上皮性卵巢癌治疗前血清CA-125升高的预后价值：一项Meta分析
Prognostic Value of Elevated Pre-treatment Serum CA-125 in Epithelial Ovarian Cancer: A Meta-Analysis.
作者信息
Wang Qingyi, Feng Xiaoling, Liu Xiaofang, Zhu Siyu
机构信息
Department of First Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin, China.
Department of Gynecology, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China.
出版信息
Front Oncol. 2022 Apr 7;12:868061. doi: 10.3389/fonc.2022.868061. eCollection 2022.
BACKGROUND
CA-125 is a clinical biomarker with predictive effect on the prognosis of different cancers. Numerous clinical trials have been conducted to investigate the possibility of using the pretreatment level of CA-125 to predict the prognosis of epithelial ovarian cancer (EOC). However, its value in predicting prognosis remains controversial. The purpose of this meta-analysis was to assess the predictive value of pretreatment CA-125 levels for prognosis in EOC patients.
METHODS
We searched the EMBASE, Cochrane library, PubMed and Web of Science databases for studies published up to 3 December 2021, according to specific inclusion and exclusion criteria. The clinical studies that were included investigated the relationship between pretreatment CA-125 levels and ovarian cancer prognosis. Combined hazard ratios (HR) of overall survival (OS) and progression-free survival (PFS) reported in the studies were compared and analyzed using fixed-effects/random-effects models. Sensitivity analysis was used to assess study stability, while Egger's and Begg's tests were used to assess publication bias.
RESULTS
This meta-analysis included 23 studies published in 2004 - 2021 with a total of 10,594 EOC patients. Comprehensive analysis demonstrated that the serum level of CA-125 before treatment was significantly correlated with overall survival (OS: HR=1.62, 95%CI=1.270-2.060, p<0.001) and progression-free survival (PFS: HR=1.59, PFS: HR=1.59, 95%CI=1.44~1.76, p<0.001). After comparing data from different FIGO stages and treatments, we discovered that a high pre-treatment serum CA-125 level was associated with a low survival rate.
CONCLUSION
According to the results of this study, a higher pre-treatment serum CA-125 level is associated with poor survival outcomes, which can be utilized to predict the prognosis of EOC patients. Pre-treatment serum CA-125 level might provide reliable basis for predicting the risk of EOC disease progression. This study is registered with the International Prospective Register of Systematic Reviews (CRD42022300545).
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=300545, identifier [CRD42022300545].
背景
CA - 125是一种对不同癌症预后具有预测作用的临床生物标志物。已经进行了大量临床试验来研究使用CA - 125的治疗前水平预测上皮性卵巢癌（EOC）预后的可能性。然而，其在预测预后方面的价值仍存在争议。本荟萃分析的目的是评估治疗前CA - 125水平对EOC患者预后的预测价值。
方法
我们根据特定的纳入和排除标准，检索了截至2021年12月3日在EMBASE、Cochrane图书馆、PubMed和Web of Science数据库中发表的研究。纳入的临床研究调查了治疗前CA - 125水平与卵巢癌预后之间的关系。使用固定效应/随机效应模型对研究中报告的总生存期（OS）和无进展生存期（PFS）的合并风险比（HR）进行比较和分析。敏感性分析用于评估研究的稳定性，而Egger检验和Begg检验用于评估发表偏倚。
结果
本荟萃分析纳入了2004年至2021年发表的23项研究，共10594例EOC患者。综合分析表明，治疗前CA - 125血清水平与总生存期（OS：HR = 1.62，95%CI = 1.270 - 2.060，p < 0.001）和无进展生存期（PFS：HR = 1.59，PFS：HR = 1.59，95%CI = 1.44~1.76，p < 0.001）显著相关。在比较不同FIGO分期和治疗的数据后，我们发现治疗前血清CA - 125水平高与生存率低相关。
结论
根据本研究结果，治疗前血清CA - 125水平较高与生存结果较差相关，可用于预测EOC患者的预后。治疗前血清CA - 125水平可能为预测EOC疾病进展风险提供可靠依据。本研究已在国际系统评价前瞻性注册库（CRD42022300545）注册。
系统评价注册
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=300545，标识符[CRD42022300545]
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