Muhammad Shittu Adamu, Olaoye Stephen Oyewole, Umar Farouk Kabir
Department of Obstetrics and Gynaecology, Federal Medical Centre Gusau, Zamfara State, Nigeria.
Department of Radiology, Usman Danfodiyo University Teaching Hospital, Sokoto, Sokoto State, Nigeria.
Niger Med J. 2024 May 23;65(2):108-118. doi: 10.60787/nmj-v65i2-418. eCollection 2024 Mar-Apr.
Most patients with epithelial ovarian cancers (EOC) present with advanced-stage disease because of non-specific symptoms and lack of reliable strategies for early diagnosis. Cancer antigen 125 (CA-125) is suggested as a useful prognostic biomarker, its serum level is raised in over 80.0% of patients with EOC. Primary debulking surgery (PDS) followed by chemotherapy is the conventional treatment, but neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS) is offered to patients with unresectable disease. There are inconsistencies regarding the role of preoperative CA-125 serum levels to adopt in stratifying patients for treatment choice that offers the most benefit. This review aimed to determine the role of preoperative CA-125 levels in predicting optimal cytoreduction and the association between optimal cytoreduction and survival outcome in patients with EOC.
Three electronic databases CINAHL, Cochrane library and PubMed were searched for potentially relevant articles from 2016 to 2021 on the role of preoperative CA-125 levels in predicting optimal cytoreduction and survival in patients with epithelial ovarian carcinomas.
In patients who underwent NACT-IDS, a lower preoperative CA-125 value is a predictor of optimal cytoreduction and an increase in preoperative CA-125 value is consistently associated with a decrease in optimal cytoreduction. There was insufficient data to assess overall survival. However, a raised preoperative CA-125 level is poor predictor of chance of achieving optimal cytoreduction and the rate of optimal cytoreduction was a weak predictor of overall survival in women who had primary debulking surgery.
大多数上皮性卵巢癌（EOC）患者因症状不特异且缺乏可靠的早期诊断策略而在疾病晚期才被发现。癌抗原125（CA-125）被认为是一种有用的预后生物标志物，超过80.0%的EOC患者血清水平升高。初始肿瘤细胞减灭术（PDS）后进行化疗是传统治疗方法，但对于无法切除的疾病患者，则采用新辅助化疗后进行间隔肿瘤细胞减灭术（NACT-IDS）。关于术前CA-125血清水平在对患者进行分层以选择最有益治疗方案中的作用，存在不一致的观点。本综述旨在确定术前CA-125水平在预测EOC患者最佳肿瘤细胞减灭方面的作用，以及最佳肿瘤细胞减灭与生存结果之间的关联。
检索了三个电子数据库CINAHL、Cochrane图书馆和PubMed，以查找2016年至2021年期间关于术前CA-125水平在预测上皮性卵巢癌患者最佳肿瘤细胞减灭和生存方面作用的潜在相关文章。
在接受NACT-IDS的患者中，术前CA-125值较低是最佳肿瘤细胞减灭的预测指标，术前CA-125值升高与最佳肿瘤细胞减灭率降低始终相关。评估总生存的数据不足。然而，术前CA-125水平升高对实现最佳肿瘤细胞减灭可能性的预测较差，而最佳肿瘤细胞减灭率对接受初始肿瘤细胞减灭术的女性总生存的预测作用较弱。
