Makar A P, Kristensen G B, Kaern J, Børmer O P, Abeler V M, Tropé C G
Department of Gynecologic Oncology, Norwegian Radium Hospital, Oslo.
Obstet Gynecol. 1992 Jun;79(6):1002-10.
The prognostic significance of the serum CA 125 level was studied in 687 patients with invasive epithelial ovarian malignancies. The samples were collected preoperatively in 200 and postoperatively in 487 patients. Median follow-up was 27 months (range 3-84). The serum CA 125 level was elevated preoperatively in 90% of cases, with a median value of 429 U/mL. In patients with evidence of disease at the time of sampling, the CA 125 serum level correlated directly to tumor stage, tumor load, and histologic grade. Using Cox multivariate analysis, the preoperative serum CA 125 level had no independent prognostic significance, whereas the postoperative level did. In patients without residual disease after primary surgery, histologic type (P less than .0001), postoperative CA 125 level with 35 U/mL as the cutoff value (P = .0009), and tumor grade (P = .034) were independent prognostic factors for survival. For those with residual tumor after primary surgery, histologic type (P less than .0001), postoperative treatment (P = .0002), size of residual disease (P = .0005), and postoperative serum CA 125 level with 65 U/mL as a cutoff (P = .003) were independent prognostic factors.
对687例浸润性上皮性卵巢恶性肿瘤患者的血清CA 125水平的预后意义进行了研究。200例患者在术前采集样本，487例患者在术后采集样本。中位随访时间为27个月（范围3 - 84个月）。90%的病例术前血清CA 125水平升高，中位值为429 U/mL。在采样时存在疾病证据的患者中，CA 125血清水平与肿瘤分期、肿瘤负荷和组织学分级直接相关。使用Cox多变量分析，术前血清CA 125水平无独立预后意义，而术后水平有。在初次手术后无残留疾病的患者中，组织学类型（P <.0001）、以35 U/mL为临界值的术后CA 125水平（P =.0009）和肿瘤分级（P =.034）是生存的独立预后因素。对于初次手术后有残留肿瘤的患者，组织学类型（P <.0001）、术后治疗（P =.0002）、残留疾病大小（P =.0005）以及以65 U/mL为临界值的术后血清CA 125水平（P =.003）是独立预后因素。
