Gallion H H, Hunter J E, van Nagell J R, Averette H E, Cain J M, Copeland L J, Higgins R V, Husseinzadeh N, Nahhas W A, Partridge E E
Department of Obstetrics and Gynecology, University of Kentucky Medical Center, Lexington 40536.
Gynecol Oncol. 1992 Jul;46(1):29-32. doi: 10.1016/0090-8258(92)90190-t.
Second-look laparotomy is performed to evaluate response to chemotherapy and to determine the need for additional treatment. The relationship between absolute levels of serum CA 125 less than 35 u/ml and disease status at second-look operation was evaluated in 95 patients with advanced-stage epithelial ovarian cancer. Eighty-six patients had Stage III disease and nine patients had Stage IV cancer. Residual tumor was documented at second-look laparotomy in 52 (55%) of the patients studied. Forty-nine percent of the 82 patients with serum CA 125 values less than 20 u/ml had residual disease. In contrast, 12 of 13 (92%) patients with serum CA 125 values of 20-35 u/ml had residual tumor at second-look laparotomy. All patients with serous cystadenocarcinomas and serum CA 125 values of 20-35 u/ml had residual tumor, and two-thirds of these cases had grossly visible disease. The positive predictive value of a serum CA 125 level of 20-35 u/ml was 0.92. These data suggest that second-look laparotomy should be deferred in patients with advanced-stage ovarian cancer until serum CA 125 values are less than 20 u/ml.
二次剖腹探查术用于评估化疗反应并确定是否需要进一步治疗。对95例晚期上皮性卵巢癌患者进行了血清CA 125绝对水平低于35 u/ml与二次剖腹探查术时疾病状态之间关系的评估。86例患者为Ⅲ期疾病，9例患者为Ⅳ期癌症。在接受研究的患者中，52例（55%）在二次剖腹探查术中发现有残留肿瘤。血清CA 125值低于20 u/ml的82例患者中，49%有残留疾病。相比之下，血清CA 125值为20 - 35 u/ml的13例患者中有12例（92%）在二次剖腹探查术中发现有残留肿瘤。所有浆液性囊腺癌且血清CA 125值为20 - 35 u/ml的患者均有残留肿瘤，其中三分之二的病例有肉眼可见的疾病。血清CA 125水平为20 - 35 u/ml的阳性预测值为0.92。这些数据表明，晚期卵巢癌患者应推迟二次剖腹探查术，直到血清CA 125值低于20 u/ml。
