在ProMisE分子分类的背景下，血清CA125水平提供了术前预后信息，可以指导子宫内膜癌的治疗。

IF 4.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Gynecologic oncology Pub Date : 2025-02-01 DOI:10.1016/j.ygyno.2024.12.010

Andrea Neilson , Amy Jamieson , Derek Chiu , Samuel Leung , Amy Lum , Stefan Kommoss , David G. Huntsman , Aline Talhouk , C. Blake Gilks , Jessica N. McAlpine

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引用次数: 0

摘要

目的：既往研究提示子宫内膜癌（EC）患者血清CA125可反映子宫外病变。我们的目的是确定CA125是否可以识别子宫外和/或淋巴结转移患者，该生物标志物与EC分子亚型的关联，并探索在这种情况下的最佳切断。方法：我们评估了CA125水平与1107例分子分类EC的临床病理和预后数据的关系。结果：CA125异常（bbb35ku /L）与所有EC和各分子亚型的高分期和淋巴结转移（LNM）相关，单变量（p35ku /L）对LNM的敏感性为0.82，特异性为0.53，阳性预测值为0.92，阴性预测值为0.31,>I期的值相似。CA125 > 35 kU/L与所有EC、p53abn （OS、DSS、PFS）、NSMP （OS、DSS）和MMRd （OS、DSS）亚型中较差的总（OS）、疾病特异性（DSS）和无进展生存（PFS）相关。CA125 > 35 kU/L与III/IV期疾病的相对危险度（RR）为2.50 （p 24 kU/L）与临床参数和生存结果有相似的相关性。结论：CA125水平与分子亚型、>I期疾病和SEOC/CAM相关。在分子分类时代，CA125仍然是诊断EC的有效临床工具。

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Serum CA125 levels in the context of ProMisE molecular classification provides pre-operative prognostic information that can direct endometrial cancer management

Objective

Previous research suggests serum CA125 reflects extra-uterine disease in patients with endometrial carcinoma (EC). Our objective was to determine if CA125 can identify patients with extra-uterine and/or nodal metastases, the association of this biomarker with EC molecular subtype, and to explore an optimal cutoff in this context.

Methods

We assessed the association of CA125 levels with clinicopathologic and outcomes data on a cohort of 1107 molecularly classified EC.

Results

Abnormal CA125 (>35kU/L) was associated with higher stage and lymph node metastases (LNM) in all EC and in each molecular subtype on univariate (p < 0.01) and multivariate (p < 0.05) analyses. POLEmut had the lowest median CA125 level and proportion of CA125 abnormal patients, and p53abn the highest proportion (p < 0.001). CA125 > 35 kU/L had a sensitivity of 0.82, specificity 0.53, positive-predictive-value 0.92, and negative-predictive-value 0.31 for LNM, with similar values for stage>I. CA125 > 35 kU/L was associated with worse overall (OS), disease-specific (DSS), and progression-free survival (PFS) in all EC, p53abn (OS, DSS, PFS), NSMP (OS, DSS), and MMRd (OS, DSS) subtypes. CA125 > 35 kU/L demonstrated a relative risk (RR) of 2.50 with presence of stage III/IV disease (p < 0.001) and RR 18.4 for the presence of synchronous endometrial and ovarian carcinomas (SEOC)/co-existing adnexal malignancies (CAM) (p < 0.001). An exploratory cut point, optimized for correlation with DSS (CA125 > 24 kU/L) show similar association with clinical parameters and survival outcome.

Conclusions

CA125 levels are associated with molecular subtype, stage>I disease, and SEOC/CAM. CA125 remains a useful clinical tool in the triage of EC in the era of molecular classification.

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来源期刊

Gynecologic oncology 医学-妇产科学

CiteScore

8.60

自引率

6.40%

发文量

1062

审稿时长

37 days

期刊介绍： Gynecologic Oncology, an international journal, is devoted to the publication of clinical and investigative articles that concern tumors of the female reproductive tract. Investigations relating to the etiology, diagnosis, and treatment of female cancers, as well as research from any of the disciplines related to this field of interest, are published. Research Areas Include: • Cell and molecular biology • Chemotherapy • Cytology • Endocrinology • Epidemiology • Genetics • Gynecologic surgery • Immunology • Pathology • Radiotherapy