Liu L, Hong W, Hou Y, Yao Z, Wu A, Wang X
Cancer Hospital, CAMS, Beijing.
Chin Med Sci J. 1991 Jun;6(2):96-9.
Thirty patients with ovarian cancers underwent second-look operations in our hospital between 1981 and 1989, and the results were compared with serum CA125 values. The over-all positive rate determined by second-look laparotomy in the present series was 56.7% (17/30)-40% as gross and 17% an microscopic tumors. The result of the second-look was related to the staging and size of the residual tumor after the previous operation: 1/3 of stage I and II lesions and 16/27 of stage III and recurrent lesions were positive on second-look. The positive rates of those patients who were free from residual tumor and those with residual tumors less than or equal to 2 cm or greater than 2 cm were 28.6% (2/7), 60% (9/15) and 75% (6/8), respectively. Among the 23 patients assayed as to serum CA125 level before the second-look, 18 (78%) were within normal limits (less than 65 U/ml), including 12 patients (66.6%) who were second-look positive and 6 who were negative. Five patients with microscopic tumors and 3 patients with gross tumors less than or equal to 2 cm all had normal CA125 levels before the second-look. Among the 5 of 9 patients with gross tumors greater than 2 cm who had elevated CA125 levels, not one was found to be negative on second-look. This may imply that the elevated CA125 levels indicate recurrence, though a normal CA125 assay certainly does not preclude recurrence.
1981年至1989年间，30例卵巢癌患者在我院接受了二次探查手术，并将结果与血清CA125值进行了比较。本系列中二次探查剖腹术确定的总体阳性率为56.7%（17/30）——肉眼可见肿瘤为40%，镜下肿瘤为17%。二次探查结果与上次手术后的分期及残留肿瘤大小有关：Ⅰ期和Ⅱ期病变的1/3以及Ⅲ期和复发病变的16/27二次探查为阳性。无残留肿瘤、残留肿瘤小于或等于2 cm以及大于2 cm的患者的阳性率分别为28.6%（2/7）、60%（9/15）和75%（6/8）。在二次探查前检测血清CA125水平的23例患者中，18例（78%）在正常范围内（小于65 U/ml），其中12例（66.6%）二次探查为阳性，6例为阴性。5例镜下肿瘤患者和3例肉眼肿瘤小于或等于2 cm的患者二次探查前CA125水平均正常。9例肉眼肿瘤大于2 cm且CA125水平升高的患者中，无一例二次探查为阴性。这可能意味着CA125水平升高提示复发，尽管CA125检测正常并不能排除复发。
