血清CA125水平与晚期卵巢癌NACT后肿瘤细胞减灭术疗效的关系

Relationship between serum CA125 level and the efficacy of tumor cell reduction after NACT for patients with advanced ovarian cancer

目的探讨血清CA125水平与晚期上皮性卵巢癌新辅助化疗(NACT)后肿瘤细胞减灭术疗效的关系。方法选择温州市中心医院收治的43例晚期上皮性卵巢癌患者为研究对象,患者均采用新辅助化疗联合肿瘤细胞减灭术以及术后化疗,动态测定患者术前和治疗后血清CA125水平的变化,同时测定CA125半衰期、第1个化疗疗程的下降率。分析新辅助化疗后不同效果、肿瘤细胞减灭术不同效果与患者血清CA125水平的关系。结果 43例患者经过NACT后,34例患者获得部分缓解,缓解率为79.07%;9例达到稳定期,占20.93%。43例患者中,肿瘤细胞减灭术后有32例患者达到满意,满意率为74.42%,11例患者残留病灶>1cm,未达到满意,占25.58%。NACT后肿瘤缓解期组治疗前血清CA125水平、化疗1个疗程后血清CA125水平均显著低于肿瘤稳定期组(t值分别为5.274、4.872,均P<0.05)。肿瘤缓解期血清CA125半衰期时间显著短于肿瘤稳定期组(t=8.242,P<0.05),且第1个化疗疗程下降率显著高于肿瘤稳定期组(t=2.230,P<0.05)。肿瘤细胞减灭术效果满意组患者术前、术后血清CA125水平均明显低于效果不满意组(t值分别为19.913、12.789,均P<0.05),CA125半衰期明显短于效果不满意组(t=6.823,P<0.05),且第1个化疗疗程下降率明显高于效果不满意组(t=3.370,P<0.05)。结论对于晚期上皮性卵巢癌患者,其基础血清CA125水平、CA125半衰期以及第1个化疗疗程后CA125下降程度对预测NACT和肿瘤细胞减灭术的疗效具有重要意义。

Objective To investigate the relationship between serum CA125 level and the efficacy of tumor cell reduction after neoadjuvant chemotherapy(NACT)for advanced epithelial ovarian cancer.Methods 43 cases of advanced epithelial ovarian cancer in Wenzhou Central Hospital were selected as the research objects.All patients were treated with neoadjuvant chemotherapy combined with tumor cell reduction and postoperative chemotherapy.The changes in serum CA125 level of the patients before and after treatment were dynamically measured,and the half-life period of CA125 and the decline rate of the first chemotherapy course were also measured.The relationship between different effects of neoadjuvant chemotherapy and different effects of tumor cell reduction and serum CA125 level of patients were analyzed.Results After receiving neoadjuvant chemotherapy,34 patients obtained partial remission with a remission rate of 79.07%,whlie 9 cases reached the stable period,accounting for 20.93%.Among the 43 patients,32 patients were satisfied after tumor cell reduction,with a satisfaction rate of 74.42%,while 11 patients with residual lesions of>1cm were not satisfied,accounting for 25.58%.The serum CA125 levels before treatment and after 1 course of chemotherapy in the tumor remission group after NACT were significantly lower than those in the stable group(t values were 5.274 and 4.872,respectively,both P<0.05).The half-life time of serum CA125 in remission stage was significantly shorter than that in the stable stage group(t=8.242,P<0.05),and the rate of decline in the first chemotherapy course was significantly higher than that in the stable stage group(t=2.230,P<0.05).The preoperative and postoperative serum CA125 levels of patients in the satisfactory group were all significantly lower than those in the unsatisfactory group(t values were 19.913 and 12.789,respectively,both P<0.05),the half-life of CA125 was significantly shorter than that in the unsatisfactory group(t=6.823,P<0.05),and the decrease rate of the first chemotherapy course was significantly higher than that in the unsatisfactory group(t=3.370,P<0.05).Conclusion For the patients with advanced epithelial ovarian cancer,the basic serum CA125 level,the half-life of CA125 and the degree of CA125 decrease after the first chemotherapy course is important for judging the effect of neoadjuvant chemotherapy and tumor cell ablation.