| BackgroundAbout 90% of malignant ovarian neoplasm is epithelial ovarian cancer (EOC), and about 75% of EOC cases are recognized in advanced stages. We all know the basic way of therapy in EOC is primary cytoreduction and chemotherapy after surgery. If the residual rumor nodule remaining at the end of the surgery measured more than 2 cm, the prognosis of EOC is worse. The neoadjuvant chemotherapy and interval operation to the cases that would suffer the suboptimal primary cytoreducioncan can improve the success of surgery and quality of the life. So it is very important to predict if we can make optimal cytoreducion of advanced EOC before operation. But now there is not any optimal way to predict correctly.The role of rumor markers in monitoring of ovarian cancer is well established. Cancer antigen 125(CA125) has proved to be a useful tumor marker, the change of which is in much relation with the status of EOC. Recently, some literatures show the value of CA125 levels to ability in predicting the optimal primary cytoreduction, but some literatures don't think so. And there is much dispute on the threshold of CA125.The aim of this study of 62 patients with EOC is to investigate of the relation of CA125 and some parameters of clinical pathology and the predictive value of serum CA125 levels to ability of optimal primary cytoreduction and the suitable threshold.Materials and MethodsRetrospective records study 62 patients with EOC with all stages (2000.10-2003.8). Study the relation between preoperative CA125 and some parameters of clinical pathology (age, histology, grade and FIGO stage). The ability of CA125 at threshold level of 500 U/ml 1000 U/ml and 1500 U/ml to predict suboptimal cytoreduction and get each sensitivity specificity positive predicative value (PPV), negative predicative value (NPV) accuracy and the suitable threshold.Results1 CA125 of early stage EOC is much lower than of advanced EOC, and there are statistical differences (X~2=15. 61, P<0. 05) at the threshold of 500u/ml. There is no difference among difference histology (X~2=1.36, P>0. 05) . There is no cases of grade I in 62 cases. And there is statistical differences of CA125 level in grade II and grade III (X2=11.24, P<0. 05) 2 At the CA125 threshold of 500u/ml the sensitivity for predicting suboptimal debulking is 78.57%, specificity is 64.71%, accuracy is 70.97%, PPV is 64. 71%,NPV is 78.57%. At the CA125 threshold of 500u/ml the sensitivity for predicting suboptimal debulking is 78.57 % and specificity is 61. 11% in forty-six patients of stage III or IV.3, At the CA125 thresholdl of 1000u/ml the sensitivity for predicting suboptimal debulking is 50.00%, specificity is 79.41%, accuracy is 66.13%, PPV is 66. 67%, NPV is 65.85%.4, At the CA125 thresholdl of 1500u/ml the sensitivity for predicting suboptimal debulking is 42.86%, specificity is 85.29%, accuracy is 66.13%, PPV is 70.59%,NPV is 64.44%.ConclusionsThere are some relations between CA125 level and some clinical pathological parameters. The preoperative serum CA125 level can predict the optimalcytoreduction of EOC The suitable threshold of CA125 is 500 u/ml. But the sensitivity and other index are not all perfect, so we should need use other ways simultaneous. |
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