Division of Gynecologic Oncology, Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada.
Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada.
Int J Gynaecol Obstet. 2018 Feb;140(2):247-252. doi: 10.1002/ijgo.12376. Epub 2017 Nov 26.
To investigate the ability of preoperative CA125 and post-surgical CA125 changes to predict outcomes among patients with high-grade serous ovarian cancer (HGSC).
The present retrospective cohort study included patients with HGSC who underwent surgery between January 1, 2003, and December 31, 2011 at Princess Margaret Cancer Center, Toronto, ON, Canada. CA125 was measured at diagnosis and following surgery, and the CA125 ratio was calculated (preoperative CA125/postoperative CA125). Optimal CA125 cutoff levels were identified using the point with the most significant log-rank-test result. Univariate and multivariate analyses with Cox proportional hazard modeling was used to study overall survival.
Among 212 patients, an optimal baseline CA125 cutoff value of 174 U/mL and a seven-fold decrease in CA125 after surgery were positive prognostic indicators. A 10-fold increase in baseline CA125 was associated with decreased overall survival (univariate hazard ratio 1.55, 95% confidence interval [CI] 1.17-2.06; P=0.002; multivariate hazard ratio 1.72, 95% CI 1.21-2.44; P=0.002). An increase in the CA125 ratio (log [preoperative CA125/postoperative CA125]) was associated with improved overall survival (univariate hazard ratio 0.63, 95% CI 0.43-0.90; P=0.012; multivariate hazard ratio 0.41, 95% CI 0.24-0.70, P<0.001).
CA125 demonstrated prognostic value for HGSC; baseline CA125 of 174 U/mL or lower and a post-surgical decline of seven-fold or greater were associated with improved overall survival.
探讨术前 CA125 和术后 CA125 变化预测高级别浆液性卵巢癌（HGSC）患者结局的能力。
本回顾性队列研究纳入了 2003 年 1 月 1 日至 2011 年 12 月 31 日在加拿大安大略省多伦多玛格丽特公主癌症中心接受手术的 HGSC 患者。在诊断时和手术后测量 CA125，并计算 CA125 比值（术前 CA125/术后 CA125）。使用具有最显著对数秩检验结果的点确定最佳 CA125 截止值。使用 Cox 比例风险模型进行单变量和多变量分析以研究总生存率。
在 212 例患者中，基线 CA125 最佳截断值为 174 U/mL，术后 CA125 下降 7 倍是预后良好的指标。基线 CA125 增加 10 倍与总生存率降低相关（单变量危险比 1.55，95%置信区间 [CI] 1.17-2.06；P=0.002；多变量危险比 1.72，95% CI 1.21-2.44；P=0.002）。CA125 比值（log[术前 CA125/术后 CA125]）增加与总生存率提高相关（单变量危险比 0.63，95%CI 0.43-0.90；P=0.012；多变量危险比 0.41，95%CI 0.24-0.70，P<0.001）。
CA125 对 HGSC 具有预后价值；基线 CA125 为 174 U/mL 或更低，术后下降 7 倍或更高与总生存率提高相关。
