术前血清人绒毛膜促性腺激素β作为原发性输卵管癌的预后标志物

Preoperative serum hCGbeta as a prognostic marker in primary fallopian tube carcinoma.

作者信息

Riska A, Alfthan H, Finne P, Jalkanen J, Sorvari T, Stenman U H, Leminen A

机构信息

Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, Finland.

出版信息

Tumour Biol. 2006;27(1):43-9. doi: 10.1159/000090155. Epub 2005 Dec 8.

DOI:10.1159/000090155

PMID:16340249

Abstract

OBJECTIVES

It was the aim of this study to evaluate the prognostic value of the pretreatment serum concentrations of the beta-subunit of human chorionic gonadotropin (hCGbeta), CA 125 and tumour-associated trypsin inhibitor (TATI) in primary fallopian tube carcinoma (PFTC).

METHODS

The pretreatment serum concentrations of hCGbeta, CA 125 and TATI were analyzed in serum samples from 60 women with a mean age of 61 years, treated for PFTC between 1985 and 2000. Of the 91 patients treated during this period, 31 were excluded because no serum sample was available. The patients were followed-up for recurrence and survival until February 14, 2003. The prognostic value of the serum markers were compared with those of stage, grade and histological type.

RESULTS

The median survival time was 27 months and the overall 5-year survival rate 33%. Stage and size of the residual tumour (<1 vs. > or =1 cm) predicted both overall and disease-free survival (p < 0.050). Histology (serous vs. others) (p = 0.023) also influenced overall survival. Overall 5-year survival was 38% when serum hCGbeta was below 3.5 pmol/l, while it was 18% when the level was higher (p = 0.052). The corresponding disease-free 5-year survival was 38 and 20%, respectively (p = 0.014). Patients with CA 125 values above 1,017 kU/l had an overall 5-year survival of 39% as compared with 14% for those with lower values (p = 0.009), while the disease-free survival was 37 and 23%, respectively (p = 0.096). Serum TATI was not a prognostic marker. Serum concentrations of hCGbeta and CA 125 correlated significantly with stage (p = 0.049 and p = 0.050, respectively). In multivariate Cox proportional hazards regression analysis, only hCGbeta, stage and histology emerged as independent prognostic factors.

CONCLUSIONS

Clearly elevated serum concentrations of hCGbeta and CA 125 predict survival in fallopian tube carcinoma, but in multivariate analyses, only hCGbeta is a prognostic factor independent of stage and histology.

摘要

目的

本研究旨在评估人绒毛膜促性腺激素β亚基（hCGβ）、CA 125和肿瘤相关胰蛋白酶抑制剂（TATI）的预处理血清浓度在原发性输卵管癌（PFTC）中的预后价值。

方法

分析了1985年至2000年间接受PFTC治疗的60名平均年龄为61岁女性的血清样本中hCGβ、CA 125和TATI的预处理血清浓度。在此期间接受治疗的91名患者中，31名因无血清样本而被排除。对患者进行随访以观察复发和生存情况，直至2003年2月14日。将血清标志物的预后价值与分期、分级和组织学类型的预后价值进行比较。

结果

中位生存时间为27个月，总体5年生存率为33%。残留肿瘤的分期和大小（<1 cm与≥1 cm）可预测总体生存和无病生存（p<0.050）。组织学类型（浆液性与其他类型）（p = 0.023）也影响总体生存。血清hCGβ低于3.5 pmol/l时，总体5年生存率为38%，而水平较高时为18%（p = 0.052）。相应的无病5年生存率分别为38%和20%（p = 0.014）。CA 125值高于1017 kU/l的患者总体5年生存率为39%，而值较低的患者为14%（p = 0.009），无病生存率分别为37%和23%（p = 0.096）。血清TATI不是预后标志物。hCGβ和CA 125的血清浓度与分期显著相关（分别为p = 0.049和p = 0.050）。在多变量Cox比例风险回归分析中，只有hCGβ、分期和组织学类型是独立的预后因素。