对卵巢癌预后的评估价值

目的评价腹水糖链抗原125（carbohydrate antigen 125,CA125）对卵巢癌患者是否具有预后评估价值。方法回顾性分析95例于2005-01/2011-12月作者医院就诊、具有腹水体征的初诊卵巢癌患者的住院病历,从病历中提取患者在入院时的腹水和血清CA125水平。采用电话交流或者门诊查体的方式对患者的存活状况进行调查。采用受试者工作特征曲线（receiver operating characteristic curve,ROC）法和Kaplan-Meier法分析腹水CA125对卵巢癌患者的预后是否具有评估价值。结果共有55例患者在随访期内死亡。死亡的卵巢癌患者血清和腹水CA125水平较存活患者明显增高。腹水和血清中CA125预测患者死亡的曲线下面积（95%可信区间）分别为0.64（0.53～0.75）和0.69（0.59～0.80）。腹水CA125增高（大于972.9 kU/L）和血清中CA125增高（大于189.90 kU/L）的卵巢癌患者,其预后较差。结论腹水CA125是评估卵巢癌患者预后的有用标志物,其与血清CA125联合使用更有助于评估卵巢癌患者预后。

Prognostic Value of CA125 in Ascitic Fluid for Ovarian Cancer

Objective To estimate the prognostic value of carbohydrate antigen 125（CA125） in ascetic fluid for patients with ovarian cancer.Methods The medical records of 95 patients with newly diagnosed ovarian cancer with the sign of ascites,who admitted in our hospital during January 2005 and December 2011,were retrospectively reviewed.The CA125 concentration in serum and ascitic fluid on admission was extracted.The survival status of patients was confirmed by face-to-face talk or by telephone contacting to their relatives.Receiver operating characteristic（ROC） curve analysis and time dependent Kaplan-Meier methods were used to estimate the prognostic value of CA125 in serum and ascitic fluid for ovarian cancer patients.Results Fifty-five patients died during the follow-up.Increased CA125 in serum and ascitic fluid was observed in these patients.The area under curve（95% confidence interval） of serum and ascitic fluid CA125 for predicting death were 0.69（0.59-0.80） and 0.64（0.53-0.75） respectively.Increased serum CA125（defined as more than 189.90 kU/L） and ascitic fluid CA125（defined as more than 972.90 kU/L） were associated with worse outcomes in patients with ovarian cancer.Conclusion CA125 in ascitic fluid is a useful marker to evaluate the prognosis of patients with ovarian cancer.Combined use of serum and ascitic fluid CA125 may improve the prognostic accuracy.