摘要
目的探讨化疗前后CA125变化对上皮性卵巢癌疗效、预后判定的临床价值。方法对北京协和医院1989-12-01-2001-12-01初治的203例上皮性卵巢癌患者进行血清CA125的检测,计算化疗2疗程后血清CA125值较化疗前下降的百分比,观察CA125不同组复发中位时间及生存期限的差异。结果203例患者中有102例复发,CA125下降≥75%组、50%～<75%组、<50%组各组复发的中位时间差异有显著性(F=8.422,P<0.001),且CA125下降<50%组的复发时间短;Kaplan-Meier法计算生存率,得出化疗2疗程后CA125值下降水平≥75%组的中位生存时间为42.8个月,50%～<75%组为34.6个月,<50%组为24.0个月,CA125上升组为9.3个月,以log-rank时序检验比较各组生存率曲线的分布差异有显著性(χ2=33.097,P<0.001);COX风险模型分析上皮性卵巢癌预后的多因素结果表明CA125下降水平、FIGO分期、术后残存病灶大小与卵巢上皮癌预后明显相关。结论化疗2疗程后CA125值与化疗前下降的百分比对上皮性卵巢癌的预后评定有一定的临床价值,检测该指标可协助判断复发,尽早予以相应的治疗措施。
Objective To evaluate the relationship between the percentage of decrease of serum CA125 after 2 courses of chemotherapy and the outcome and prognosis of epithelial ovarian carcinoma. Methods The level of serum CA125 were examined in 203 patients with epithelial ovarian carcinoma treated primarily in Peking University Medical College Hospital during the period from December 1, 1989 to December 1,2001. Calculate the percentage of decrease of serum CA125 after 2 courses of chemotherapy and the mean time of recurrence and the median survival. Results According to the percentage of decrease of serum CA125 after 2 courses of chemotherapy,all patients were divided into four groups： decrease of 75% or more, of 50 ～ 〈 75%, 〈 50% and increase in CA125. In recurrent patients, there were significant difference between the mean time of recurrence in the CA125 decrease of 75% or more and of 50 ～ 〈75% and 〈50%. The median survival of these groups were calculated by Kaplan-Meier and the difference was significant in the survival rate curve between these groups by log-rank test. The decrease level of CA125 after chemotherapy and FIGO staging as well as the residual disease were identified by COX regression multivariate analysis as the most powerful indicator for survival. Conclusion It is possible to predict treatment response and prognosis of the epithelial ovarian carcinoma by the decrease percentage of serum CA125 after the second course of chemotherapy.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2008年第3期204-206,共3页
Chinese Journal of Practical Gynecology and Obstetrics
关键词
上皮性卵巢癌
CA125
血清
化疗
epithehal ovarian carcinoma
CA125, serum
chemotherapy
