Jacobs I J, Skates S, Davies A P, Woolas R P, Jeyerajah A, Weidemann P, Sibley K, Oram D H
Department of Gynaecological Oncology, St Bartholomew's Hospital, London.
BMJ. 1996 Nov 30;313(7069):1355-8. doi: 10.1136/bmj.313.7069.1355.
To determine the risk of invasive epithelial ovarian cancer and fallopian tube cancer associated with a raised concentration of the tumour marker CA 125 in asymptomatic postmenopausal women.
Serum CA 125 concentration was measured annually in study participants for one to four years. Participants with a concentration > or = 30 U/ml were recalled for abdominal ultrasonography. Follow up was by annual postal questionnaire.
General practice, occupational health departments, ovarian cancer screening unit in a teaching hospital.
22,000 volunteers, all postmenopausal women > or = 45 years of age; recruited between 1 June 1986 and 1 May 1990.
Surgical investigation if the ultrasound examination was abnormal.
Cumulative and relative risk of developing an index cancer (invasive epithelial cancer of the ovary or fallopian tube) after a specified CA 125 result.
49 index cancers developed in the study population during a mean follow up of 6.76 years. The overall cumulative risk of developing an index cancer was 0.0022 for the entire study population and was lower for women with a serum CA 125 concentration < 30 U/ml (cumulative risk 0.0012) but was appreciably increased for women with a concentration > or = 30 U/ml (0.030) and > 100 U/ml (0.149). Compared with the entire study population the relative risk of developing an index cancer within one year and five years was increased 35.9-fold (95% confidence interval 18.3 to 70.4) and 14.3-fold (8.5 to 24.3) respectively after a serum CA 125 concentration > or = 30 U/ml and 204.8-fold (79.0 to 530.7) and 74.5-fold (31.1 to 178.3) respectively after a concentration > or = 100 U/ml.
CA 125 is a powerful index of risk of ovarian and fallopian tube cancer in asymptomatic postmenopausal women.
确定无症状绝经后女性中肿瘤标志物CA 125浓度升高与侵袭性上皮性卵巢癌和输卵管癌的风险。
在一至四年内每年测量研究参与者的血清CA 125浓度。CA 125浓度≥30 U/ml的参与者被召回进行腹部超声检查。通过年度邮寄问卷进行随访。
全科医疗、职业健康部门、教学医院的卵巢癌筛查单位。
22000名志愿者，均为年龄≥45岁的绝经后女性；于1986年6月1日至1990年5月1日招募。
如果超声检查异常则进行手术检查。
在特定CA 125结果后发生指数癌（卵巢或输卵管侵袭性上皮癌）的累积风险和相对风险。
在平均6.76年的随访期间，研究人群中发生了49例指数癌。整个研究人群发生指数癌的总体累积风险为0.0022，血清CA 125浓度<30 U/ml的女性累积风险较低（累积风险0.0012），但浓度≥30 U/ml（0.030）和>100 U/ml（0.149）的女性风险显著增加。与整个研究人群相比，血清CA 125浓度≥30 U/ml后一年内和五年内发生指数癌的相对风险分别增加35.9倍（95%置信区间18.3至70.4）和14.3倍（8.5至24.3），浓度≥100 U/ml后分别增加204.8倍（79.0至530.7）和74.5倍（31.1至178.3）。
CA 125是无症状绝经后女性卵巢和输卵管癌风险的有力指标。
