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Abstract：
Objectives The current carbohydrate antigen 125 (CA125) cutoff value demonstrated high specificity but low sensitivity. Therefore, we used new cutoff values to evaluate the clinical impact of perioperative CA125 in gastric cancer. Methods This study retrospectively analyzed 525 patients with gastric cancer (349 males and 176 females), of whom 445 patients underwent R0 resection and 80 patients underwent R1/R2 resection between 2011 and 2020. The receiver operating characteristic curve indicated preoperative and postoperative cutoff CA125 values of 15.7 IU/mL and 17.3 IU/mL, respectively, to predict overall survival. Furthermore, we analyzed changes in postoperative CA125 levels and evaluated their prognostic impact using multivariate analysis. Results The preoperative CA125-positive rate was 25%. Males, advanced TNM factors, and noncurative resection cases demonstrated significantly higher positive rates than the other group. The preoperative CA125-positive group exhibited a significantly higher noncurative resection rate than the preoperative CA125-negative group (32% versus 10%, P < 0.01). Preoperatively, CA125-positive status was an independent poor prognostic factor (P < 0.01), and at three months postoperatively, it tended to be a poor prognostic factor. Conclusions High preoperative CA125 (>15.7 IU/mL) was a significant predictor for noncurative resection and poor overall prognosis in gastric cancer. Furthermore, postoperative CA125-positive status three months postoperatively was also a potential predictor of recurrence and poor prognosis.
摘要：
目的目前的糖类抗原125（CA125）截止值表现出高特异性，但敏感性较低。因此,我们使用新的临界值来评估胃癌围手术期CA125的临床影响.方法回顾性分析525例胃癌患者(男349例,女176例),其中445例患者在2011~2020年间接受了R0切除,80例患者接受了R1/R2切除.受试者工作特征曲线显示术前和术后CA125截止值分别为15.7IU/mL和17.3IU/mL,分别,预测总体生存率。此外，我们分析了术后CA125水平的变化,并使用多变量分析评估了其对预后的影响.结果术前CA125阳性率为25%。男性,先进的TNM因素，非治愈性切除病例的阳性率明显高于另一组。术前CA125阳性组的非治愈性切除率明显高于术前CA125阴性组（32％对10％，P<0.01)。术前,CA125阳性状态是独立的不良预后因素（P<0.01），术后三个月，它往往是一个不良的预后因素。结论术前高CA125（>15.7IU/mL）是胃癌非治愈性切除和总体预后不良的重要预测因素。此外，术后3个月CA125阳性状态也是复发和不良预后的潜在预测因素.
