van Dalen A, Favier J, Hallensleben E, Burges A, Stieber P, de Bruijn H W A, Fink D, Ferrero A, McGing P, Harlozinska A, Kainz Ch, Markowska J, Molina R, Sturgeon C, Bowman A, Einarsson R, Goike H
Institute of Tumor Marker Oncology, Gouda, The Netherlands.
Eur J Gynaecol Oncol. 2009;30(6):609-15.
To evaluate the prognostic significance for overall survival rate for the marker combination TPS and CA125 in ovarian cancer patients after three chemotherapy courses during long-term clinical follow-up.
The overall survival of 212 (out of 213) ovarian cancer patients (FIGO Stages I-IV) was analyzed in a prospective multicenter study during a 10-year clinical follow-up by univariate and multivariate analysis.
In patients with ovarian cancer FIGO Stage I (34 patients) or FIGO Stage II (30 patients) disease, the univariate and multivariate analysis of the 10-year overall survival data showed that CA125 and TPS serum levels were not independent prognostic factors. In the FIGO Stage III group (112 patients), the 10-year overall survival was 15.2%; while in the FIGO Stage IV group (36 patients) a 10-year overall survival of 5.6% was seen. Here, the tumor markers CA125 and TPS levels were significant prognostic factors in both univariate and multivariate analysis (p < 0.0001). In a combined FIGO Stage III + FIGO Stage IV group (60 patients with optimal debulking surgery), multivariate analysis demonstrated that CA125 and TPS levels were independent prognostic factors. For patients in this combined FIGO Stage III + IV group having both markers below respective discrimination level, 35.3% survived for more than ten years, as opposed to patients having one marker above the discrimination level where the 10-year survival was reduced to 10% of the patients. For patients showing both markers above the respective discrimination level, none of the patients survived for the 10-year follow-up time.
In FIGO III and IV ovarian cancer patients, only patients with CA 125 and TPS markers below the discrimination level after three chemotherapy courses indicated a favorable prognosis. Patients with an elevated level of CA 125 or TPS or both markers after three chemotherapy courses showed unfavorable prognosis.
在长期临床随访期间，评估肿瘤标志物组合TPS和CA125对卵巢癌患者在三个化疗疗程后的总生存率的预后意义。
在一项前瞻性多中心研究中，对213例卵巢癌患者（国际妇产科联盟（FIGO）分期I-IV期）中的212例患者进行了为期10年的临床随访，通过单因素和多因素分析对其总生存率进行分析。
在FIGO I期（34例患者）或FIGO II期（30例患者）的卵巢癌患者中，对10年总生存数据的单因素和多因素分析表明，CA125和TPS血清水平不是独立的预后因素。在FIGO III期组（112例患者）中，10年总生存率为15.2%；而在FIGO IV期组（36例患者）中，10年总生存率为5.6%。在此，肿瘤标志物CA125和TPS水平在单因素和多因素分析中均为显著的预后因素（p<0.0001）。在FIGO III期+FIGO IV期联合组（60例接受了最佳减瘤手术的患者）中，多因素分析表明CA125和TPS水平是独立的预后因素。对于FIGO III期+IV期联合组中两种标志物均低于各自鉴别水平的患者，35.3%存活超过十年，而对于其中一种标志物高于鉴别水平的患者，10年生存率降至患者总数的10%。对于两种标志物均高于各自鉴别水平的患者，在10年随访期内无一例存活。
在FIGO III期和IV期卵巢癌患者中，只有在三个化疗疗程后CA125和TPS标志物低于鉴别水平的患者预后良好。在三个化疗疗程后CA125或TPS水平升高或两种标志物均升高的患者预后不良。
