化疗后 CA125 正常化独立预测晚期子宫内膜癌的生存。

CA 125 normalization with chemotherapy is independently predictive of survival in advanced endometrial cancer.

机构信息

Division of Medical Oncology, BC Cancer Agency, Vancouver, British Columbia, Canada.

出版信息

Gynecol Oncol. 2011 Jan;120(1):52-5. doi: 10.1016/j.ygyno.2010.09.014. Epub 2010 Oct 13.

DOI:10.1016/j.ygyno.2010.09.014

PMID:20947152

Abstract

OBJECTIVE

Changes in CA 125 with chemotherapy predict outcome for epithelial ovarian cancer. There is no such data for advanced endometrial cancer.

METHOD

Retrospective review of all women receiving carboplatin and paclitaxel for advanced endometrial cancer at any of the institutions of the British Columbia Cancer Agency between September 1995 and September 2006.

RESULTS

185 newly diagnosed women were treated. Univariable analysis for progression-free survival identified as adverse predictors: grade 3, positive residual, age > 60, deep myometrial invasion, increasing stage/substage, papillary serous subtype, presence of cervical involvement, ECOG 1 or greater, CA 125 above 35 either preoperatively or at start of cycle 1 and CA 125 greater than 24 at the start of cycle 3. Upon multivariate analysis, CA 125 above 24 at cycle 3, grade 3 and positive residual remained as independent predictors. The single most important factor identified by decision tree analysis was CA 125 level at cycle 3.

CONCLUSION

As with epithelial ovarian cancer, changes in CA 125 are highly predictive of outcome for advanced, chemotherapy treated endometrial cancer.

摘要

目的

化疗过程中 CA125 的变化可预测上皮性卵巢癌的预后。然而，对于晚期子宫内膜癌，尚无此类数据。

方法

回顾性分析了不列颠哥伦比亚癌症中心所有机构于 1995 年 9 月至 2006 年 9 月期间接受卡铂联合紫杉醇治疗的晚期子宫内膜癌患者的临床资料。

结果

共纳入 185 例新诊断的女性患者。单因素分析显示，无进展生存期的不良预测因素包括：组织学分级为 3 级、有残留病灶、年龄>60 岁、深肌层浸润、分期/亚分期增加、乳头状浆液性亚型、宫颈受累、ECOG 评分为 1 或更高、术前或第 1 周期开始时 CA125 超过 35U/ml 和第 3 周期开始时 CA125 超过 24U/ml。多因素分析显示，第 3 周期 CA125 超过 24U/ml、组织学分级为 3 级和有残留病灶是独立的预测因素。决策树分析确定的最重要因素是第 3 周期的 CA125 水平。