卵巢恶性上皮性肿瘤化疗期间血清CA_(125)水平动态监测价值的初步探讨

Discussion of Usefulness of Serum CA_(125) Serial Measurements during Chemotherapy in Epithelian Ovarian Cancer

目的 探讨血清CA12 5在评估卵巢恶性上皮性肿瘤化疗效果及预后方面的价值。方法 对 2 5例卵巢恶性上皮性肿瘤患者术前、后的化疗期间以及 8例存活率≥ 5年的患者 2次探查术前、后的血清CA12 5值进行了动态监测。结果 首次化疗期间 ,血清CA12 5值≥ 6 5U /ml者占 80 % (2 0 / 2 5 )。在化疗期间疗程之前 ,6 3.3% (14/ 2 2 )患者血清CA12 5值降至≤ 35U/ml;6例血清CA12 5值≥ 6 5U/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CA12 5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 ,2次探查术组织病理学检查结果阴性的 5例中 ,4例血清CA12 5值持续 <2 0U/ml;癌肿复发者 3例 ,其血清CA12 5值均 >6 5U/ml。化疗期间 ,8例癌肿复发者中 ,有 6例血清CA12 5值的升高较临床发现平均早 4个月。结论 提示血清CA12 5值是监测卵巢恶性上皮性肿瘤临床病理变化的敏感肿瘤标记物 ;化疗第 3疗程之前 ,动态监测血清CA12 5值下降幅度是评价化疗效果及预后的重要依据。

Objective Our purpose was to investigate the changes of serum CA 125 levels and to evaluate the clinical usefulness of CA 125 assay for monitoring epithelial ovarian cancer during the chemotherapy Method The serum CA 125 levels of 25 patients with epithelial ovarian cancer were serially measured within 12 courses of chemotherapy Result During the second look laparatomy, these serum CA 125 concentrations were higher than 65 U/ml in 80% of 25 patients during initial surgery or primary chemotherapy, the serum CA 125 concentrations were below 35 U/ml in 63.3% of 22 patients, but persistent tumor was detected in 5 of 6 patients with CA 125 concentrations higher than 65 U/ml Whereas 5 of 6 patients with CA 125 assay above 35 U/ml had recurrent or persistent tumor after subsequent chemotherapy The serum CA 125 concentrations were persistent below 20 U/ml in 4 of 5 patients whose survival time for 5 years with negative second look finding, 3 of 3 patients with CA 125 concentrations higher than 65 U/ml had recurrent disease CA 125 values raised above 65 U/ml before clinical recurrence in 6 of 8 patients with a median lead time of 4 months Conclusion CA 125 is the most useful marker for the monitoring of response to chemotherapy and follow up of patients with epithelial ovarian cancer The trend of CA 125 levels in the first three courses of chemotherapy is a strong predistor for response to chemotherapy and prognosis