The fatality rate of ovarian cancer (OC) is the highest, and the 5-year survival rate is only 50.8%. For more than 40 years, CA125 has been the most concerned and widely used biomarker of OC in clinical practice. In r...The fatality rate of ovarian cancer (OC) is the highest, and the 5-year survival rate is only 50.8%. For more than 40 years, CA125 has been the most concerned and widely used biomarker of OC in clinical practice. In recent years, many researchers have proposed a reliable strategy of multiple markers combined with CA125 to screen OC to make up for the lack of accuracy of CA125, redefine the biochemical recurrence threshold of CA125, and use mathematical model scores to provide help for the feasibility of treatment and survival prognosis. To fully understand the role of CA125 in OC screening, initial treatment, and recurrence prediction, and summarize the limitations of CA125, this review has summarized the new progress of CA125 in the diagnosis and treatment of OC in recent years which can also provide a reference for clinicians.展开更多
Objective： Human epididymis protein 4（HE4） is a promising biomarker of epithelial ovarian cancer（EOC）. But its role in assessing the primary optimal debulking（OD） of EOC remains unknown. The purpose of this stu...Objective： Human epididymis protein 4（HE4） is a promising biomarker of epithelial ovarian cancer（EOC）. But its role in assessing the primary optimal debulking（OD） of EOC remains unknown. The purpose of this study is to elucidate the ability of preoperative HE4 in predicting the primary cytoreductive outcomes in advanced EOC, tubal or peritoneal carcinoma.Methods： We reviewed the records of 90 patients with advanced ovarian, tubal or peritoneal carcinoma who underwent primary cytoreduction at the Department of Obstetrics and Gynecology of Peking University People＇s Hospital between November 2005 and October 2010. Preoperative serum HE4 and CA125 levels were detected with EIA kit. A receiver operating characteristic（ROC） curve was used to determine the most useful HE4 cut-off value. Logistic regression analysis was performed to identify significant preoperative clinical characteristics to predict optimal primary cytoreduction.Results： OD was achieved in 47.7%（43/48） of patients. The median preoperative HE4 level for patients with OD vs. suboptimal debulking was 423 and 820 pmol/L, respectively（P〈0.001）. The areas under the ROC curve for HE4 and CA125 were 0.716 and 0.599, respectively（P=0.080）. The most useful HE4 cut-off value was 473 pmol/L. Suboptimal cytoreduction was obtained in 66.7%（38/57） of cases with HE4 ≥473 pmol/L compared with only 27.3%（9/33） of cases with HE4 〈473 pmol/L. At this threshold, the sensitivity, specificity, positive predictive value（PPV） and negative predictive value（NPV） for diagnosing suboptimal debulking were 81%, 56%, 67%, and 73%, respectively. Logistic regression analysis showed that the patients with HE4 ≥473 pmol/L were less likely to achieve OD（odds ratio =5.044, P=0.002）.Conclusions： Preoperative serum HE4 may be helpful to predict whether optimal cytoreductive surgery could be obtained or whether extended cytoreduction would be needed by an interdisciplinary team.展开更多
目的探讨上皮性卵巢癌初始治疗后CA125最低值及其动态变化与预后的关系。方法选择2008年1月至2013年1月中国医科大学附属盛京医院初始治疗达到完全缓解,术前CA125高于35 k U/L的上皮性卵巢癌复发患者120例。我们将卵巢癌复发的CA125参...目的探讨上皮性卵巢癌初始治疗后CA125最低值及其动态变化与预后的关系。方法选择2008年1月至2013年1月中国医科大学附属盛京医院初始治疗达到完全缓解,术前CA125高于35 k U/L的上皮性卵巢癌复发患者120例。我们将卵巢癌复发的CA125参考值设为15 k U/L,其中33例CA125≥15 k U/L,87例CA125<15 k U/L。比较两组的无进展生存期、总生存期。结果 CA125<15 k U/L组的无进展生存期[(17.58±1.23)个月]、总生存期[(22.38±2.41)个月]均显著高于CA125≥15 k U/L组[(10.88±3.01)个月及(11.42±4.21)个月](P<0.05)。COX比例风险模型分析初始治疗后CA125最低值≥15 k U/L预示卵巢癌早期复发。同时CA125在正常范围内连续3次升高出现的时间[(15.22±10.8)个月]早于影像学诊断肿瘤复发[(22.59±17.22)个月]7个月。结论初始治疗后CA125降至15 k U/L以下的患者预后相对较好。动态监测CA125水平,如果在35 k U/L内连续3次升高,应及时进行影像学评价,可能对部分患者早期诊断复发有意义。展开更多
文摘The fatality rate of ovarian cancer (OC) is the highest, and the 5-year survival rate is only 50.8%. For more than 40 years, CA125 has been the most concerned and widely used biomarker of OC in clinical practice. In recent years, many researchers have proposed a reliable strategy of multiple markers combined with CA125 to screen OC to make up for the lack of accuracy of CA125, redefine the biochemical recurrence threshold of CA125, and use mathematical model scores to provide help for the feasibility of treatment and survival prognosis. To fully understand the role of CA125 in OC screening, initial treatment, and recurrence prediction, and summarize the limitations of CA125, this review has summarized the new progress of CA125 in the diagnosis and treatment of OC in recent years which can also provide a reference for clinicians.
