血清CA125动态变化对判断上皮性卵巢癌的疗效及预后价值

Value of Dynamic Changes in Serum CA125Levels in Judgment of Curative Efficacy and Prognosis in Patients with Epithelial Ovarian Cancer

目的探讨血清CA125动态变化对判断上皮性卵巢癌(EOC)的疗效及预后价值。方法回顾性分析92例EOC患者的临床资料。手术前1d、手术后1周、化疗6周期后检测患者血清CA125的变化,记录患者肿瘤转移、复发及存活时间。结果患者手术前、手术后1周及化疗6周期后血清CA125水平逐级递减[(148.7±38.2)、(89.5±25.6)、(61.5±22.8)U·mL-1,均P<0.01]。到随访截点,CA125转阴时间(NT)≤8周组患者复发率(21.82%)、缓解率(67.27%),与NT>8周组比较(45.95%、40.50%)差异均有统计学意义(均P<0.01);NT≤8周存活时间及复发时间均长于NT>8周组[(38.1±19.7)个月比(25.6±21.1)个月、(17.2±3.3)个月比(8.3±2.9)个月,均P<0.01];CA125半衰期(T1/2)≤20d组存活时间显著长于T1/2>20d组[(39.9±18.4)个月比(32.4±16.6)个月,P<0.01]。结论动态监测血清CA125的变化对EOC患者的疗效判断及预后评估有重要价值,但是临床应用时应结合CA125T1/2、NT进行综合评价。

Objective To investigate the value of dynamic changes in serum CA125 levels in the judgment of curative efficacy and prognosis in patients with epithelial ovarian cancer （EOC）. Methods Clinical data of 92 patients with EOC were analyzed retrospectively.Serum CA125 levels were detected 1 day before operation,1 week after operation and after 6 cycles of chemotherapy.Tumor metastasis,recurrence and survival time were recorded in all patients.Results Serum CA125 levels progressively decreased after operation and after chemotherapy[（148.7 ± 38.2）、（89.5±25.6）、（61.5±22.8）U·mL^-1 ,P 〈0.01].At the follow-up cut-off point,recurrence rate and remission rate were,respectively,21.82% and 67.27% in CA125 negative turning time （NT）≤8 weeks group,and 45.95% and 40.50% in NT〉8 weeks group.Differences were significant between the two groups（P 〈0.01）.Furthermore,survival time and recurrence time in NT≤8 weeks group were significantly longer than those in NT〉8 weeks group[（38.1±19.7）months vs （25.6 ±21.1）months、（17.2±3.3）months vs（8.3±2.9）months,P 〈0.01].Moreover,survival time in CA125 half-life（T1/2 ）≤20 days group was significantly longer than that in T1/2 〉20 days group [（39.9±18.4）months vs （32.4±16.6）months,P 〈0.01].Conclusion Dynamic monitoring of＆amp;nbsp;serum CA125 levels is of great value but should be combined with CA125 half-life and NT time for comprehensively evaluating the clinical efficacy and prognosis in patients with EOC.