PDF(Pubmed)
Abstract：
Using 70 U/ml or 35 U/ml as CA125 routine abnormal threshold may result in omissions in the relapse detection of Ovarian cancer (OvCa). This study aimed to clarify the association between a biochemical relapse (only the elevation of CA125) and an image-identified relapse to predict the relapsed lesions better. 162 patients who achieved complete clinical response were enrolled from women diagnosed with stage I-IV serous ovarian, tubal, and peritoneal cancers from January 2013 to June 2019 at our center. The CA125 level of 2 × nadir was defined as the indicator of image-identified relapse (P < 0.001). Compared to CA125 level exceeding 35 U/ml, the 2 × nadir of CA125 improve the sensitivity of image-identified relapse (84.9% vs 67.4%, P < 0.001); the 2 × nadir value can act as an earlier warning relapse signal with a longer median time to image-identified relapse (2.7 vs. 0 months, P < 0.001). Of the relapsed population, there was no difference of CA125 changing trend between the neoadjuvant chemotherapy (NACT) and primary debulking surgery (PDS) group after initial treatment. Compared with 35 U/ml, CA125 reaching 2 × nadir during the follow-up process might be a more sensitive and early relapse signal in patients with serous OvCa. This criterion may help guide patients to be recommended for imaging examination to detect potential relapse in time.
摘要：
使用70U/ml或35U/ml作为CA125常规异常阈值可能导致卵巢癌（OvCa）复发检测的遗漏。这项研究旨在阐明生化复发（仅CA125升高）与影像识别复发之间的关联，以更好地预测复发病变。162名获得完全临床反应的患者来自诊断为I-IV期浆液性卵巢的女性，输卵管,和腹膜癌2013年1月至2019年6月在我们中心。2×最低点的CA125水平被定义为图像识别复发的指标（P<0.001）。与超过35U/ml的CA125水平相比，CA125的2倍最低点提高了图像识别复发的敏感性（84.9%vs67.4%，P<0.001）；2×最低点值可以作为较早的警告复发信号，图像识别复发的中位时间更长（2.7vs.0个月,P<0.001)。在复发的人群中，初始治疗后，新辅助化疗（NACT）和原发性减瘤手术（PDS）组的CA125变化趋势无差异。与35U/ml相比，在浆液性OvCa患者中，CA125在随访过程中达到2×最低点可能是更敏感和早期复发的信号。该标准可以帮助指导患者被推荐进行影像学检查以及时发现潜在的复发。