基金the National Science Foundation of China(Inhibitory Effects of Sulfated Polysaccharides/Sulfated Polypeptides from Softenning Indurated Mass Herbs on Tumor Associated Fibroblast,No.81173376)New Century Excellent Talent(No.NCET-11-1068)
文摘ObjectiveTo 评估在紫色带蓝色的舌头和血小板计数之间的关系，并且推进与 82 个上皮的卵巢的癌症病人全部的上皮的卵巢的 cancer.MethodsA 的复发检验他们的协会在这研究被注册。簇分析被用于组织 patients’P <sub > 红绿蓝 </sub>(Red-R；Green-G；Blue-B；红绿蓝的平均百分比， P <sub > 红绿蓝 </sub>) 价值。接收装置操作特征(巨鸟) 曲线为检测紫色带蓝色的舌头的诊断标准被执行。<sup>2</sup> 测试被用来估计在紫色带蓝色的舌头和血小板之间的关系上皮的卵巢的癌症的计数，和复发。perioperative (外科手术前) 血小板水平是 examinedwith 舌头图象，疾病 recurrence.ResultsTongue 图象被分类进基于 P <sub 的二个组 > 由簇分析的图象的红绿蓝 </sub> 价值。在簇 “1” 的盒子的数字(正常颜色舌头) 是 16 并且聚类 “2”(紫色带蓝色的舌头) 是 66。二组 P <sub > 红绿蓝 </sub> 价值，由簇分析分类，显著地与基于视觉的舌头颜色识别被相关(Kappa = 0.852， P < 0.001 ) 。巨鸟曲线证明 P <sub 的比率 > b </sub> 到 P <sub > r </sub> 有最高诊断的价值。敏感和 P <sub 的比率的特性 > b </sub> 到 P <sub > r </sub> 分别地是 95.3% 和 88.9% ，最佳的截止的点是 0.71。紫色带蓝色的舌头显著地与增加的血小板计数被相关(P < 0.001 ) 。两个都，增加的血小板数( P = 0.01 )并且紫色带蓝色的舌头与上皮的卵巢的癌症的复发被联系( P < 0.001 ) P <sub 的 .ConclusionThe 比率> b </sub>到 P <sub >当为紫色带蓝色的舌头诊断的指示物在症状模式使用了，比 0.71 大的 r </sub>能服务在繁体中文药的鉴定。紫色带蓝色的舌头，与增加的血小板计数联系了，密切也与上皮的卵巢的癌症的复发被相关。
基金supported by Natural Science Foundation of China(NSFC-81172454)the Specialized Research Fund for Doctoral Program of Higher Education(SRFDR-20100001110079)
文摘Objective： Human epididymis protein 4（HE4） is a promising biomarker of epithelial ovarian cancer（EOC）. But its role in assessing the primary optimal debulking（OD） of EOC remains unknown. The purpose of this study is to elucidate the ability of preoperative HE4 in predicting the primary cytoreductive outcomes in advanced EOC, tubal or peritoneal carcinoma.Methods： We reviewed the records of 90 patients with advanced ovarian, tubal or peritoneal carcinoma who underwent primary cytoreduction at the Department of Obstetrics and Gynecology of Peking University People＇s Hospital between November 2005 and October 2010. Preoperative serum HE4 and CA125 levels were detected with EIA kit. A receiver operating characteristic（ROC） curve was used to determine the most useful HE4 cut-off value. Logistic regression analysis was performed to identify significant preoperative clinical characteristics to predict optimal primary cytoreduction.Results： OD was achieved in 47.7%（43/48） of patients. The median preoperative HE4 level for patients with OD vs. suboptimal debulking was 423 and 820 pmol/L, respectively（P〈0.001）. The areas under the ROC curve for HE4 and CA125 were 0.716 and 0.599, respectively（P=0.080）. The most useful HE4 cut-off value was 473 pmol/L. Suboptimal cytoreduction was obtained in 66.7%（38/57） of cases with HE4 ≥473 pmol/L compared with only 27.3%（9/33） of cases with HE4 〈473 pmol/L. At this threshold, the sensitivity, specificity, positive predictive value（PPV） and negative predictive value（NPV） for diagnosing suboptimal debulking were 81%, 56%, 67%, and 73%, respectively. Logistic regression analysis showed that the patients with HE4 ≥473 pmol/L were less likely to achieve OD（odds ratio =5.044, P=0.002）.Conclusions： Preoperative serum HE4 may be helpful to predict whether optimal cytoreductive surgery could be obtained or whether extended cytoreduction would be needed by an interdisciplinary team.
文摘目的探讨上皮性卵巢癌初始治疗后CA125最低值及其动态变化与预后的关系。方法选择2008年1月至2013年1月中国医科大学附属盛京医院初始治疗达到完全缓解,术前CA125高于35 k U/L的上皮性卵巢癌复发患者120例。我们将卵巢癌复发的CA125参考值设为15 k U/L,其中33例CA125≥15 k U/L,87例CA125<15 k U/L。比较两组的无进展生存期、总生存期。结果 CA125<15 k U/L组的无进展生存期[(17.58±1.23)个月]、总生存期[(22.38±2.41)个月]均显著高于CA125≥15 k U/L组[(10.88±3.01)个月及(11.42±4.21)个月](P<0.05)。COX比例风险模型分析初始治疗后CA125最低值≥15 k U/L预示卵巢癌早期复发。同时CA125在正常范围内连续3次升高出现的时间[(15.22±10.8)个月]早于影像学诊断肿瘤复发[(22.59±17.22)个月]7个月。结论初始治疗后CA125降至15 k U/L以下的患者预后相对较好。动态监测CA125水平,如果在35 k U/L内连续3次升高,应及时进行影像学评价,可能对部分患者早期诊断复发有意义。
