Prediction of a high-risk group based on postoperative nadir CA-125 levels in patients with advanced epithelial ovarian cancer.
Prediction of a high-risk group based on postoperative nadir CA-125 levels in patients with advanced epithelial ovarian cancer.
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DOI：
10.3802/jgo.2011.22.4.269
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发表时间：
2011-12
影响因子：
3.9
通讯作者：
Park SY
中科院分区：
文献类型：
--
作者：
Kang S;Kim TJ;Seo SS;Kim BG;Bae DS;Park SY
我们的目的是确定预测无进展生存期的最低血清CA-125水平的理想截止值。在267例化疗后达到完全缓解的患者中，根据CA-125的分布进行分组，比较CA-125最低值与无进展生存期的相关性。在不同的临界点比较诊断优势比和受试者工作特征曲线下面积。最低CA-125水平在12 U/mL（至75百分位数）以下没有预后价值。相比之下，只有当CA-125水平大于12（75百分位数）时，它们才与无进展生存期显著相关（p=0.034）。在预测无进展生存期<6和12个月时，截止值18（90百分位数）显示出优于10或12 U/mL的上级诊断性能。与最低水平为0 - 12 U/mL的患者相比（0至75百分位数），最低值>18 U/mL的患者显示风险比为2.85（95%置信区间，1.70至4.76; p<0.001）;最低水平为18 - 12 U/mL的患者的风险比为1.68（95%置信区间，1.11至2.56; p=0.015）与最低水平低于12 U/mL的患者相比。传统临界值10 U/mL对风险组分类或识别高风险患者的预测能力不令人满意。在18 U/mL的临界值下观察到最佳诊断性能，可以建议将临界值二分，以预测个体患者的结局。
We aimed to determine the ideal cut-off of nadir serum CA-125 level for prediction of progression free survival. Among 267 patients who achieved complete remission after chemotherapy, the correlation between nadir CA-125 and progression free survival were compared among the subgroups classified according to the distribution of CA-125. The diagnostic odds ratio and area under the receiver operator characteristics curve were compared at various cut-off points. The nadir CA-125 levels did not have prognostic value under 12 U/mL (to 75 percentile). In contrast, they were significantly correlated with progression free survival only when the CA-125 level was greater than 12, which was 75 percentile (p=0.034). In predicting progression free survival <6 and 12 months, the cut-off value of 18 (90 percentile) showed superior diagnostic performance over 10 or 12 U/mL. Compared with patients who showed nadir levels between 0 and 12 U/mL (0 to 75 percentile), those with nadir >18 U/mL showed a hazard ratio of 2.85 (95% confidence interval, 1.70 to 4.76; p<0.001); patients with nadir levels between 18 and 12 U/mL showed a the hazard ratio of 1.68 (95% confidence interval, 1.11 to 2.56; p=0.015) compared with those whose nadir levels were under 12 U/mL. The predictive power of the traditional cut-off of 10 U/mL to classify a risk group or to identify high risk patients was unsatisfactory. The optimal diagnostic performance was observed at the cut-off of 18 U/mL and this can be proposed to dichotomize cut-off values to predict outcomes among individual patients.
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影响因子：
50.5
作者：
Crawford, SM;Peace, J
通讯作者：
Peace, J
影响因子：
2.5
作者：
Kang, Sokbom;Seo, Sang-Soo;Park, Sang-Yoon
通讯作者：
Park, Sang-Yoon
影响因子：
50.5
作者：
Prat, A.;Parera, M.;Del Campo, J. M.
通讯作者：
Del Campo, J. M.
DOI：
10.1002/ssu.2980060604
发表时间：
1990-01-01
期刊：
SEMINARS IN SURGICAL ONCOLOGY
影响因子：
--
作者：
OLT, GJ;BERCHUCK, A;BAST, RC
通讯作者：
BAST, RC
影响因子：
45.3
作者：
Markmann, M;Liu, PY;Alberts, DS
通讯作者：
Alberts, DS