评估术前血清CA-125水平作为子宫内膜癌的预后生物标志物：一项全面的荟萃分析。

Evaluating pretreatment serum CA-125 levels as prognostic biomarkers in endometrial cancer: a comprehensive meta-analysis.

作者信息

Yu Zhong, Sun Yue, Guo Cuishan

机构信息

Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.

出版信息

Front Oncol. 2024 Sep 27;14:1442814. doi: 10.3389/fonc.2024.1442814. eCollection 2024.

DOI:10.3389/fonc.2024.1442814

PMID:39399178

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11466722/

Abstract

BACKGROUND

In recent years, the incidence of endometrial cancer (EC) has been rising. This meta-analysis aims to clarify the prognostic significance of serum CA-125 levels in EC.

METHODS

Articles up to March 1, 2024, were systematically searched in EMBASE, Cochrane Library, PubMed, and Web of Science. This analysis pooled hazard ratios (HR) and 95% confidence intervals (CI) from qualifying studies to evaluate the association of CA-125 levels with overall survival (OS), progression-free survival (PFS), disease-free/relapse-free survival (DFS/RFS), and disease-specific survival (DSS).

RESULTS

25 studies involving 7,716 patients were included. The analysis revealed that elevated CA-125 levels correlate with poorer OS (HR = 1.848, 95% CI: 1.571-2.175, p < 0.001). This association persisted across various study regions and sample sizes, and was notably strong in subgroups with a CA-125 cut-off value of less than 35 (HR = 2.07, 95% CI: 1.13-3.80, p = 0.019) and equal to 35 (HR = 2.04, 95% CI: 1.49-2.79, p < 0.001), and among type II pathology patients (HR = 1.72, 95% CI: 1.07-2.77, p = 0.025). Similarly, high CA-125 levels were linked to reduced PFS, particularly in subgroups with a CA-125 cut-off value less than 35 (HR = 1.87, 95% CI: 1.15-3.04, p = 0.012) and equal to 35 (HR = 4.94, 95% CI: 2.56-9.54, p < 0.001), and in endometrioid endometrial cancer patients (HR = 2.28, 95% CI: 1.18-4.40, p = 0.014). Elevated CA-125 levels were also indicative of worse DFS/RFS (HR = 2.17, 95% CI: 1.444-3.262, p < 0.001) and DSS (HR = 2.854; 95% CI: 1.970-4.133, p < 0.001).

CONCLUSION

Serum CA-125 levels before treatment was highly associated with prognosis of EC patients.

摘要

背景

近年来，子宫内膜癌（EC）的发病率一直在上升。本荟萃分析旨在阐明血清CA - 125水平在子宫内膜癌中的预后意义。

方法

截至2024年3月1日的文章在EMBASE、Cochrane图书馆、PubMed和科学网中进行了系统检索。本分析汇总了符合条件研究的风险比（HR）和95%置信区间（CI），以评估CA - 125水平与总生存期（OS）、无进展生存期（PFS）、无病/无复发生存期（DFS/RFS）和疾病特异性生存期（DSS）之间的关联。

结果

纳入了25项涉及7716例患者的研究。分析显示，CA - 125水平升高与较差的总生存期相关（HR = 1.848，95% CI：1.571 - 2.175，p < 0.001）。这种关联在各个研究地区和样本量中均持续存在，并且在CA - 125临界值小于35（HR = 2.07，95% CI：1.13 - 3.80，p = 0.019）和等于35（HR = 2.04，95% CI：1.49 - 2.79，p < 0.001）的亚组以及II型病理患者中（HR = 1.72，95% CI：1.07 - 2.77，p = 0.025）尤为明显。同样，高CA - 125水平与无进展生存期缩短相关，特别是在CA - 125临界值小于35（HR = 1.87，95% CI：1.15 - 3.04，p = 0.012）和等于35（HR = 4.94，95% CI：2.56 - 9.54，p < 0.001）的亚组以及子宫内膜样子宫内膜癌患者中（HR = 2.28，95% CI：1.18 - 4.40，p = 0.014）。CA - 125水平升高也表明无病/无复发生存期（HR = 2.17，95% CI：1.444 - 3.262，p < 0.001）和疾病特异性生存期较差（HR = 2.854；95% CI：1.970 - 4.133，p < 0.001）。