CA 125和CA 72-4在卵巢交界性肿瘤中的预测价值。

Predictive value of CA 125 and CA 72-4 in ovarian borderline tumors.

作者信息

Lenhard Miriam S, Nehring Stefanie, Nagel Dorothea, Mayr Doris, Kirschenhofer Angela, Hertlein Linda, Friese Klaus, Stieber Petra, Burges Alexander

机构信息

Department of Obstetrics and Gynecology, Ludwig-Maximilians-University Munich, Campus Grosshadern, Munich, Germany.

出版信息

Clin Chem Lab Med. 2009;47(5):537-42. doi: 10.1515/CCLM.2009.134.

DOI:10.1515/CCLM.2009.134

PMID:19317653

Abstract

BACKGROUND

The aim of this study was to assess the prognostic value of cancer antigen (CA) 125 and CA 72-4 in patients with ovarian borderline tumor (BOT).

METHODS

All women diagnosed and treated for BOT at our institution between 1981 and 2008 were included into this retrospective study (n=101). Preoperatively collected serum samples were analyzed for CA 125 (Architect, Abbott and Elecsys, Roche) and CA 72-4 (Elecsys, Roche) with reference to clinical data and compared to healthy women (n=109) and ovarian cancer patients (n=130).

RESULTS

With a median of 34.7 U/mL (range 18.1-385.0 U/mL) for CA 125 and 2.3 U/mL (range 0.2-277.0 U/mL) for CA 72-4, serum tumor markers in BOT patients were significantly elevated as compared to healthy women with a median CA 125 of 13.5 U/mL (range 4.0-49.7 U/mL) and median CA 72-4 of 0.8 U/mL (range 0.2-20.6 U/mL). In addition, there was a significant difference compared with ovarian cancer patients who showed a median CA 125 of 401.5 U/mL (range 12.5-35,813 U/mL), but no difference was observed for CA 72-4 (median 3.9 U/mL, range 0.3-10,068 U/mL). Patients with a pT1a tumor stage had significantly lower values of CA 125 but not of CA 72-4 compared with individuals with higher tumor stages (median CA 125 29.9 U/mL for pT1a vs. 50.9 U/mL for >pT1a; p=0.014). There was a trend for increased concentrations of CA 125 but not of CA 72-4 in the presence of ascites, endometriosis or peritoneal implants at primary diagnosis. With respect to the prognostic value of CA 125 or CA 72-4, CA 125 was significantly higher at primary diagnosis in patients who later developed recurrence (251.0 U/mL vs. 34.65 U/mL, p=0.012).

CONCLUSIONS

Serum CA 125 and CA 72-4 concentrations in BOT patients differ from healthy controls and patients with ovarian cancer. CA 125, but not CA 72-4, at primary diagnosis correlates with tumor stage and tends to be increased in the presence of ascites, endometriosis or peritoneal implants. Moreover, CA 125 at primary diagnosis appears to have prognostic value for recurrence.

摘要

背景

本研究旨在评估癌抗原（CA）125和CA 72 - 4在卵巢交界性肿瘤（BOT）患者中的预后价值。

方法

纳入1981年至2008年间在本机构诊断并接受治疗的所有BOT女性患者（n = 101）进行这项回顾性研究。术前采集的血清样本检测CA 125（Architect检测平台，雅培公司；以及Elecsys检测平台，罗氏公司）和CA 72 - 4（Elecsys检测平台，罗氏公司），并参考临床数据，与健康女性（n = 109）和卵巢癌患者（n = 130）进行比较。

结果

BOT患者的CA 125中位数为34.7 U/mL（范围18.1 - 385.0 U/mL），CA 72 - 4中位数为2.3 U/mL（范围0.2 - 277.0 U/mL），与健康女性相比，血清肿瘤标志物显著升高，健康女性的CA 125中位数为13.5 U/mL（范围4.0 - 49.7 U/mL），CA 72 - 4中位数为0.8 U/mL（范围0.2 - 20.6 U/mL）。此外，与卵巢癌患者相比存在显著差异，卵巢癌患者的CA 125中位数为401.5 U/mL（范围12.5 - 35,813 U/mL），但CA 72 - 4无差异（中位数3.9 U/mL，范围0.3 - 10,068 U/mL）。与肿瘤分期较高的个体相比，pT1a期肿瘤患者的CA 125值显著较低，但CA 72 - 4无差异（pT1a期的CA 125中位数为29.9 U/mL，而>pT1a期为50.9 U/mL；p = 0.014）。在初次诊断时存在腹水、子宫内膜异位症或腹膜种植的情况下，CA 125浓度有升高趋势，但CA 72 - 4无此趋势。关于CA 125或CA 72 - 4的预后价值，初次诊断时CA 125在后来发生复发的患者中显著更高（251.0 U/mL对34.65 U/mL，p = 0.012）。