术前血清 CA-125 水平可预测晚期上皮性卵巢癌患者肿瘤细胞减灭术的范围。
Preoperative serum CA-125 level as a predictor for the extent of cytoreduction in patients with advanced stage epithelial ovarian cancer.
机构信息
Department of Gynaecological Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
出版信息
Radiol Oncol. 2021 Aug 10;55(3):341-346. doi: 10.2478/raon-2021-0013.
BACKGROUND
Ovarian cancer is the seventh most common cancer in women worldwide and the eighth most common cause of cancer death. Due to the lack of effective early detection strategies and the unspecific onset of symptoms, it is diagnosed at an advanced stage in 75% of cases. The cancer antigen (CA) 125 is used as a prognostic marker and its level is elevated in more than 85% of women with advanced stages of epithelial ovarian cancer (EOC). The standard treatment is primary debulking surgery (PDS) followed by adjuvant chemotherapy (ACT), but the later approach is neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS). Several studies have been conducted to find out whether preoperative CA-125 serum levels influence treatment choice, surgical resection and survival outcome. The aim of our study was to analyse experience of single institution as Cancer comprehensive center with preoperative usefulness of CA-125.
PATIENTS AND METHODS
At the Institute of Oncology Ljubljana a retrospective analysis of 253 women with stage FIGO IIIC and IV ovarian cancer was conducted. Women were divided into two groups based on their primary treatment. The first group was the NACT group (215 women) and the second the PDS group (38 women). The differences in patient characteristics were compared using the Chi-square test and ANOVA and the Kaplan-Meier method was used for calculating progression-free survival (PFS) and overall survival (OS).
RESULTS
The median serum CA-125 level was higher in the NACT group than in the PDS group, 972 IU/ml and 499 IU/ ml, respectively. The PFS in the NACT group was 8 months (95% CI 6.4-9.5) and 18 months (95% CI 12.5-23.4) in the PDS group. The median OS was lower in the NACT group than in the PDS group, 25 months (95% CI 20.6-29.5) and 46 months (95% CI 32.9-62.1), respectively.
CONCLUSIONS
Preoperative CA-125 cut off value of 500 IU/ml is a promising threshold to predict a successful PDS.
背景
卵巢癌是全球女性中第七种最常见的癌症，也是第八种最常见的癌症死因。由于缺乏有效的早期检测策略和症状的非特异性，75%的病例在晚期才被诊断出来。癌症抗原（CA）125 被用作预后标志物，超过 85%的晚期上皮性卵巢癌（EOC）女性的 CA125 水平升高。标准治疗是初次减瘤手术（PDS）后辅助化疗（ACT），但后续方法是新辅助化疗（NACT）后间隔减瘤手术（IDS）。已经进行了多项研究，以确定术前 CA-125 血清水平是否影响治疗选择、手术切除和生存结局。我们的研究旨在分析作为癌症综合中心的单机构经验，并探讨术前 CA-125 的有用性。
患者和方法
在卢布尔雅那肿瘤研究所，对 253 名 FIGO IIIC 和 IV 期卵巢癌女性进行了回顾性分析。根据主要治疗方法将女性分为两组。第一组为 NACT 组（215 例），第二组为 PDS 组（38 例）。使用卡方检验和 ANOVA 比较患者特征的差异，使用 Kaplan-Meier 方法计算无进展生存期（PFS）和总生存期（OS）。
结果
NACT 组的中位血清 CA-125 水平高于 PDS 组，分别为 972IU/ml 和 499IU/ml。NACT 组的 PFS 为 8 个月（95%CI 6.4-9.5），PDS 组为 18 个月（95%CI 12.5-23.4）。NACT 组的中位 OS 低于 PDS 组，分别为 25 个月（95%CI 20.6-29.5）和 46 个月（95%CI 32.9-62.1）。
结论
术前 CA-125 截断值 500IU/ml 是预测 PDS 成功的有希望的阈值。
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