术前血清CA125水平与上皮性卵巢癌临床病理特征及预后的关系

[目的] 分析上皮性卵巢癌患者术前血清 CA125 水平和临床病理特征及预后之间的关系.[方法] 回顾性分析 279 例上皮性卵巢癌患者术前血清 CA125 水平与组织类型、分级、FIGO 分期、腹腔积液以及生存的关系.[结果] 患者的术前 CA125 水平波动范围3.6～20 220.0U/ml,中位数值为 339.2 U/ml.浆液性癌术前血清 CA125 水平明显高于非浆液性癌(P＜0.05);对非浆液性癌中不同组织类型的分析显示,黏液性癌及透明细胞癌 CA125 水平明显低于浆液性癌(P＜0.01),其余类型与浆液性癌并无明显区别(P＞0.05).早期卵巢癌(Ⅰ期)术前血清 CA125 水平明显低于中、晚期癌患者(Ⅱ～Ⅳ期) (P=0.000),在非黏液/透明细胞癌患者中,早期患者常常表现出低水平 CA125 值,预后较好;晚期患者更多表现出较高水平的血清 CA125 值,但晚期患者中,那些术前血清 CA125 水平较高的患者较那些中等水平的患者表现出更好的预后.[结论] 上皮性卵巢癌患者术前血清 CA125 水平可以反映浆液性以及其他非黏液/透明细胞癌的肿瘤负荷.     

血清CA125测定对晚期上皮性卵巢癌理想减瘤术的预测价值

目的 :探讨Ⅲ期上皮性卵巢癌患者术前血清CA12 5水平对理想肿瘤细胞减灭术的预测价值。方法 :回顾分析 1992年 1月 - 1999年 12月应用放射免疫法检测 172例Ⅲ期上皮性卵巢癌患者术前血清CA12 5含量与肿瘤大小、分期、组织分级、术前化疗的关系 ,及其对理想减瘤术的影响。结果 :全组患者的中位血清CA12 5水平为 70 6 μ mL。有 16 2例 (94 % )CA12 5值高于正常 ,以阈值CA12 5 5 0 0 μ mL为标准 ,预测理想与非理想手术的敏感性为 77% ,特异性为 74 %。CA12 5 <5 0 0 μ mL者 73%达到理想减瘤术 ,CA12 5≥ 5 0 0 μ mL时达到理想手术者仅为 2 6 % ,P <0 0 1。术前血清CA12 5水平与肿瘤大小有关 ,P <0 0 1。术前化疗能提高理想减瘤术的成功率。结论 :术前血清CA12 5对Ⅲ期上皮性卵巢癌患者理想肿瘤细胞减灭术有预测价值。术前血清CA12 5≥ 5 0 0 μ mL者 ,宜新辅助化疗 1～ 3个周期后再行减瘤术     

Ⅲ期卵巢上皮癌术前CA125水平与手术彻底性的关系

目的:探讨Ⅲ期卵巢上皮癌术前CA125水平与手术彻底性的关系。方法:回顾手术治疗的86例Ⅲ期卵巢上皮癌患者术前CA125水平以及相应的手术彻底性临床资料,应用受试者工作特征(ROC)曲线探讨术前CA125水平与手术彻底性的关系,并确定作为预测手术彻底性诊断界点的CA125水平。结果:86例患者中46例(53.5%)完成了满意的肿瘤减灭术(残留肿瘤最大径≤2cm);随着CA125水平增加肿瘤减灭术满意性下降;CA125预测手术彻底性的诊断界点是750μ/ml,术前CA125<750μ/ml的患者中34例(63.4%)完成了满意的减灭术,而术前CA125>750μ/ml的患者中12例(35.3%)完成了满意的减灭术;以超过750μ/ml无法完成满意的减灭术为阳性,敏感性64.7%,特异性65.4%,阳性预测值55.0%,阴性预测值73.9%。结论:Ⅲ期卵巢上皮癌患者术前CA125超过750μ/ml者,须充分评估手术可行性。     

卵巢癌血清HE4、CA72-4、CA125水平测定

目的 探讨卵巢癌血清人附睾分泌蛋白4（HE4）、CA72-4、CA125水平及临床意义.方法 入组我院收治的卵巢癌患者45例、卵巢良性病变30例,并纳入同期女性健康体检者30例作为对照,采用电化学发光法分别检测各组血清中HE4、CA72-4、CA125水平.结果 卵巢癌组血清HE4、CA72-4、CA125水平均高于卵巢良性病变组和健康对照组（P〈0.05）.HE4以〉150 pmol·L-1,CA72-4以5.3 u·mL-1,CA125以35 u·mL-1为阳性参考值,三者联合检测的敏感性为93.3%,特异性为73.3%.结论 卵巢癌患者血清中HE4、CA72-4、CA125处于高水平,联合检测可提高卵巢癌的诊断率.     

