论文部分内容阅读
目的评估术前癌抗原125(CA125)水平与原发性卵巢癌患者预后的关系。方法对142例术前行血清CA125测定的卵巢上皮癌患者进行回顾性分析,评估CA125水平与术前、术后各种变量的关系。用电化学发光免疫分析法(ECLIA)测定CA125水平。结果所有患者CA125中位数为582kU/L(7～52930kU/L),术前CA125水平与年龄差异不存在相关性(P=0.40)。但术前CA125中位数在浆液组织及其他组织类型(870kU/Lvs334kU/L,P=0.02),肿瘤分期高(Ⅲ.MⅣ)与低(Ⅰ/Ⅱ)(893kU/Lvs174kU/L,P<0.01)、肿瘤病理分级高(G3)与低(G1、G2)(928kU/Lvs323kU/L,P<0.01)、出现腹水有无(893kU/Lvs220kU/L,P<0.01)等方面,差异具有非常显著性意义。次优化肿瘤细胞减灭术(肿瘤残端>1cm)者CA125明显高于最优化肿瘤细胞减灭术(1067kU/Lvs399kU/L,P<0.01)。最优化肿瘤细胞减灭术患者术前CA125<500kU/L者,阳性预测值为82%,阴性预测值为48%,校正协变量后,CA125水平与规定疾病存活率密切相关。术前CA125水平升高(最高者除外)患者,其死亡危险性升高。结论术前CA125水平为卵巢上皮癌的一种独立预测因子,但不是最优化肿瘤细胞减灭术的可靠预测因子。
Objective To evaluate the relationship between preoperative cancer antigen 125 (CA125) and the prognosis of patients with primary ovarian cancer. Methods A retrospective analysis was performed on 142 cases of ovarian epithelial carcinoma with serum CA125 before operation to evaluate the relationship between CA125 level and various variables before and after operation. The level of CA125 was determined by electrochemiluminescence immunoassay (ECLIA). Results The median of CA125 in all patients was 582 kU / L (7 ~ 52930 kU / L). There was no correlation between preoperative CA125 levels and age (P = 0.40). However, the median preoperative CA125 was significantly higher in serous tissue and other tissue types (870kU / L vs 334kU / L, P = 0.02), higher stage Ⅲ.MⅣ and lower Ⅰ / Ⅱ 893kU / L vs 174kU / L, 0.01). There were significant differences in the pathological grade (G3), low (G1, G2) (928 kU / L vs 323kU / L, P <0.01) and the presence of ascites (893kU / L vs 220kU / L, P <0.01) Significant significance. The suboptimal tumor cytoreductive surgery (tumor stump> 1cm) CA125 was significantly higher than the optimal cytoreductive surgery (1067kU / L vs399kU / L, P <0.01). In patients with optimized cytoreductive surgery, preoperative CA125 <500kU / L, the positive predictive value was 82% and the negative predictive value was 48%. After adjusting for covariates, the level of CA125 was closely related to the defined disease survival rate. Preoperative CA125 levels (except for the highest) patients, the increased risk of death. Conclusions Preoperative CA125 levels are an independent predictor of epithelial ovarian cancer but not a reliable predictor of optimal cytoreductive surgery.