CAJ | 학술논문

目的：探讨腹腔肿瘤（上皮性卵巢癌、输卵管癌及腹膜癌）化疗前后血清糖类抗原125（CA125）水平的变化及其对预后效果的临床预测价值。方法收集该院2005年1月至2008年1月收治的腹腔肿瘤患者174例（上皮性卵巢癌107例、输卵管癌35例、腹膜癌32例），同时计算化疗3疗程后患者血清CA125水平与术前相比下降的百分比，并分析CA125下降水平与化疗敏感性及不同CA125水平患者中位生存时间及生存期限的差异。结果化疗后，CA125下降水平大于或等于75％42例，下降51％～75％62例，下降25％～50％32例，下降小于25％38例，其中CA125水平下降大于或等于75％组的化疗效果优于其余各组，差异有统计学意义（P＜0．05）。经单因素分析可知，CA125水平下降比例与患者化疗效果呈正相关（r＝0．396，P＝0．000）。采用Kaplan-Meier法计算患者生存率及中位生存时间可知，CA125水平下降大于或等于75％组5年生存率及中位生存时间显著优于其他各组，差异有统计学意义（P＜0．05）。经单因素分析可知，CA125水平下降比例与患者远期疗效呈正相关（r＝0．412，P＝0．000）。经COX风险模型分析可知，患者FIGO分期、CA125水平、化疗效果是影响患者预后的独立危险因素。结论血清CA125水平是腹腔肿瘤患者预后的独立危险因子，CA125下降的比例可了解患者化疗的效果及远期治疗效果，可作为评价腹腔肿瘤患者预后指标。
목적：탐토복강종류（상피성란소암、수란관암급복막암）화료전후혈청당류항원125（CA125）수평적변화급기대예후효과적림상예측개치。방법수집해원2005년1월지2008년1월수치적복강종류환자174례（상피성란소암107례、수란관암35례、복막암32례），동시계산화료3료정후환자혈청CA125수평여술전상비하강적백분비，병분석CA125하강수평여화료민감성급불동CA125수평환자중위생존시간급생존기한적차이。결과화료후，CA125하강수평대우혹등우75％42례，하강51％～75％62례，하강25％～50％32례，하강소우25％38례，기중CA125수평하강대우혹등우75％조적화료효과우우기여각조，차이유통계학의의（P＜0．05）。경단인소분석가지，CA125수평하강비례여환자화료효과정정상관（r＝0．396，P＝0．000）。채용Kaplan-Meier법계산환자생존솔급중위생존시간가지，CA125수평하강대우혹등우75％조5년생존솔급중위생존시간현저우우기타각조，차이유통계학의의（P＜0．05）。경단인소분석가지，CA125수평하강비례여환자원기료효정정상관（r＝0．412，P＝0．000）。경COX풍험모형분석가지，환자FIGO분기、CA125수평、화료효과시영향환자예후적독립위험인소。결론혈청CA125수평시복강종류환자예후적독립위험인자，CA125하강적비례가료해환자화료적효과급원기치료효과，가작위평개복강종류환자예후지표。
Objective To investigate the changes of CA125 level with intra-abdominal tumor(epithelial ovarian cancer ,fallopian tube cancer and peritoneal cancer ) before and after chemotherapy serum and their effect on the prognosis of patients and their the clinical predictive value .Methods 174 cases(107 cases of epithelial ovarian cancer ,35 cases of fallopian tube cancer ,and 32 cases of peritoneal cancer) with peritoneal cancer patients were selected from January 2007 to January 2008 .The percentage decrease of ser-um CA125 were calculated after 3 courses of chemotherapy and CA125 decreased level of sensitivity with chemotherapy were ana-lyzed .The different levels of CA125 of median survival time and median survival time were compared .Results After chemothera-py ,CA125 decreased ≥ 75% in 42 cases ,decreased from 51% to 75% in 62 cases ,decreased from 25% to 50% in 32 cases ,and de-creased less than 25% in 38 cases .In CA125 decreased ≥ 75% group ,the chemotherapy effects was better than the other groups (P<0 .05) .Univariate analysis showed that the decrease proportion of CA 125 was positively correlated with chemotherapy effect (r=0 .396 ,P=0 .000) .Using the Kaplan-Meier method ,the patient's survival rate and median survival time were caculated and it showed that the 5 years survival and median survival time were significantly better in group CA 125 decline ≥ 75% than the other groups(P<0 .05) .Univariate analysis shows that the CA125 decline proportion of patients and long term efficacy was positively correlated(r=0 .412 ,P=0 .000) .The COX risk model analysis showed that FIGO stage ,CA125 level and the effect of chemothera-py were independent prognostic risk factors .Conclusion The level of CA125 is the independent risk factor of epithelial ovarian cancer ,fallopian tube cancer and peritoneal cancer prognosis .CA125 decline proportion could be used to know the effect of chemo-therapy and long term treatment ,and be the prognosis indicators for patients with intra abdominal tumor .