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血清 HE4 和 CA125 的早期清除预测上皮性卵巢癌对铂类药物的敏感性和预后。

Early clearance of serum HE4 and CA125 in predicting platinum sensitivity and prognosis in epithelial ovarian cancer.

机构信息

Department of Gynecologic Oncology, Guangxi Medical University Cancer Hospital, 71 Hedi Road, Nanning, Guangxi, 530021, People's Republic of China.

Key Laboratory of Early Prevention and Treatment of Regional High-Incidence Tumors, Ministry of Education, No.22 Shuangyong Road, Nanning, 530021, People's Republic of China.

出版信息

J Ovarian Res. 2021 Jan 4;14(1):2. doi: 10.1186/s13048-020-00759-9.

Abstract

OBJECTIVES

To assess the clinical value of early clearance of HE4 and CA125 for platinum sensitivity and prognosis in patients with ovarian cancer.

METHOD

HE4 and CA125 value including clinical data of 89 patients with ovarian cancer were collected. The clearance of HE4 and CA125 were assessed base on the platinum sensitivity, two-year PFS, PFS and OS.

RESULTS

Sixteen patients were classified as platinum resistant and 73 as platinum sensitive according to the response to platinum-base chemotherapy. When HE4 clearance after 3rd cycle chemotherapy or CA125 clearance after 1st cycle chemotherapy, it gave the highest AUC of 0.788, with 100% of sensitivity and 57.5% of specificity respectively between platinum resistant and platinum sensitive group. In addition, 59 patients were classified as two-year PFS group and 30 as not achieved two-year PFS group according to obtaining two-year PFS or not. It gave the highest AUC of 0.730, with 83.3% of sensitivity and 62.7% of specificity respectively when HE4 clearance after 3rd cycle chemotherapy or CA125 clearance after 1st cycle. The prolonged PFS and OS were significantly associated by the clearance of HE4 after 3rd cycle chemotherapy (p< 0.0001, p< 0.0001) as well as CA125 after 1st cycle chemotherapy (p< 0.0001, p< 0.0001).

CONCLUSIONS

Our data suggested that the early clearance of HE4 and CA125 could predict platinum response and prognosis in patients with ovarian cancer. Monitoring the HE4 and CA125 during first-line chemotherapy might be helpful in predicting platinum sensitivity and risk to progress and relapse.

摘要

目的

评估 HE4 和 CA125 早期清除率对卵巢癌患者铂类药物敏感性和预后的临床价值。

方法

收集 89 例卵巢癌患者的 HE4 和 CA125 值及临床资料,根据铂类药物敏感性、2 年 PFS、PFS 和 OS 评估 HE4 和 CA125 的清除率。

结果

根据铂类化疗药物的反应,16 例患者被分为铂耐药组,73 例患者被分为铂敏感组。当第 3 周期化疗后 HE4 清除率或第 1 周期化疗后 CA125 清除率时,其在铂耐药组和铂敏感组之间的 AUC 最高为 0.788,灵敏度为 100%,特异性为 57.5%。此外,根据是否获得 2 年 PFS 将 59 例患者分为 2 年 PFS 组和 30 例未达到 2 年 PFS 组。当第 3 周期化疗后 HE4 清除率或第 1 周期化疗后 CA125 清除率时,其 AUC 最高为 0.730,灵敏度为 83.3%,特异性为 62.7%。第 3 周期化疗后 HE4 清除率(p<0.0001,p<0.0001)以及第 1 周期化疗后 CA125 清除率(p<0.0001,p<0.0001)与 PFS 和 OS 的延长显著相关。

结论

本研究数据表明,HE4 和 CA125 的早期清除率可预测卵巢癌患者的铂类药物反应和预后。在一线化疗期间监测 HE4 和 CA125 可能有助于预测铂类药物敏感性以及进展和复发的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dace/7780648/f707fde9225d/13048_2020_759_Fig1_HTML.jpg

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