Yang Zhi-Jun, Zhao Bing-Bing, Li Li
Department of Gynecologic Oncology, Affiliated Tumor Hospital of Guangxi Medical University, 71# Hedi Road, Nanning, Guangxi, 530021, People's Republic of China.
J Ovarian Res. 2016 Sep 15;9(1):57. doi: 10.1186/s13048-016-0266-3.
Ovarian cancer has the highest mortality rate of the three main malignant tumors of the female reproductive system, with a 5-year overall survival (OS) of only 20-30 %. Approximately 70 % of patients relapse without being cured. To explore the significance of serum CA125 level pre-treatment and the change pattern of CA125 post-treatment for judging prognosis and diagnosing recurrences of epithelial ovarian cancer (EOC).
A radioimmunoassay was used to continuously monitor levels of serum CA125 in 152 patients with EOC. The first test was done before surgery, then once a month after surgery for more than two consecutive years. The data were analyzed by using Kaplan-Meier curves and the log-rank test, stratified chi-square test, Pearson correlation analysis, and multivariate Cox regression analysis.
(1) There was a relationship between patient outcomes and the serum CA125 levels before treatment and the extent and speed of serum CA125 decrease after treatment. The outcomes of patients with pre-treatment serum CA125 ≤ 35 U/ml were better than those with serum CA125 > 35 U/ml; the outcomes of patients with serum CA125 who had a logarithmic decrease or a decrease to normal within a month after treatment were also better than those with a non-logarithmic decrease or a decrease to normal that took longer than a month. (2) The results of multivariate Cox regression analysis showed that serum CA125 levels before treatment and a decreased speed of decline after treatment were independent prognostic factors; (3) The mean level of serum CA125 at relapse was 116.28 U/ml. The average time from serum CA125 increase to detection of a recurrent lesion by physical or imaging examination was 122 days. The correlation coefficient of serum CA125 level increase and tumor recurrence time was -0.674. (4) The area under the Receiver Operating Characteristic (ROC) curve of serum CA125 for diagnosing EOC recurrence was 0.879, and the sensitivity and specificity were 67.39 and 86.79 %, respectively.
It is important to monitor serum CA125 levels pre-treatment and the change pattern of CA125 post-treatment for judging prognosis and diagnosing recurrences of EOC.
卵巢癌是女性生殖系统三大主要恶性肿瘤中死亡率最高的，其5年总生存率仅为20% - 30%。约70%的患者复发而未治愈。为探讨上皮性卵巢癌（EOC）治疗前血清CA125水平及治疗后CA125变化模式对判断预后和诊断复发的意义。
采用放射免疫分析法连续监测152例EOC患者血清CA125水平。首次检测在手术前进行，术后连续两年每月检测一次。采用Kaplan - Meier曲线、对数秩检验、分层χ²检验、Pearson相关分析和多因素Cox回归分析对数据进行分析。
（1）患者预后与治疗前血清CA125水平及治疗后血清CA125下降程度和速度有关。治疗前血清CA125≤35 U/ml的患者预后优于血清CA125>35 U/ml的患者；治疗后1个月内血清CA125呈对数下降或降至正常的患者预后也优于非对数下降或降至正常时间超过1个月的患者。（2）多因素Cox回归分析结果显示，治疗前血清CA125水平及治疗后下降速度是独立的预后因素；（3）复发时血清CA125平均水平为116.28 U/ml。从血清CA125升高到通过体格检查或影像学检查发现复发灶的平均时间为122天。血清CA125水平升高与肿瘤复发时间的相关系数为 - 0.674。（4）血清CA125诊断EOC复发的受试者工作特征（ROC）曲线下面积为0.879，灵敏度和特异度分别为67.39%和86.79%。
监测治疗前血清CA125水平及治疗后CA125变化模式对判断EOC预后和诊断复发具有重要意义。
