Yu Zhong, Sun Yue, Guo Cuishan
Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
Front Oncol. 2024 Sep 27;14:1442814. doi: 10.3389/fonc.2024.1442814. eCollection 2024.
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.
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).
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).
Serum CA-125 levels before treatment was highly associated with prognosis of EC patients.
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。
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。
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）。
治疗前血清CA - 125水平与子宫内膜癌患者的预后高度相关。
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