HE4及CA125评估卵巢癌生物学行为及预后的临床研究
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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。
[Objective] To evaluate the application of preoperative serum CA125 and HE4 levels for assessment of biological behavior of primary ovarian cancer and prognosis of patients. [Methods] The clinicopathological data of 127 patients with ovarian cancer admitted between January2008 and April 2014 were retrospectively reviewed. The correlation of preoperative serum CA125 and HE4 levels with FIGO stage,histological grade,ascites,size of residual lesions and prognosis of patients were analyzed. [Results ] The preoperative serum CA125 level was correlated with FIGO stage(P=0.006). The serum HE4 level was elevated in patients with serous ovarian cancer,higher FIGO stage and poorer differentiation(P<0.05). Serum CA125 and HE4 levels were not correlated with size of residual lesions and ascites. The overall 1-year,3-year,5-year survival of primary ovarian cancer was 94.7%,78.8%,61.9% respectively. The 1-year and 3 year overall survival in patients with lower HE4 level was higher than that of patients with higher HE4 level,while the 5-year overall survival in patients with higher CA125 level was lower than that of patients with low CA125 level. [Conclusion] Preoperative serum CA125 and HE4 level can be used for evaluation of the FIGO stage of ovarian cancer and survival of patients.
[Objective] To evaluate the application of preoperative serum CA125 and HE4 levels for assessment of biological behavior of primary ovarian cancer and prognosis of patients. [Methods] The clinicopathological data of 127 patients with ovarian cancer admitted between January2008 and April 2014 were retrospectively reviewed. The correlation of preoperative serum CA125 and HE4 levels with FIGO stage,histological grade,ascites,size of residual lesions and prognosis of patients were analyzed. [Results ] The preoperative serum CA125 level was correlated with FIGO stage(P=0.006). The serum HE4 level was elevated in patients with serous ovarian cancer,higher FIGO stage and poorer differentiation(P<0.05). Serum CA125 and HE4 levels were not correlated with size of residual lesions and ascites. The overall 1-year,3-year,5-year survival of primary ovarian cancer was 94.7%,78.8%,61.9% respectively. The 1-year and 3 year overall survival in patients with lower HE4 level was higher than that of patients with higher HE4 level,while the 5-year overall survival in patients with higher CA125 level was lower than that of patients with low CA125 level. [Conclusion] Preoperative serum CA125 and HE4 level can be used for evaluation of the FIGO stage of ovarian cancer and survival of patients.
引文
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[3]Tang M,Lin LH,Lin Y,et al.Expression of serum human epididymis protein 4 and CA125 in patients with epithelial ovarian cancer and their relationships with prognosis[J]Acad J Chin PLA Med Sch,2018,39(1):24-27.[唐梅,林丽慧,林元,等.血清人附睾蛋白4与CA125在上皮性卵巢癌中的表达及其与预后的关系[J].解放军医学院学报,2018,39(1):24-27.]
[4]Chen Q.Clinical value of serum HE4 combined with CA125 detection in early diagnosis and prognosis of ovarian cancer[J].Journal of Clinical Transfusion&Laboratory Medicine,2016,18(5):478-481.
[5]Romagnolo C,Leon AE,Fabricio A S,et al.HE4,CA125and risk of ovarian malignancy algorithm(ROMA)as diagnostic tools for ovarian cancer in patients with a pelvic mass:an Italian multicenter study[J].Gynecologic Oncology,2016,141(2):303-311.
[6]Kondalsamy-Chennakesavan S,Hackethal A,Bowtell D.Differentiating stage 1 epithelial ovarian cancer from benign ovarian tumours using a combination of tumour markers HE4,CA125,and CEA and patient's age[J].Gynecol Oncol,2013,129(3):467-471.
[7]Wu L,Dai ZY,Qian YH,et al.Diagnostic value of serum human epididymis protein 4(HE4)in ovarian carcinoma:a systematic review and meta-analysis[J].Int J Gynecol Cancer,2012,22(7):1106-1112.
[8]Azzam AZ,Hashad DI,Kamel NA.Evaluation of HE4 as an extrabiomarker to CA125 to improve detection of ovarian carcinoma:is it time for a step forward?[J].Arch Gynecol Obstet,2013,288(1):167-172.
[9]Chen Y,Zheng LL,Yuan XQ.Expression of HE4 and CA125 in ovarian cancer ascites[J].J Clin Res,2015,32(10):1894-1896.[陈颖,郑丽琳,袁晓青.HE4和CA125蛋白在卵巢癌腹水中的表达及其意义[J].医学临床研究,2015,32(10):1894-1896.]
