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分别对25例卵巢恶性上皮性肿瘤患者化疗期间以及8例存活时间≥5年的患者二次探查术前、后的血清CA125值进行了动态监测。结果:术前或首次化疗期间,血清CA125值≥65U/ml者占80%(20/25)。在化疗第3疗程之前,633%(14/22)患者血清CA125值降至≤35U/ml;6例血清CA125值≥65U/ml患者中,5例盆腔内有癌肿持续存在。化疗第3疗程以后各疗程期间,血清CA125值≥35U/ml者6例,5例盆腔内有癌肿的复发或持续存在。存活时间≥5年、二次探查术组织病理学检查结果阴性的5例中,4例血清CA125值持续<20U/ml;癌肿复发者3例,其血清CA125值均>65U/ml。化疗期间,8例癌肿复发者中,有6例血清CA125值升高,较临床发现早4个月。说明血清CA125值是监测卵巢恶性上皮性肿瘤临床病程变化的敏感肿瘤标记物;化疗第3疗程之前,动态监测血清CA125值下降幅度是评价化疗效果及预后重要而有效的手段。
Twenty-five patients with malignant epithelial ovarian tumors and eight patients with a survival time of ≥5 years were monitored dynamically for CA125 before and after the second exploration. RESULTS: Preoperatively or during the first chemotherapy period, serum CA125 values ≥ 65 U/ml accounted for 80% (20/25). Before the third course of chemotherapy, the serum CA125 value of 63. 3% (14/22) patients dropped to ≤ 35 U/ml; of the 6 patients with serum CA125 values ≥ 65 U/ml, 5 cases had persistent pelvic cancer. During the course of treatment after the third course of chemotherapy, serum CA125 values were higher than 35 U/ml in 6 cases, and 5 cases had recurrence or persistent cancer in the pelvis. Among the 5 patients whose survival time was ≥5 years and whose histological examination results were negative after the second exploratory operation, serum CA125 values were <20 U/ml in 4 cases, and CA125 values were >65 U/ml in 3 cases of cancer recurrence. During chemotherapy, serum CA125 levels were elevated in 6 of 8 cases of cancer recurrence, which was 4 months earlier than the clinical findings. It is concluded that serum CA125 value is a sensitive tumor marker to monitor the clinical course of malignant epithelial ovarian tumors; before the third course of chemotherapy, the dynamic monitoring of the decrease of serum CA125 value is an important and effective means to evaluate the effect of chemotherapy and prognosis.