Serum carbohydrate antigen 125 is not an independent prognostic factor in patients with chronic lymphocytic leukemia.
Serum carbohydrate antigen 125 is not an independent prognostic factor in patients with chronic lymphocytic leukemia.
复制标题
DOI：
10.3233/cbm-130304
复制
发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Zhi-jian Zou;L. Fan;Li Wang;Run Zhang;Li-Na Zhang;Shu Yang;Jian-yong Li;W. Xu
中科院分区：
文献类型：
--
作者：
Zhi-jian Zou;L. Fan;Li Wang;Run Zhang;Li-Na Zhang;Shu Yang;Jian-yong Li;W. Xu
背景糖抗原125（CA-125）是由上皮细胞和间皮细胞产生的糖蛋白。血清CA-125可以在许多良性和恶性疾病中升高，其中这些组织参与。方法检测112例慢性淋巴细胞白血病（CLL）患者血清CA-125浓度，并分析其与Binet分期、血清乳酸脱氢酶（LDH）、β 2-微球蛋白（β2-MG）、CD 38、70-kDa zeta相关蛋白（ZAP-70）、免疫球蛋白重链可变区（IGHV）突变及细胞遗传学异常的关系。结果CA-125与Binet分期（r=0.463，p< 0.001）、LDH（r=0.404，p< 0.001）、β2-MG（r=0.274，p=0.004）、IGHV未突变（r=0.366，p=0.009）相关。多因素分析显示，晚期Binet（p<0.001）和未突变IGHV状态（p=0.018）是高CA-125水平的危险因素。单因素分析中，Binet分期影响无治疗生存期（TFS）和总生存期（OS）（分别为p<0.001和p=0.042），LDH（分别为p=0.018和p=0.013），β2-MG（p=0.006，仅TFS），ZAP-70（p=0.031，仅OS），CD 38（p=0.003，仅OS），del（17 p13）或del（11q22.3）（分别为p=0.006和p=0.049）、IGHV突变状态（分别为p=0.018和p< 0.001）和CA-125（分别为p=0.003和p=0.034）。多因素分析中，仅Binet分期提前（p<0.001）是TFS缩短的独立危险因素。CD 38阳性（p=0.020）和未突变IGHV状态（p=0.034）是恶化OS的独立危险因素。结论：高CA-125水平与许多晚期临床特征、不良预后因素、恶化TFS和OS显著相关。
BACKGROUND Carbohydrate antigen 125 (CA-125) is a glycoprotein produced by epithelial and mesothelial cells. Serum CA-125 can be elevated in many benign and malignant conditions in which these tissues are involved. METHODS We measured serum CA-125 concentration in 112 patients with chronic lymphocytic leukemia (CLL) and evaluated their association with Binet stage, serum lactate dehydrogenase (LDH), beta2-microglobulin (β2-MG), CD38, 70-kDa zeta-associated protein (ZAP-70), immunoglobulin heavy-chain variable region (IGHV) mutated status and cytogenetic abnormalities. RESULTS The high level of CA-125 was associated with advanced Binet stage (r=0.463, p< 0.001), high level of LDH (r=0.404, p< 0.001) and β2-MG (r=0.274, p=0.004), and unmutated IGHV status (r=0.366, p=0.009). Multivariate analysis showed that advanced Binet (p<0.001) and unmutated IGHV status (p=0.018) were risk factors for the high CA-125 level. In univariate analysis, treatment-free survival (TFS) and overall survival (OS) were affected by Binet stage (p<0.001 and p=0.042, respectively), LDH (p=0.018 and p=0.013, respectively), β2-MG (p=0.006, TFS only), ZAP-70 (p=0.031, OS only), CD38 (p=0.003, OS only), the presence of del(17p13) or del(11q22.3) (p=0.006 and p=0.049, respectively), IGHV mutation status (p=0.018 and p< 0.001, respectively) and CA-125 (p=0.003 and p=0.034, respectively). In multivariate analysis, only advance Binet stage (p<0.001) was independent risk factor of shorter TFS. CD38-positive (p=0.020) and unmutated IGHV status (p=0.034) were independent risk factors of worse OS. CONCLUSIONS The results support a high CA-125 level correlates significantly with many clinical features of advanced stage, poor prognostic factors, and worse TFS and OS. However, CA-125 is not an independent prognostic factor in patients with CLL.