CA125检测在评价卵巢癌预后中的作用

目的:研究CA125水平与原发性卵巢癌病人预后的关系。方法:对142例术前行血清CA125测定的卵巢上皮性癌病人进行回顾性分析,评估CA125水平与术前、术后各种变量的关系。用电化学发光免疫分析法(ECLIA)测定CA125水平。结果:所有病人CA125中位数为582kU/L(7kU/L～52930kU/L),术前CA125水平与年龄差异不存在相关性(P>0.05)。但术前CA125中位数在浆液组织及其他组织类型(870vs334kU/L,P<0.05),肿瘤分期高(Ⅲ/Ⅳ)与低(893vs174kU/L,P<0.01),肿瘤病理分级高(G3)与低(G1,2)(928vs323kU/L,P<0.01),出现腹水有无(893vs220kU/L,P<0.01)等方面,差异具有非常显著性意义。次优化肿瘤细胞减灭术(肿瘤残端>1cm)者CA125明显高于最优化肿瘤细胞减灭术(1067kU/Lvs399kU/L,P<0.01)。最优化肿瘤细胞减灭术病人术前CA125<500kU/L者,阳性预测值为82%,阴性预测值为48%,校正协变量后,CA125水平与规定疾病存活率密切相关。术前CA125水平升高(最高者除外)病人,其死亡危险性升高。结论:CA125可作为预测卵巢癌预后的一种标志物。

Evaluating CA125 in Predicting the Prognosis of Patients with Ovarian Cancer

Objective To study the association of CA125 levels with outcome in primary ovarian cancer patients.Methods 142 patients with epithelial ovarian cancer,who had aserum CA125 level drawn before surgery,were retrospectively evaluated.The relationship of preoperative CA125 levels and various preoperative and post operative variables was evaluated.CA125 levels were measured using electrochemi luminescence immunoa ssay(ECLIA).Results The median CA125 value for all patients was 582 kU/L(range 7～52 930kU/L).preoperative CA125 values did not correlate with increasing age(P>0.05),but were found to be singnifieantly associated with histology compared with other histology(median CA125 of 870 vs 334 kU/L,P<0.05),high-stage(Ⅲ/Ⅳ)compared with low-stage(median CA125(median CA125 of 928 vs 323 kU/L,P<0.01),and the presence of ascites compared with absence of ascites(median CA125 of 893 vs 220 kU/L,P<0.01).Suboptimal cytoreductive surgery(more than 1 cm residual)was associated with significantly higher CA125 levels compared with individuals with optimal cytoreductive surgery(1 067 vs 399 kU/L,P<0.01).Preoperative CA125 levels less than 500 kU/L had a positive predictive value for optimal cytoreductive surgery of 82%,but a poor negative predictive value of 48%,After adjusting for covarlates,there was a significant association between CA125 levels and disease-specific survival.As preoperative CA125 levels increased,the risk of death increased except at the highest value of CA125.Conclusion CA125 is a marker of prognosis of patients with ovarian cancer.