Tomás C, Penttinen J, Risteli J, Risteli L, Vuori J, Kauppila A
Department of Obstetrics and Gynecology, University of Oulu, Finland.
Cancer. 1990 Dec 1;66(11):2399-406. doi: 10.1002/1097-0142(19901201)66:11<2399::aid-cncr2820661126>3.0.co;2-e.
Serum CA 125 (a marker of coelomic epithelial cells) and aminoterminal propeptide of type III procollagen (PIIINP; an indicator of collagen metabolism) concentrations were measured in 148 patients with endometrial carcinoma. An initial serum concentration of CA 125 was pathologic in 17% of the patients, the frequency of abnormal values being higher (P = 0.0001) in advanced (63%) than in early disease (10%). The serum PIIINP concentration was increased in 35% of the patients and more often (P less than 0.05) so in advanced (63%) than in early disease (31%). Among all the patients, at least one of the tumor markers was increased in 43% of the cases. In early disease 12 of 108 patients contracted recurrent cancer. The accuracy of the pathologic CA 125 (9%) and PIIINP (18%) concentrations in their prediction was poor. In the total material, pathologic CA 125 and PIIINP concentrations appeared simultaneously in 11 patients, of whom eight had poor prognoses. In monitoring of treatment response of 24 patients, regression was accompanied by normal or decreasing CA 125 and PIIINP values. The persistence of pathologic CA 125 and/or PIIINP concentration predicted relapse of the malignancy. In progressive disease, CA 125 and PIIINP concentrations together or separately remained at a pathologic level or increased continuously. In clinically stable endometrial carcinoma, CA 125 gave false-negative results in 71% of the determinations and PIIINP only in 12%. The current results suggest the use of CA 125 and PIIINP, simultaneously, in monitoring the clinical course of advanced endometrial carcinoma.
对148例子宫内膜癌患者测定了血清CA 125(体腔上皮细胞标志物)和Ⅲ型前胶原氨基端前肽(PIIINP;胶原代谢指标)的浓度。17%的患者CA 125初始血清浓度异常,晚期患者(63%)异常值出现频率高于早期疾病患者(10%)(P = 0.0001)。35%的患者血清PIIINP浓度升高,晚期患者(63%)升高的比例高于早期疾病患者(31%)(P<0.05)。在所有患者中,43%的病例至少有一种肿瘤标志物升高。早期疾病患者中,108例中有12例复发。CA 125(9%)和PIIINP(18%)浓度异常对复发的预测准确性较差。在全部病例中,11例患者同时出现CA 125和PIIINP浓度异常,其中8例预后不良。在对24例患者的治疗反应监测中,CA 125和PIIINP值正常或下降伴随病情缓解。CA 125和/或PIIINP浓度异常持续提示恶性肿瘤复发。病情进展时,CA 125和PIIINP浓度共同或分别维持在异常水平或持续升高。在临床病情稳定的子宫内膜癌患者中,CA 125检测结果假阴性率为71%,而PIIINP仅为12%。目前的结果提示,可同时使用CA 125和PIIINP监测晚期子宫内膜癌的临床病程。