血清CA125水平动态变化对卵巢上皮癌疗效的预测价值

目的 探讨血清CA125动态变化对卵巢上皮癌疗效的预测价值.方法 采用微粒子捕捉免疫发光技术(MEIA)测定75例卵巢上皮癌患者治疗前、每疗程化疗后3周、手术前及手术后7～14天血清中CA125浓度.计算CA125半衰期、第一疗程化疗后血清CA125下降率,分析CA125半衰期、第一疗程化疗后血清CA125下降率与近期治疗缓解率、长期生存率的关系.结果 75例患者治疗前CA125大于35 ku/l 72例.半衰期≤15天组完全缓解率高于半衰期>15天组(P=0.000);第一疗程化疗后血清CA125下降率≥50%组完全缓解率高于下降率<50%组(P=0.000);晚期卵巢癌CA125半衰期≤15天组生存率、中位生存时间高于半衰期>15天组(P=0.013);晚期卵巢癌第一疗程化疗后血清CA125下降率≥50%组与<50%组生存率、中位生存时间无显著差异;多因素生存分析表明晚期卵巢癌术后残留灶大小和术后疗程数是独立预后因素.结论 CA125半衰期、第一疗程化疗后血清CA125下降率可作为反映化疗敏感性的临床指标.     

HE4及CA125评估卵巢癌生物学行为及预后的临床研究

摘 要：［目的］ 探讨术前血清CA125和HE4对原发性卵巢癌生物学行为及其预后的预测价值。［方法］ 回顾性分析浙江省肿瘤医院2008年1月至2014年4月间收治的127例原发性卵巢癌患者的病例资料,分析患者术前血清CA125及HE4与病理类型、FIGO分期、组织分级、腹水量、术后残余病灶大小及预后的关系。［结果］ 术前血清CA125仅与FIGO分期显著性相关（P=0.006）。浆液性卵巢癌、FIGO分期越晚、组织分化越差的患者HE4表达阳性率更高（P＜0.05）。CA125与HE4表达与手术残余病灶、腹水量无统计学意义相关性。原发性卵巢癌术后1年生存率为94.7%,3年生存率为78.8%,5年生存率为61.9%。HE4低水平患者的1年生存率及3年生存率显著性优于HE高水平患者;而CA125低水平患者的5年生存率显著性优于CA125高水平患者。［结论］ 术前血清CA125及HE4均可评估卵巢癌FIGO分期,但HE4更能反映卵巢癌生物学行为,且术前HE4水平可预测卵巢癌1年及3年生存率,而术前CA125水平可协助预测其5年生存率。     

血清CA125检测在卵巢上皮性癌预后评估中的价值

目的探讨卵巢上皮性癌患者术前血清CA125水平对治疗效果的预测、术后血清CA125水平的动态变化对预后的影响及复发的诊断价值。方法356例卵巢上皮性癌患者均行肿瘤细胞减灭术,术前及治疗期间采用电化学发光法定量检测CA125,治疗及随访期间监测血清CA125。结果术前CA125>500ku/L(48.7%)手术不能达到理想肿瘤细胞减灭术的明显高于术前CA125≤500ku/L(20.1%)(P值<0.01)的。术前CA125>500ku/L(73.1%)复发或转移率明显高于术前CA125<500ku/L(59.2%)(P<0.05)。189例患者在发现复发或转移病灶前或同时检测血清CA125异常(>35ku/L)。结论术前CA125以500ku/L为界值可作为术前判断能否实施理想肿瘤细胞减灭术的1项重要指标,术后化疗期间血清CA125动态监测能很好地观察卵巢癌的治疗效果及预后,CA125作为卵巢上皮性癌治疗后的病情监测指标有着非常重要的作用。     

Preoperative Serum CA-125 Level As a Predictor for The Extent of Cytoreduction in Patients with Advanced Stage Epithelial Ovarian Cancer

