| 韩姗姗,马玲.乳腺癌易感基因联合癌抗原 125动态监测在预测晚期上皮性卵巢癌病人铂敏感性及预后中的价值[J].安徽医药,2024,28(1):159-164. |
| 乳腺癌易感基因联合癌抗原 125动态监测在预测晚期上皮性卵巢癌病人铂敏感性及预后中的价值 |
| Value of dynamic monitoring of breast cancer susceptibility genes combined with cancer antigen 125 in predicting platinum sensitivity and prognosis of advanced epithelial ovarian cancer patients |
| |
| DOI：10.3969/j.issn.1009-6469.2024.01.033 |
| 中文关键词: 卵巢肿瘤 基因， BRCA1 基因， BRCA2 CA125抗原 抗药性，肿瘤 预后 铂敏感性 |
| 英文关键词: Ovarian neoplasm Gene, BRCA1 Genes, BRCA2 CA125 antigen Drug resistance, neoplasm Prognosis Plat-inum sensitivity |
| 基金项目: |
|
| 摘要点击次数: 193 |
| 全文下载次数: 80 |
| 中文摘要: |
| 目的评估胚系乳腺癌易感基因( BRCA)联合动态监测血清癌抗原 125(CA125)在晚期上皮性卵巢癌( EOC)病人初治铂敏感性预测及判断预后中的价值。方法收集并回顾性分析 2017年 1月至 2020年 1月在蚌埠医学院第一附属医院行满意减瘤术且术后采用 TC(紫杉醇 +卡铂) /TP(紫杉醇 +顺铂)方案静脉化疗的 EOC病人 151例的临床病理资料。分析胚系 BRCA与 EOC病人临床病理特征之间的关系；计算曲线下面积( AUC)值等评估胚系 BRCA、治疗早期血清 CA125水平及两者联合预测晚期 EOC病人初治铂敏感性的效能；分析胚系 BRCA、治疗早期血清 CA125与晚期 EOC病人无进展生存期( PFS)的关系；并对所有 EOC病人的 PFS进行多因素生存分析。结果胚系 BRCA致病突变率为 28.5％( 43/151)。胚系 BRCA与确诊年龄、治疗前血清 CA125、遗传性乳腺癌和卵巢癌( HBOC)家族史等具有相关性( P<0.05)；胚系 BRCA、第一周期化疗后血清 CA125单独预测晚期 EOC病人初治铂敏感性的 AUC为 0.63、0.76；胚系 BRCA与第一周期化疗后血清 CA125串联预测晚期 EOC病人初治铂敏感性的效能最高， AUC为 0.79，95%CI:(0.69，0.90)灵敏度为 69.7%，特异度为 89.2%；在晚期 EOC病人中， BRCA野生型 +第一周期化疗后 CA125>35 U/mL组病人的 PFS生存曲线显，著低于 BRCA突变型 +第一周期化疗后 CA125≤35 U/mL组、 BRCA突变型 +第一周期化疗后 CA125>35 U/mL组、 BRCA野生型 +第一周期化疗后 CA125≤35 U/mL组( P=0.013、0.007、0.003)。多因素 Cox回归分析显示第一周期化疗后血清 CA125水平是 EOC病人肿瘤无进展生存时间( PFS)的独立预后因素。结论胚系 BRCA联合血清 CA125动态监测对晚期 EOC病人铂敏感性及预后有一定的预测价值。胚系 BRCA野生型且第一周期化疗后血清 CA125水平未正常提示 EOC病人铂耐药及易复发的风险高。 |
| 英文摘要: |
| Objective To evaluate the value of germline breast cancer susceptibility gene (BRCA) combined with dynamic monitor-ing of serum cancer antigen 125 (CA125) in predicting primary platinum sensitivity and determining prognosis in patients with ad-vanced epithelial ovarian cancer (EOC).Methods The clinicopathological data of EOC patients who underwent satisfactory subtrac-tive surgery together with postoperative intravenous chemotherapy with the TC (paclitaxel + carboplatin)/TP (paclitaxel + cisplatin) regi-men in the First Affiliated Hospital of Bengbu Medical College from January 2017 to January 2020 were collected and retrospectivelyanalyzed. The relationship between germline BRCA and clinicopathological features of EOC patients was analyzed. The area under thecurve (AUC) values were calculated to assess the efficacy of germline BRCA, serum CA125 levels in the early stage of treatment, andthe combination of the two in predicting primary platinum sensitivity in patients with advanced EOC. To analyze the relationship be-tween germline BRCA, early treatment serum CA125 and progression-free survival (PFS) in patients with advanced EOC; and to per- form a multifactorial survival analysis of PFS in all EOC patients.Results Germline BRCA pathogenic mutation rate was 28.5% (43/151). The germline BRCA was correlated with age at diagnosis, pretreatment serum CA125, and family history of hereditary breast andovarian cancer (HBOC) (P < 0.05). The AUCs of germline BRCA and postfirst-cycle chemotherapy serum CA125 alone for predictingprimary platinum sensitivity in patients with advanced EOC were 0.63 and 0.76, respectively. The tandem combination of germlineBRCA and postfirst-cycle chemotherapy serum CA125 had the highest efficacy in predicting primary platinum sensitivity in patientswith advanced EOC, with an AUC of 0.79, a 95%CI of (0.69, 0.90), a sensitivity of 69.7% and specificity of 89.2%. In patients with ad-vanced EOC, the PFS survival curves of patients in the BRCA wild-type + postfirst-cycle chemotherapy serum CA125 > 35 U/mL group were significantly lower than those in the BRCA mutant +postfirst-cycle chemotherapy serum CA125 ≤ 35 U/mL group, the BRCA mu- tant + postfirst-cycle chemotherapy serum CA125 > 35 U/mL group, and the BRCA wild-type + postfirst-cycle chemotherapy serum CA125 ≤ 35 U/mL group (P = 0.013, 0.007, 0.003). Multifactorial Cox regression analysis showed that the serum CA125 level after thefirst cycle of chemotherapy was an independent prognostic factor for tumor PFS in EOC patients.Conclusions Germline BRCA com- bined with Dynamic monitoring of serum CA125 has a certain predictive value for platinum sensitivity and prognosis in patients withadvanced EOC. Germline BRCA wild-type and nonnormalization of serum CA125 levels after the first cycle of chemotherapy suggestthat EOC patients are at high risk of platinum resistance and recurrence. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
