Atguden Zeynep, Yildiz Askin, Aksut Hayri, Yalcin Serenat Eris, Yalcin Yakup, Uysal Dilek, Yetimalar Hakan
Gynecology and Obstetrics Department, Akropol Medical Hospital, Ankara, Turkey E-mail :
Asian Pac J Cancer Prev. 2016;17(2):497-501. doi: 10.7314/apjcp.2016.17.2.497.
To evaluate the relationship between pre-operative CA-125 levels and myometrial invasion in patients with early-stage endometrioid-type endometrial cancer.
Two-hundred and sixty patients were diagnosed with endometrial cancer between January 2007 and December 2012. Of these, 136 patients with stage 1 endometrioid histologic-type and documented pre-operative serum CA-125 levels were included in the study. Age, preoperative CA-125 level, histologic grade, surgical grade, and presence of deep myometrial invasion were recorded. Additionally, 16, 20, and 35 IU/ml cutoff values were used and compared to evaluate the relationship between pre-operative CA-125 levels and myometrial invasion.
The average serum CA-125 level was 35.4±36.7 in patients with deep myometrial invasion, and 21.5±35.8 in cases without deep myometrial invasion. The relationship between the presence of deep myometrial invasion and CA-125 cut-off values (16, 20, 35 IU/ml) was statistically significant, although the correlation was weak (p<0.05). When the relationship between 16, 20 and 35 IU/ml CA-125 cut-off values and the presence of deep myometrial invasion was studied, specifity and sensitivity values were identified as: 0.60-0.68 for 16 IU/ml; 0.73-0.48 for 20 IU/ml; and 0.89-0.33 for 35 IU/ml. The sensitivity of 16 IU/ml cut-off value was higher when compared to other values.
This study demonstrates that preoperative serum CA-125 values maybe used as a predictive test in patients with early stage endometrioid-type endometrium cancer, and as a prognostic factor alone. Further studies should be conducted to identify different CA-125 cut-off values in patients with low risk endometrial cancer.
评估早期子宫内膜样型子宫内膜癌患者术前CA - 125水平与肌层浸润之间的关系。
2007年1月至2012年12月期间，260例患者被诊断为子宫内膜癌。其中，136例组织学类型为1期子宫内膜样型且有术前血清CA - 125水平记录的患者被纳入研究。记录患者年龄、术前CA - 125水平、组织学分级、手术分级以及是否存在肌层深部浸润。此外，采用16、20和35 IU/ml的临界值并进行比较，以评估术前CA - 125水平与肌层浸润之间的关系。
肌层深部浸润患者的平均血清CA - 125水平为35.4±36.7，无肌层深部浸润患者为21.5±35.8。肌层深部浸润与CA - 125临界值（16、20、35 IU/ml）之间的关系具有统计学意义，尽管相关性较弱（p<0.05）。研究16、20和35 IU/ml CA - 125临界值与肌层深部浸润的关系时，特异性和敏感性值分别为：16 IU/ml时为0.60 - 0.68；20 IU/ml时为0.73 - 0.48；35 IU/ml时为0.89 - 0.33。与其他值相比，16 IU/ml临界值的敏感性更高。
本研究表明，术前血清CA - 125值可作为早期子宫内膜样型子宫内膜癌患者的预测性检测指标，且可单独作为预后因素。应进一步开展研究，以确定低风险子宫内膜癌患者的不同CA - 125临界值。