BackgroundOvarian cancer is the seventh most common cancer in women worldwide and the eighth most common cause of cancer death. Due to the lack of effective early detection strategies and the unspecific onset of symptoms, it is diagnosed at an advanced stage in 75% of cases. The cancer antigen (CA) 125 is used as a prognostic marker and its level is elevated in more than 85% of women with advanced stages of epithelial ovarian cancer (EOC). The standard treatment is primary debulking surgery (PDS) followed by adjuvant chemotherapy (ACT), but the later approach is neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS). Several studies have been conducted to find out whether preoperative CA-125 serum levels influence treatment choice, surgical resection and survival outcome. The aim of our study was to analyse experience of single institution as Cancer comprehensive center with preoperative usefulness of CA-125.Patients and methodsAt the Institute of Oncology Ljubljana a retrospective analysis of 253 women with stage FIGO IIIC and IV ovarian cancer was conducted. Women were divided into two groups based on their primary treatment. The first group was the NACT group (215 women) and the second the PDS group (38 women). The differences in patient characteristics were compared using the Chi-square test and ANOVA and the Kaplan-Meier method was used for calculating progression-free survival (PFS) and overall survival (OS).ResultsThe median serum CA-125 level was higher in the NACT group than in the PDS group, 972 IU/ml and 499 IU/ ml, respectively. The PFS in the NACT group was 8 months (95% CI 6.4–9.5) and 18 months (95% CI 12.5–23.4) in the PDS group. The median OS was lower in the NACT group than in the PDS group, 25 months (95% CI 20.6–29.5) and 46 months (95% CI 32.9–62.1), respectively.ConclusionsPreoperative CA-125 cut off value of 500 IU/ml is a promising threshold to predict a successful PDS.Key words: ovarian cancer, tumour marker, CA-125, primary debulking surgery, neoadjuvant chemotherapy     

血清CA125在卵巢上皮癌诊疗中的应用价值

:[目的]探讨血清CA125在卵巢上皮癌诊疗中的应用价值。[方法]应用放射免疫方法测定165例原发性卵巢上皮癌治疗前血清CA125值 ,对其中87例患者术后3个月内连续性测定 ,观察疗效和CA125变化间的相关性。[结果]卵巢上皮癌CA125检测阳性率80 7% ,尤以浆液性卵巢癌最高94 8%。疗效为完全缓解的29例术后CA125水平较术前明显下降(P<0 001) ,疗效为部分缓解的40例术后CA125值较术前下降(P<0 05) ,疗效为进展的12例术后CA125值较术前升高(P<0 05) ,疗效为无改变的6例手术前后CA125值差异无显著性(P>0 05)。[结论]CA125测定是卵巢上皮癌诊断和监测疗效的有效无创性检查方法     

卵巢癌患者血清CA125与癌基因表达检测的临床意义

目的　评价卵巢癌患者血清CA 12 5表达水平的临床意义。方法　采用酶联免疫分析和流式细胞术对 3 3例卵巢癌患者血清CA12 5浓度和癌组织 p5 3V+ 、CD44S+ 、p170 + 及DNA异倍体细胞检出率进行了检测。结果　卵巢癌患者CA 12 5浓度、p5 3V+ 和 p170 + 细胞检出率均显著高于正常对照 (P <0 .0 1) ;CA 12 5浓度和 p5 3V+ 细胞表达率随临床分期增加而逐渐升高 ;p5 3V+ 和DNA异倍体细胞检出率随CA 12 5浓度增加而逐渐升高 ,CD 44S+ 细胞检出率却逐渐降低。结论　卵巢癌患者血清CA12 5浓度与癌组织 p5 3V+ 、CD44S+ 和DNA异倍体细胞检出率、肿瘤临床分期的关系都十分密切。     

