原发性输卵管癌患者血清癌抗原125浓度的临床价值：一项多中心研究。
The clinical value of serum concentrations of cancer antigen 125 in patients with primary fallopian tube carcinoma: a multicenter study.
作者信息
Hefler L A, Rosen A C, Graf A H, Lahousen M, Klein M, Leodolter S, Reinthaller A, Kainz C, Tempfer C B
机构信息
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas 77030, USA.
出版信息
Cancer. 2000 Oct 1;89(7):1555-60. doi: 10.1002/1097-0142(20001001)89:7<1555::aid-cncr20>3.0.co;2-j.
BACKGROUND
Primary fallopian tube carcinoma (PFTC) is a rare disease, and data on the serum concentration of tumor marker cancer antigen 125 (CA 125) in patients with this disease are sparse. The authors assessed the clinical value of the serum concentration of CA 125 as a prognostic and monitoring marker in patients with surgically treated PFTC.
METHODS
In a multicenter study, the concentration of CA 125 was measured in 406 serum samples from 53 patients with PFTC. The results were correlated with clinical data.
RESULTS
The pretreatment median serum CA 125 level was 183 U/mL (range, 6.5-5440.0 U/mL) in patients with PFTC. In a univariate Cox regression model, tumor stage and serum CA 125 level were associated significantly with shortened disease free survival (P = 0.006 and P < 0.001, respectively) and with overall survival (P = 0.03 and P = 0. 001, respectively). Lymph node involvement, tumor grade, and patient age were not associated with the length of survival. A multivariate Cox regression model showed that pretreatment the serum CA 125 level was a prognostic factor of disease free and overall survival, independent of tumor stage (P = 0.005 and P = 0.01, respectively). The pretreatment serum CA 125 level was correlated with tumor stage (P < 0.001) but not with lymph node involvement (P = 0.8), histologic grade (P = 0.3), or patient age (P = 0.2). The serum CA 125 level during chemotherapy was correlated significantly with Gynecologic Oncology Group response criteria to chemotherapy (P = 0. 001). During the follow-up of patients, serum CA 125 levels reached sensitivity, specificity, positive predictive value, and negative predictive value of 92%, 90%, 67%, and 98%, respectively, for differentiating between no evidence of disease and the presence of recurrent disease. In 90% of the patients, an increase of serum CA 125 level preceded the clinical or radiologic diagnosis of recurrent disease with a median lead time of 3 months (range, 0.5-7.0 months).
CONCLUSIONS
This is the largest study to date with respect to serum CA 125 levels in patients with PFTC. The current data indicate that the pretreatment serum CA 125 level is an additional independent prognostic factor of disease free and overall survival in patients with PFTC. The serum CA 125 level adequately defines the response to chemotherapy and displays good sensitivity and specificity characteristics during the follow-up of patients with PFTC.
背景
原发性输卵管癌（PFTC）是一种罕见疾病，关于该疾病患者血清肿瘤标志物癌抗原125（CA 125）浓度的数据较少。作者评估了血清CA 125浓度作为手术治疗的PFTC患者的预后和监测标志物的临床价值。
方法
在一项多中心研究中，测量了53例PFTC患者的406份血清样本中CA 125的浓度。将结果与临床数据进行关联分析。
结果
PFTC患者治疗前血清CA 125水平的中位数为183 U/mL（范围为6.5 - 5440.0 U/mL）。在单因素Cox回归模型中，肿瘤分期和血清CA 125水平与无病生存期缩短显著相关（分别为P = 0.006和P < 0.001），与总生存期也显著相关（分别为P = 0.03和P = 0.001）。淋巴结受累情况、肿瘤分级和患者年龄与生存期长短无关。多因素Cox回归模型显示，治疗前血清CA 125水平是无病生存期和总生存期的预后因素，独立于肿瘤分期（分别为P = 0.005和P = 0.01）。治疗前血清CA 125水平与肿瘤分期相关（P < 0.001），但与淋巴结受累情况（P = 0.8）、组织学分级（P = 0.3）或患者年龄（P = 0.2）无关。化疗期间血清CA 125水平与妇科肿瘤学组化疗反应标准显著相关（P = 0.001）。在患者随访期间，血清CA 125水平在区分无疾病证据和疾病复发方面的敏感性、特异性、阳性预测值和阴性预测值分别达到92%、90%、67%和98%。在90%的患者中，血清CA 125水平升高先于疾病复发的临床或影像学诊断，中位提前时间为3个月（范围为0.5 - 7.0个月）。
结论
这是迄今为止关于PFTC患者血清CA 125水平的最大规模研究。目前的数据表明，治疗前血清CA 125水平是PFTC患者无病生存期和总生存期的一个额外独立预后因素。血清CA 125水平能充分界定化疗反应，并在PFTC患者随访期间显示出良好的敏感性和特异性特征。
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