CA 125 and the detection of recurrent ovarian cancer: a reasonably accurate biomarker for a difficult disease.
CA 125 and the detection of recurrent ovarian cancer: a reasonably accurate biomarker for a difficult disease.
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DOI：
10.1002/cncr.25203
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发表时间：
2010-06-15
期刊：
影响因子：
6.2
通讯作者：
Bast, Robert C., Jr.
中科院分区：
文献类型：
--
作者：
Bast, Robert C., Jr.
自从我们小组在 25 多年前首次描述该检测以来，血清 CA125 的 1 次测量已以多种不同方式为卵巢癌患者的护理做出了贡献。 CA125 最初的应用是监测卵巢癌化疗期间的反应以及检测初次治疗后的持续性疾病。 2 在癌症患者的外周血中释放出足够数量的 CA125 使其升高时，生物标志物水平可追踪肿瘤体积，准确度高达 90%。 3 在细胞减灭手术和联合化疗后，CA125 水平持续升高与 90% 以上的病例中的持续性疾病相关。 2, 3 然而，CA125 并不是最佳敏感性，化疗后 CA125 水平正常的患者中，高达 50% 在复查手术中发现有少量持续性疾病。 2, 3诊断时，升高的 CA125 已与超声检查 4 和其他生物标志物 5, 6, 7 相结合，以确定那些最有可能患有卵巢癌的盆腔肿块患者，以及哪些患者可以从转诊至妇科肿瘤科医生进行初次手术中受益。也许连续 CA125 测定最有前途的应用是识别一小部分健康绝经后妇女，她们将受益于经阴道超声检查以早期发现卵巢癌。 8 UKCTOCS 试验涉及英国 200,000 名女性，其早期结果表明，提高 CA 125 后进行经阴道超声检查可以使早期检测到的癌症比例几乎翻倍，并且每例检测到的卵巢癌不需要超过 3 例手术。 8 SPORE 在美国赞助的一项试验证实了这些观察结果，尽管规模要小得多。 9 UKCTOCS 试验有足够的能力来检测生存优势，结果将在未来 2-3 年内公布。
Since the first description of the assay by our group more than 25 years ago, 1 measurement of serum CA125 has contributed to the care of patients with ovarian cancer in several different ways. The original application of CA125 was in monitoring response of ovarian cancer during chemotherapy and in detecting persistent disease following primary treatment. 2 In patients whose cancers shed sufficient quantities of CA125 to be elevated in peripheral blood, biomarker levels have tracked tumor volume with up to 90% accuracy. 3 After cytoreductive surgery and combination chemotherapy, persistent elevation of CA125 levels has correlated with persistent disease in> 90% of cases. 2, 3 CA125 is not, however, optimally sensitive and up to 50% of patients with normal levels of CA125 following chemotherapy were found to have small volumes of persistent disease at second look operations. 2, 3At the time of diagnosis, elevated CA125 has been combined with ultrasonography4 and other biomarkers5, 6, 7 to identify those patients with pelvic masses who are most likely to have ovarian cancer and who would benefit from referral to a gynecologic oncologist for primary surgery. Perhaps the most promising application of serial CA125 determinations is to identify a small fraction of healthy postmenopausal women who would benefit from transvaginal sonography to detect ovarian cancer at an early stage. 8 Early results from the UKCTOCS trial involving 200,000 women in the United Kingdom suggest that rising CA 125 followed by transvaginal sonography can nearly double the fraction of cancers detected in early stage and require no more than 3 operations for each case of ovarian cancer detected. 8 A SPORE sponsored trial in the United States has confirmed these observations, albeit on a much smaller scale. 9 The UKCTOCS trial is adequately powered to detect a survival advantage and results will be available in the next 2-3 years.
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影响因子：
4.7
作者：
Parker, PA;Kudelka, A;Cohen, L
通讯作者：
Cohen, L
影响因子：
51.1
作者：
Menon, Usha;Gentry-Maharaj, Aleksandra;Jacobs, Ian
通讯作者：
Jacobs, Ian
影响因子：
45.3
作者：
Santillan, A;Garg, R;Bristow, RE
通讯作者：
Bristow, RE
DOI：
10.1111/j.1471-0528.1990.tb02448.x
发表时间：
1990-10-01
期刊：
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY
影响因子：
--
作者：
JACOBS, I;ORAM, D;GRUDZINSKAS, JG
通讯作者：
GRUDZINSKAS, JG
影响因子：
4.7
作者：
Wilder, JL;Pavlik, E;van Nagell, J
通讯作者：
van Nagell, J