Predicting Circulating CA125 Levels among Healthy Premenopausal Women
Predicting Circulating CA125 Levels among Healthy Premenopausal Women
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DOI：
10.1158/1055-9965.epi-18-1120
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发表时间：
2019-06-01
影响因子：
3.8
通讯作者：
Terry, Kathryn L.
中科院分区：
文献类型：
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作者：
Sasamoto, Naoko;Babic, Ana;Terry, Kathryn L.
背景：肿瘤抗原125(CA125)是迄今为止最有前景的卵巢癌筛查生物标志物。多项研究报告称，CA125水平因个人特征而异，这可能会决定个性化的CA125阈值。然而，这在绝经前妇女中还没有得到很好的描述。方法：我们评估了来自新英格兰病例对照研究(NEC)的815名绝经前妇女CA125水平的预测因素。在欧洲癌症与营养前瞻性研究(EPIC)中，我们建立了线性和二分法CA125预测模型，并外部验证了限制可用预测因素的简化模型。结果：最终的线性CA125预测模型包括年龄、种族、输卵管结扎、子宫内膜异位症、月经抽血和子宫肌瘤，可解释CA125总方差的7%。基于简化模型的观测和预测CA125水平之间的相关性(包括年龄、种族和抽血时的月经时相)在NEC(r=0.22)和EPIC(r=0.22)中具有相似的相关系数。CA125预测模型包括年龄、输卵管结扎术、子宫内膜异位症、个人癌症诊断史、卵巢癌家族史、流产次数、月经周期、抽血、吸烟状况，AUC为0.83。简化的二分法模型(包括年龄、流产次数、采血月经阶段和吸烟状况)在NEC(0.73)和EPIC(0.78)中显示相似的AUC。结论：我们发现了与绝经前妇女CA125水平相关的因素组合。
Background: Cancer antigen 125 (CA125) is the most promising ovarian cancer screening biomarker to date. Multiple studies reported CA125 levels vary by personal characteristics, which could inform personalized CA125 thresholds. However, this has not been well described in premenopausal women.Methods: We evaluated predictors of CA125 levels among 815 premenopausal women from the New England Case Control Study (NEC). We developed linear and dichotomous (>= 35 U/mL) CA125 prediction models and externally validated an abridged model restricting to available predictors among 473 premenopausal women in the European Prospective Investigation into Cancer and Nutrition Study (EPIC).Results: The final linear CA125 prediction model included age, race, tubal ligation, endometriosis, menstrual phase at blood draw, and fibroids, which explained 7% of the total variance of CA125. The correlation between observed and predicted CA125 levels based on the abridged model (including age, race, and menstrual phase at blood draw) had similar correlation coefficients in NEC (r = 0.22) and in EPIC (r = 0.22). The dichotomous CA125 prediction model included age, tubal ligation, endometriosis, prior personal cancer diagnosis, family history of ovarian cancer, number of miscarriages, menstrual phase at blood draw, and smoking status with AUC of 0.83. The abridged dichotomous model (including age, number of miscarriages, menstrual phase at blood draw, and smoking status) showed similar AUCs in NEC (0.73) and in EPIC (0.78).Conclusions: We identified a combination of factors associated with CA125 levels in premenopausal women.Impact: Our model could be valuable in identifying healthy women likely to have elevated CA125 and consequently improve its specificity for ovarian cancer screening.