Xu F J, Yu Y H, Daly L, DeSombre K, Anselmino L, Hass G M, Berchuck A, Soper J T, Clarke-Pearson D L, Boyer C
Duke University Medical Center, Durham, NC 27710.
J Clin Oncol. 1993 Aug;11(8):1506-10. doi: 10.1200/JCO.1993.11.8.1506.
At second-look surgical surveillance procedures, normal CA-125 levels can be associated with persistent disease in 50% to 60% of patients. A novel radioimmunoassay (RIA) has been evaluated for the ability to identify patients with persistent disease who have normal levels of CA-125.
The OVX1 double-determinant assay used a murine monoclonal antibody to detect an epitope on a high-molecular weight mucin-like glycoprotein.
Apparently healthy individuals had serum OVX1 levels of 2.23 +/- 2.48 U/mL (mean +/- SD). Elevated serum OVX1 levels (> 7.2 U/mL) were found in 5% of 184 normal individuals and in 70% of 93 epithelial ovarian cancer patients with clinically evident disease. Among sera from these ovarian cancer patients, OVX1 was elevated in 68% of 76 samples with CA-125 levels more than 35 U/mL and in 76% of 17 samples with CA-125 levels less than 35 U/mL. In serum samples obtained at the time of positive second-look laparotomy, 59% of 41 patients with CA-125 levels less than 35 U/mL had elevated OVX1 antigen levels, whereas 41% of 22 patients with CA-125 levels more than 35 U/mL had elevated serum OVX1 levels. In patients with negative second-look laparotomies, false-positive results were eliminated by increasing the threshold of OVX1 to 10.5 U/mL. At this level, 32% of 41 patients with positive second-look operations had an elevated OVX1 level, despite a normal CA-125 level. When used in combination, CA-125 (> 35 U/mL) and OVX1 (> 10.5 U/mL) detected persistent disease in 56% of 63 patients with positive surveillance procedures, compared with 35% when CA-125 was used alone (P < .05).
An elevated OVX1 level can alert oncologists to the possibility that ovarian cancer has persisted, despite the return of CA-125 to a normal range.
在二次手术监测过程中，50%至60%的患者CA - 125水平正常时却可能存在持续性疾病。一种新型放射免疫测定法（RIA）已被评估用于识别CA - 125水平正常但患有持续性疾病的患者的能力。
OVX1双决定簇测定法使用一种鼠单克隆抗体来检测高分子量粘蛋白样糖蛋白上的一个表位。
表面健康的个体血清OVX1水平为2.23±2.48 U/mL（平均值±标准差）。在184名正常个体中有5%以及93名患有临床明显疾病的上皮性卵巢癌患者中有70%血清OVX1水平升高（>7.2 U/mL）。在这些卵巢癌患者的血清中，CA - 125水平超过35 U/mL的76份样本中有68%的OVX1升高，CA - 125水平低于35 U/mL的17份样本中有76%的OVX1升高。在二次剖腹探查阳性时采集的血清样本中，CA - 125水平低于35 U/mL的41名患者中有59%的OVX1抗原水平升高，而CA - 125水平超过35 U/mL的22名患者中有41%的血清OVX1水平升高。在二次剖腹探查阴性的患者中，通过将OVX1阈值提高到10.5 U/mL消除了假阳性结果。在此水平，二次探查手术阳性的41名患者中有32%的OVX1水平升高，尽管CA - 125水平正常。联合使用时，CA - 125（>35 U/mL）和OVX1（>10.5 U/mL）在63名监测程序阳性的患者中检测到56%的持续性疾病，而单独使用CA - 125时为35%（P <.05）。
尽管CA - 125恢复到正常范围，但OVX1水平升高可提醒肿瘤学家卵巢癌可能仍然存在。
