卵巢癌新辅助化疗后血清CA125变化及CT检查对肿瘤细胞减灭术疗效的预测价值

Changes of the serum CA125 levels after neoadjuvant chemotherapy of ovarian cancer and the predicative value of CT on the curative effect of cytoreductive surgery

目的:探讨血清CA125水平检测及计算机断层扫描(CT)检查对卵巢癌新辅助化疗后肿瘤细胞减灭术疗效的判定价值。方法:回顾性分析2014年1月至2017年1月收治的85例接受新辅助化疗联合肿瘤细胞减灭术的上皮性卵巢癌患者的临床资料,采用免疫化学发光法检测患者治疗前、后血清CA125水平;进行CT检查,评估疗效,按Jonathan评分标准进行评分。分析血清CA125水平变化以及CT评分与肿瘤细胞减灭术满意率的关系。结果:(1)血清CA125≤45 U/mL组患者肿瘤细胞减灭术满意率为94.3%(33/35),高于CA125>45 U/mL组的54.0%(27/50)(χ~2=14.212,P=0.000),血清CA125≤500 U/mL组患者肿瘤细胞减灭术满意率为76.7%(56/73),高于CA125>500 U/mL组的33.3%(4/12)(χ~2=7.368,P=0.006);(2)血清CA125下降≥80%组患者肿瘤细胞减灭术满意率为82.4%(42/51),高于CA125下降<80%组的52.9%(18/34)(χ~2=7.142,P=0.007);(3)术前Jonathan评分<3分组患者肿瘤细胞减灭术满意率为96.8%(60/62),高于术前Jonathan评分>3分组的34.8%(8/23)(χ~2=9.907,P=0.002)。结论:血清CA125水平检测及CT检查可作为卵巢癌肿瘤细胞减灭术的术前评估手段,能够预测患者新辅助化疗后肿瘤细胞减灭术的效果,为准确选择手术时机提供一定依据。

Objective：To investigate the value of computed tomography（CT） and CA125 on the curative effect of cytoreductive surgery after neoadjuvant chemotherapy of ovarian cancer.Methods：The clinical data of 110 patients with epithelial ovarian cancer treated with neoadjuvant chemotherapy combined with cytoreductive surgery hospitalized from January 2014 to January 2017 were retrospectively analyzed.The serum CA125 levels before and after the treatment were measured by immunochemiluminometric assays;CT examinations were performed with curative effect evaluated and scores graded according to Jonathan＇s rating criteria;the changes of serum CA125 levels and the relationship between CT scores and the satisfaction rate of cytoreductive surgery were analyzed.Results：（1） The satisfaction rate of cytoreductive surgery for patients with serum CA12545 U/ml was 94.3 %（33/35,higher than that for patients with serum CA125〉45 U/mL（54.0 %）（27/50）（χ~2=14.212,P=0.000）;The satisfaction rate of cytoreductive surgery for patients with serum CA125≤500 U/mL was 76.7 %（56/73）,higher than that for patients with serum CA125500 U/mL（33.3 %（4/12）（χ~2=7.368,P=0.006）;（2） The satisfaction rate of cytoreductive surgery for patients with the decline rate of serum CA 125≥80 % was 82.4 %（42/51）,higher than that for patients with the decline rate of serum CA 125〈80 %（52.9 %）（18/34）（χ~2=7.142,P=0.007.（3） The satisfaction rate of cytoreductive surgery for patients with Jonathan scoring less than 3 points before operation was 96.8%,higher than that for patients with Jonathan scoring more than 3 points before operation（34.8 %）（8/23）（χ~2=9.907,P=0.002）.Conclusion：Both CA125 and CT can be used as effective preoperative evaluation methods to predict the effect of cytoreductive surgery in patients with ovarian cancer and to provide the basis for the proper time of the surgery.