血清CA-125水平在早期上皮性卵巢癌术前CT及MRI中的作用

The role of serum CA-125 levels in early-stage epithelial ovarian cancer on preoperative CT and MRI.

作者信息

Kim H S, Kim J W, Cho J Y, Chung H H, Park N H, Song Y S, Kim S H, Kang S B

机构信息

Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, Chongno-Gu, Seoul, Republic of Korea.

出版信息

Eur J Surg Oncol. 2009 Aug;35(8):870-6. doi: 10.1016/j.ejso.2009.01.005. Epub 2009 Jan 29.

DOI:10.1016/j.ejso.2009.01.005

PMID:19179039

Abstract

BACKGROUND

We sought to identify the role of serum CA-125 levels in early-stage epithelial ovarian cancer (EOC) on preoperative CT and MRI.

METHODS

Clinical data of 101 patients with early-stage EOC on preoperative CT and MRI were collected between January 2000 and December 2007. Clinical stage I (n=59) was defined as tumor limited to the ovaries with or without ascites, whereas clinical stage II (n=42) was defined as tumor within the pelvis with or without ascites. The primary endpoint was to investigate the efficacy of serum CA-125 levels for the prediction of advanced-stage disease, and secondary endpoints were to evaluate the accuracy of preoperative CT and MRI, and to examine the role of serum CA-125 levels as a prognostic factor for survival.

RESULTS

The results of preoperative CT and MRI were concordant with no peritoneal implants outside the pelvis in 50/101 (50%) and no lymph node metastasis in 71/101 (70%) patients. The receiver operating characteristic curves showed that best cut-off values of serum CA-125 levels were 320 U/ml (71% sensitivity, 84% specificity) and 510 U/ml (67% sensitivity, 80% specificity) for the prediction of peritoneal implants outside the pelvis and lymph node metastasis. The serum CA-125 level (> or =320 U/ml) was a significant factor for the prediction of advanced-stage disease (adjusted OR, 7.43; 95% CI, 2.39-23.04). However, it was not an independent prognostic factor for survival.

CONCLUSIONS

Serum CA-125 levels may be very useful for the prediction of advanced-stage disease in early-stage EOC on preoperative CT and MRI.

摘要

背景

我们试图确定术前CT和MRI检查中血清CA - 125水平在早期上皮性卵巢癌（EOC）中的作用。

方法

收集2000年1月至2007年12月期间101例早期EOC患者术前CT和MRI的临床资料。临床I期（n = 59）定义为肿瘤局限于卵巢，有或无腹水；而临床II期（n = 42）定义为肿瘤位于盆腔内，有或无腹水。主要终点是研究血清CA - 125水平预测晚期疾病的有效性，次要终点是评估术前CT和MRI的准确性，以及检查血清CA - 125水平作为生存预后因素的作用。

结果

术前CT和MRI结果显示，101例患者中有50例（50%）盆腔外无腹膜种植，71例（70%）无淋巴结转移。受试者工作特征曲线显示，血清CA - 125水平预测盆腔外腹膜种植和淋巴结转移的最佳截断值分别为320 U/ml（敏感性71%，特异性84%）和510 U/ml（敏感性67%，特异性80%）。血清CA - 125水平（≥320 U/ml）是预测晚期疾病的重要因素（校正OR，7.43；95%CI，2.39 - 23.04）。然而，它不是生存的独立预后因素。