血清VEGF-C和CA125联合检测对卵巢癌淋巴结转移的预测价值

目的 探讨卵巢癌患者血清VEGF-C(血管内皮生长因子C)及CA125(癌胚抗原125)水平与卵巢癌腹膜后淋巴结转移之间的相关性.旨在发现预测上皮性卵巢癌腹膜后淋巴结转移的血清学指标.方法 上皮性卵巢癌患者治疗前采用酶联免疫吸附测定法(enzyme linked immunosorbent assay,ELISA)检测血清VEGF-C水平;采用电化学发光法(elect rocheminescence)检测血清CA125水平.卵巢癌行腹膜后淋巴结清扫术患者66例为实验组,卵巢良性肿瘤53例为对照组.结果 血清CA125与VEGF-C水平之间呈正相关(r=0.36,P＜0.05);卵巢癌患者血清CA125水平明显高于良性对照组(P＜0.01),VEGF-C水平明显高于良性对照组(P＜0.05);血清CA125≤756 ku/L组腹膜后淋巴结转移率(32.4％)低于CA125＞756 ku/L组(59.4％)(P=0.028);上皮性卵巢癌患者初诊时血清VEGF-C≤2 400 pg/ml组腹膜后淋巴结转移率(34.37％)低于VEGF-C＞2 400 pg/ml组(55.9％),但差异无统计学意义(P=0.079);上皮性卵巢癌患者初诊时血清VEGF C≤2 400 pg/ml且CA125≤756 ku/L组18例,腹膜后淋巴结转移率27.78％.血清VEGF-C＞2 400 pg/ml且CA125＞756 ku/L组18例,腹膜后淋巴结转移率77.78％,两组比较差异有统计学意义(P=0.022).结论 血清CA125水平可以作为预测卵巢癌腹膜后淋巴结转移的参考指标;血清VEFG-C水平联合CA125水平检测能更好地预测卵巢癌腹膜后淋巴结转移.     

卵巢癌术后血清CA125检测与PET-CT检查结果对比分析

目的：探讨血清CA125检测和PET-CT检查对监测卵巢癌术后复发和转移的价值。方法所有53例卵巢癌术后患者均进行血清CA125检测及PET-CT检查。结果 CA125检测对卵巢癌术后复发和转移监测的准确率为81.1%,灵敏度为95.2%,特异度为27.2%,阳性预测值为83.3%,阴性预测值为60.0%;PET-CT检查对卵巢癌术后复发和转移监测的准确率为94.3%,灵敏度为97.6%,特异度为81.8%,阳性预测值为95.3%,阴性预测值为90.0%。结论 PET-CT检查对卵巢癌术后监测优于血清CA125检测,两者联合可作为卵巢癌术后监测的首选方法。     

血清CA125水平监测上皮性卵巢癌临床复发的作用

目的：分析血清ＣＡ１２５对上皮性卵巢癌临床复发的监测作用。方法：应用放射免疫法测定血清ＣＡ１２５对经过治疗病情稳定,ＣＡ１２５降到正常的２８例上皮性卵巢患者,定期测定血清ＣＡ１２５水平及其他临床检查项目,直到临床诊断肿瘤复发,分析血清ＣＡ１２５水平与肿瘤复发的关系（以ＣＡ１２５〈３５Ｕ／ｍｌ为正常值）。结果：本组２８例患者中,血清ＣＡ１２５〉３５Ｕ／ｍｌ者１２例,阳性率为４２．９％;血清ＣＡ１２５     

调强放疗对非小细胞肺癌患者生存情况、血清CA125水平及不良反应的影响

目的探讨调强放疗对非小细胞肺癌患者生存情况、血清CA125水平及不良反应的影响。方法选取非小细胞肺癌患者74例,将患者随机分为对照组和观察组,每组37例。对照组采用三维适形放疗(3D-CRT),观察组采用调强放疗(IMRT)。观察比较两组患者的近期治疗效果等情况。结果观察组和对照组患者总有效率分别为75.68%、72.97%,差异无统计学意义(P>0.05)。观察组和对照组患者的1年生存率为75.68%、67.56%,差异有统计学意义(P<0.05)。观察组患者的血清CA125水平为(76.32±8.25),低于对照组(101.38±15.24),差异有统计学意义(P<0.05)。观察组不良反应发生包括白细胞减少、血小板减少、消化道反应、放射性肺炎、放射性食管炎,明显较对照组低,差异有统计学意义(P<0.05)。观察组的CI值低于对照组,HI值高于对照组,差异有统计学意义(P<0.05)。结论调强放疗和三维适形放疗,对非小细胞肺癌患者的治疗疗效相近,调强放疗能够有效降低患者的血清CA125水平,减少不良反应的发生,并且靶区剂量分布更加合理。     

