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[CA 125在卵巢癌中与传统肿瘤标志物相比的价值]

[Value of CA 125 in comparison to conventional tumor markers in ovarian cancer].

作者信息

Paulick R, Kaesemann H, Caffier H

出版信息

Geburtshilfe Frauenheilkd. 1986 Aug;46(8):509-14. doi: 10.1055/s-2008-1036246.

Abstract

It was the aim of this study to evaluate the clinical significance of the monoclonal test system CA 125 in comparison to 7 conventional laboratory procedures (TPA, PHI, CEA, LDH, GGT, AP, ESR) as tumour marker in ovarian cancer. Serum samples from 327 patients with histologically proven cancer of the ovary were analysed. Marker results were correlated to tumour activity as defined by the criteria of the UICC. Furthermore, in 175/327 patients who were clinically symptom-free after primary therapy, marker courses were analysed with regard to the development of recurrence. Positive rates and median values of CA 125, TPA, PHI and ESR showed significant increases with progression of the disease, whereas correlation was less clear-cut with CEA, LDH, GGT and AP. In clinically tumour-free patients without evidence of recurrence during the further course, intermittent increases of PHI, ESR and especially TPA were found in 19-47%. However, such "false positive" marker courses were not seen with CA 125. Those patients who developed recurrent disease exhibited increasing CA 125 titres in 68%. The incidence of such "true positive" markers courses was less frequent with PHI, ESR and TPA. Our results indicate that CA 125 and--with limitations--TPA, PHI and ESR may be used in ovarian cancer control. When monitoring tumour-free patients, CA 125 exhibited the highest specificity and sensitivity. Using 65 U/ml as cut-off, a positive CA 125 titre indicates recurrent disease with great certainty. When employing PHI, ESR and especially TPA, however, the possibility of "false positive" increases has to be taken into account.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本研究旨在评估单克隆检测系统CA 125与7种传统实验室检测项目(组织多肽抗原、磷脂酰肌醇蛋白聚糖、癌胚抗原、乳酸脱氢酶、γ-谷氨酰转移酶、碱性磷酸酶、红细胞沉降率)相比,作为卵巢癌肿瘤标志物的临床意义。对327例经组织学证实患有卵巢癌的患者的血清样本进行了分析。标志物结果与根据国际抗癌联盟标准定义的肿瘤活性相关。此外,在327例经初始治疗后临床无症状的患者中,有175例分析了标志物变化过程与复发情况的关系。CA 125、组织多肽抗原、磷脂酰肌醇蛋白聚糖和红细胞沉降率的阳性率及中位数随疾病进展显著升高,而与癌胚抗原、乳酸脱氢酶、γ-谷氨酰转移酶和碱性磷酸酶的相关性则不太明确。在临床无肿瘤且后续过程中无复发迹象的患者中,19% - 47%的患者出现了组织多肽抗原、红细胞沉降率尤其是组织多肽抗原的间歇性升高。然而,CA 125未出现此类“假阳性”标志物变化过程。复发患者中有68%的CA 125滴度升高。组织多肽抗原、红细胞沉降率和组织多肽抗原出现此类“真阳性”标志物变化过程的发生率较低。我们的结果表明,CA 125以及在一定程度上组织多肽抗原、磷脂酰肌醇蛋白聚糖和红细胞沉降率可用于卵巢癌监测。在监测无肿瘤患者时,CA 125表现出最高的特异性和敏感性。以65 U/ml作为临界值,CA 125滴度阳性高度提示复发。然而,使用组织多肽抗原、红细胞沉降率尤其是组织多肽抗原时,必须考虑“假阳性”增加的可能性。(摘要截选至250词)

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[Tumor-associated antigens and fibrin derivatives as reaction products of ovarian cancer].
Geburtshilfe Frauenheilkd. 1986 Jan;46(1):1-10. doi: 10.1055/s-2008-1036152.

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