[10]K觟bel M,Kalloger SE,Boyd N,et al.Ovarian carcinoma subtypes are different diseases:implications for biomarker studies[J].PLoS Medicine,2008,5(12):e232.
[11]Sturgeon Catharine M,Duffy Michael J,Stenman UlfH覽kan,et al.National academy of clinical biochemistry laboratory medicine practice guidelines for use of tumor markers in testicular,prostate,colorectal,breast,and ovarian cancers[J].Clin Chem,2008,54:e11-e79.
[12]Paek J,Lee SH,Yim GW,et al.Prognostic significance of human epididymis protein 4 in epithelial ovarian cancer[J].European Journal of Obstetrics Gynecology&Reproductive Biology,2011,158(2):338-342.
[13]Hu SS,Wang MJ,Gao J,et al.The clinical value of serum HE4 for prognosis evaluation in patients with ovarian cancer[J].China Cancer,2012,21(8):638-640.[胡书生,王慜杰,高佳,等.血清HE4在卵巢癌患者预后判断中的临床价值[J].中国肿瘤,2012,21(8):638-640.]
[2]Gentry-Maharaj A,Menon U.Screening for ovarian cancer in the general population[J].Best Pract Res Clin Obstet Gynaecol,2012,26(2):243-256.
[3]Tang M,Lin LH,Lin Y,et al.Expression of serum human epididymis protein 4 and CA125 in patients with epithelial ovarian cancer and their relationships with prognosis[J]Acad J Chin PLA Med Sch,2018,39(1):24-27.[唐梅,林丽慧,林元,等.血清人附睾蛋白4与CA125在上皮性卵巢癌中的表达及其与预后的关系[J].解放军医学院学报,2018,39(1):24-27.]
[4]Chen Q.Clinical value of serum HE4 combined with CA125 detection in early diagnosis and prognosis of ovarian cancer[J].Journal of Clinical Transfusion&Laboratory Medicine,2016,18(5):478-481.
[5]Romagnolo C,Leon AE,Fabricio A S,et al.HE4,CA125and risk of ovarian malignancy algorithm(ROMA)as diagnostic tools for ovarian cancer in patients with a pelvic mass:an Italian multicenter study[J].Gynecologic Oncology,2016,141(2):303-311.
[6]Kondalsamy-Chennakesavan S,Hackethal A,Bowtell D.Differentiating stage 1 epithelial ovarian cancer from benign ovarian tumours using a combination of tumour markers HE4,CA125,and CEA and patient's age[J].Gynecol Oncol,2013,129(3):467-471.
[7]Wu L,Dai ZY,Qian YH,et al.Diagnostic value of serum human epididymis protein 4(HE4)in ovarian carcinoma:a systematic review and meta-analysis[J].Int J Gynecol Cancer,2012,22(7):1106-1112.
[8]Azzam AZ,Hashad DI,Kamel NA.Evaluation of HE4 as an extrabiomarker to CA125 to improve detection of ovarian carcinoma:is it time for a step forward?[J].Arch Gynecol Obstet,2013,288(1):167-172.
[9]Chen Y,Zheng LL,Yuan XQ.Expression of HE4 and CA125 in ovarian cancer ascites[J].J Clin Res,2015,32(10):1894-1896.[陈颖,郑丽琳,袁晓青.HE4和CA125蛋白在卵巢癌腹水中的表达及其意义[J].医学临床研究,2015,32(10):1894-1896.]
[10]K觟bel M,Kalloger SE,Boyd N,et al.Ovarian carcinoma subtypes are different diseases:implications for biomarker studies[J].PLoS Medicine,2008,5(12):e232.
[11]Sturgeon Catharine M,Duffy Michael J,Stenman UlfH覽kan,et al.National academy of clinical biochemistry laboratory medicine practice guidelines for use of tumor markers in testicular,prostate,colorectal,breast,and ovarian cancers[J].Clin Chem,2008,54:e11-e79.
[12]Paek J,Lee SH,Yim GW,et al.Prognostic significance of human epididymis protein 4 in epithelial ovarian cancer[J].European Journal of Obstetrics Gynecology&Reproductive Biology,2011,158(2):338-342.
[13]Hu SS,Wang MJ,Gao J,et al.The clinical value of serum HE4 for prognosis evaluation in patients with ovarian cancer[J].China Cancer,2012,21(8):638-640.[胡书生,王慜杰,高佳,等.血清HE4在卵巢癌患者预后判断中的临床价值[J].中国肿瘤,2012,21(8):638-640.]
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