Recurrence Season Impacts the Survival of Epithelial Ovarian Cancer Patients

Background: Several studies indicated that the diagnosis season affects the prognosis of some cancers, suchas examples in the prostate, colon and breast This retrospective study aimed to investigate whether the diagnosisand recurrent season impacts the prognosis of epithelial ovarian cancer patients. Methods: From January 2005to August 2010, 161 epithelial ovarian cancer patients were analyzed and followed up until August 2013. Kaplan-Meier survival curves and the log-rank test were used to make the survival analysis. Multivariate analysis wasconducted to identify independent prognostic factors. Results: The prognostic factors of overall survival inepithelial ovarian cancer patients included age, clinical stage, pathological type, histological grade, residualdisease after primary surgery, recurrent season and adjuvant chemotherapy cycles. Moreover, clinical stage,histological grade, residual disease after primary surgery, recurrent season and adjuvant chemotherapy cyclesalso impacted the progression-free survival of epithelial ovarian cancer patients. The diagnosis season did nothave a significantly relationship with the survival of operable epithelial ovarian cancer patients. Median overallsurvival of patients with recurrent month from April to November was 47 months, which was longer (P < 0.001)than that of patients with recurrence month from December to March (19 months). Median progression-freesurvival of patients with recurrence month from April to November and December to March was 20 and 8months, respectively (P < 0.001). Conclusion: The recurrence season impacts the survival of epithelial ovariancancer patients. However, the diagnosed season does not appear to exert a significant influence.     

TPS和CA125在卵巢癌患者血清中的表达及其临床意义

目的　检测卵巢良性及恶性肿瘤患者血清TPS和CA12 5水平及卵巢癌患者两疗程化疗前后二者水平的变化。为卵巢癌的临床诊断、病情监测提供新方法。方法　用ELISA法分别检测血清TPS和CA12 5水平。结果　卵巢癌患者血清TPS和CA12 5水平均较良性肿瘤患者高 ,差异有显著性。血清TPS和CA12 5诊断卵巢癌的敏感度和特异度无差别。卵巢癌患者两疗程化疗后血清TPS和CA12 5水平显著下降。结论　血清TPS和CA12 5均可作为卵巢癌诊断、病情监测的临床指标 ,二者联合检测可提高其临床应用价值。     

Pattern of Tissue Expression of CA-125 and HE4 in Primary Epithelial Ovarian Tumours and Correlation with Serum CA-125 Levels

The objective of this study is to assess tissue expression of CA-125 and HE4 protein in primary benign andmalignant epithelial tumours of the ovary and correlate with serum CA-125 levels. A total of 100 formalin-fixed,paraffin embedded sections of ovarian tumours which included serous adenoma (11), mucinous adenoma (42),serous carcinoma (20), mucinous carcinoma (12) and endometrioid carcinoma (15), histologically diagnosedbetween 1st January 2004 to 31st December 2012 at the University Malaya Medical Centre, were stained for HE4(rabbit polyclonal antibody, Abcam, UK) and CA-125 (mouse monoclonal antibody clone: OC125, Cell MarqueCorporation, Rocklin, California, USA). Pre-operative serum CA-125 levels were obtained from the laboratoryinformation system. Immunoscore (I score) for HE4 and CA-125 was given based on the intensity of staining andpercentage of positive tumour cells and considered significant when it was >50 (intensity of staining multiplied bypercentage of positive tumour cells). Serum CA-125 levels were compared with the I score of HE4 and CA-125in tissues. We noted that the CA-125 levels in serum and tissues were significantly raised in malignant comparedto benign ovarian tumours (p value<0.05). Tissue expression of HE4 protein was also significantly raised inmalignant tumours compared to benign tumours (p value<0.05). We conclude that HE4 can be a useful tissueimmunomarker in addition to CA-125.     

血清CA19—9联合CA125检测在卵巢肿瘤中的应用价值

目的：探讨单独检测血清CA19－9值及结合CA125检测值在卵巢肿瘤中的应用价值。方法：采用ELISA法,检测206例卵巢包块（其中恶性肿瘤48例,良性包块158例）手术前血清CA19－9及CA125值,并对部分恶性肿瘤患者术后进行连续动态监测、随访。结果：恶性肿瘤组血清CA19－9及CA125检测的敏感性、特殊性分别为83．3％、71．5％;而联合CA19－9与CA125,对卵巢恶性肿瘤的敏感性可达91．6％。恶性肿瘤患者术后连续监测CA19－9及CA125值显示,两者升高则预后极差;两者维持在正常范围则预后好。结论：CA19－9的检测可作为CA125的补充,提高诊断的敏感性;同时对术后病情监测也有较大意义。