血清CA125用于预测上皮性卵巢癌、输卵管癌及腹膜癌化疗反应性的研究

Study on serum CA125 level used in predicting sensitivity to chemotherapy in epithelial ovarian carcinoma,fallopian carcinoma and peritoneal carcinoma patients

目的:探讨上皮性卵巢癌、输卵管癌及腹膜癌对铂类+紫杉醇类化疗敏感性与CA125变化的关系。方法:选取2009年1月至2011年5月上海市第一妇婴保健院手术及化疗的71例上皮性卵巢癌、6例输卵管癌和1例腹膜癌患者,以3次化疗后血清CA125能否降至正常(<35kU/L),术后前3次化疗后每次CA125同上次比较能否降低50%作为判断铂类敏感的指标,比较分析化疗敏感型患者CA125数值变化规律。结果:(1)术前CA125数值对于判断患者第2次及第3次化疗后血清CA125能否下降50%以上具有统计学意义(P<0.01);(2)术后首次CA125数值对于判断患者第2次(P=0.028),第3次(P<0.01)化疗后血清CA125能否下降50%,以及3次化疗后血清CA125能否降至正常(P=0.046)具有统计学意义;(3)较早FIGO分期(FIGOⅠ～Ⅱ期),无腹水,满意的肿瘤灭减术也是决定患者化疗敏感性的临床指标。结论:术前和术后血清CA125水平、较早的FIGO分期、无腹水、满意的肿瘤减灭术是影响卵巢癌、输卵管癌、腹膜癌患者化疗敏感性的有意义的临床指标。

Objective：To investigate the relationship between serum CA125 changes and response to chemotherapy based on platinum in epithelial ovarian carcinoma,fallopian carcinoma and peritoneal carcinoma patients.Methods：From Jan.2009 to May 2011,78 patients with epithelial ovarian carcinoma,fallopian carcinoma and peritoneal carcinoma undergoing treatment in Shanghai First maternity infant hospital were studied retrospectively.The level of serum CA125 dropped to less than 35kU/L after 3 cycles or dropped down more than 50% after each cycle were considered as chemotherapy sensitivity to compound of taxane＋platinum.Those changes of CA125 were compared with clinical parameters.Results：（1） Pre-operative serum CA125 could predict whether the level of serum CA125 would drop down more than 50% after second and third cycle of chemotherapy（P0.01）.（2）Postoperative serum CA125 could predict whether the level of serum CA125 would drop down more than 50% after second（P=0.028） and third cycle of chemotherapy（P0.01）.（3） Early FIGO stage（FIGOⅠ~Ⅱ）,ascites fluid and optimal cytoreduction were also associated with the sensitivity to paclitaxel/carboplatin chemotherapy.Conclusions：Pre-and post-operative serum CA125,early FIGO stage,ascites fluid and optimal cytoreduction are clinical useful variables to predict sensitivity to paclitaxel/carboplatin.