文章摘要
肿瘤特异性生长因子在奥拉帕利治疗卵巢癌患者临床疗效监测中的价值
Value of tumor-specific growth factors in monitoring the curative effect of Olaparib on ovarian cancer
投稿时间：2020-10-06  
DOI：10.3969/j.issn.1000-0399.2021.04.003
中文关键词: 卵巢癌  奥拉帕利  肿瘤特异性生长因子  糖类抗原125  人附睾蛋白4  白细胞介素-6
英文关键词: Ovarian cancer  Olaparib  Tumor-specific growth factor  Carbohydrate antigen 125  Human epididymis protein 4  Interleukin-6
基金项目:河南省重点研发与推广专项（项目编号：2020-414）；漯河医学高等专科学校关于创新创业发展能力提升工程项目（项目编号：2019-LYZKYZD017）
作者单位
冯磊 476000 河南南阳 河南省南阳市中心医院妇科二病区 
杨然 476000 河南南阳 河南省南阳市中心医院妇科二病区 
张清伟 462000 河南漯河 漯河医学高等专科学校第一附属医院妇科 
汪爱兵 476000 河南南阳 河南省南阳市中心医院妇科二病区 
杨建敏 476000 河南南阳 河南省南阳市中心医院妇科二病区 
孙丽 476000 河南南阳 河南省南阳市中心医院妇科二病区 
董莉丽 476000 河南南阳 河南省南阳市中心医院妇科二病区 
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中文摘要:
      目的 探讨肿瘤特异性生长因子糖类抗原125（CA125）、人附睾蛋白4（HE4）、白细胞介素-6（IL-6）在奥拉帕利治疗卵巢癌疗效监测中的价值。方法 收集2018年1~12月南阳市中心医院收治的卵巢癌患者119例，按是否使用奥拉帕利分为奥拉帕利组（n=66）与常规化疗组（n=53），两组患者均接受紫杉醇+铂类化疗，奥拉帕利组加用奥拉帕利维持治疗，比较两组患者化疗效果及不同疗效患者肿瘤特异性生长因子水平的差异；监测化疗前、化疗结束患者CA125、HE4、IL-6变化情况；随访2年，观察患者无进展生存时间（PFS），比较不同PFS患者CA125、HE4、IL-6差异；采用受试者工作特征曲线分析CA125、HE4、IL-6预测卵巢癌进展的价值。结果 奥拉帕利组化疗结束、治疗1年、治疗2年CA125、HE4、IL-6较常规化疗组低，存在组间、交互效应（P<0.05）。奥拉帕利组疗效等级优于常规化疗组，差异有统计学意义（P<0.05）。化疗结束、治疗1年、治疗2年奥拉帕利组中有效组CA125、HE4、IL-6水平低于无效组，存在组间、时间、交互效应（P<0.05）。奥拉帕利组中位PFS为18.41个月（95% CI：16.80~20.02）较常规化疗组长（P<0.05）。术前进展组CA125、HE4、IL-6均高于非进展组（P<0.05）。HE4预测卵巢癌进展的敏感度、特异性分别为63.24%、96.08%；CA125预测卵巢癌进展的敏感度、特异性分别为72.06%、84.31%；IL-6预测卵巢癌进展的敏感度、特异性分别为77.94%、58.82%；CA125、HE4预测卵巢癌进展的价值均高于IL-6（P<0.05）。结论 奥拉帕利维持治疗可提高卵巢癌获益率，延长PFS，降低肿瘤特异性生长因子CA125、HE4、IL-6水平，CA125、HE4预测卵巢癌进展价值较高。
英文摘要:
      Objective To investigate the value of tumor-specific growth factors carbohydrate antigen 125 (CA125), human epididymis protein 4 (HE4) and interleukin-6 (IL-6) in monitoring the curative effect of Olaparib on ovarian cancer. Methods From January to December 2018, 119 patients with ovarian cancer admitted to Nanyang Central Hospital were recruited and divided into Olaparib group (n=66) and conventional chemotherapy group (n=53) according to the use of new drug Olaparib. All subjects were treated with paclitaxel and platinum chemotherapy, and Olaparib group was additionally given maintenance treatment with Olaparib. Effects of chemotherapy and levels of tumor-specific growth factors in patients with different therapeutic effects were compared. Changes in CA125, HE4 and IL-6 before and after chemotherapy were monitored, and the patients were followed up for 2 years to observe their progression free survival (PFS) time. CA125, HE4 and IL-6 in patients with different PFS were compared. and receiver operating characteristic curves were used to analyze the value of CA125, HE4 and IL-6 in predicting progression of ovarian cancer. Results CA125, HE4 and IL-6 in Olaparib group were lower than those in the conventional chemotherapy group after chemotherapy, 1 year and 2 years of treatment, with inter-group and interaction effects (P<0.05). The grade of curative effect in Olaparib group was better than that in conventional chemotherapy group, and the difference was statistically significant (P<0.05). For Olaparib group, the levels of CA125, HE4 and IL-6 in effective group were lower than those in the ineffective group after chemotherapy, 1 year and 2 years of treatment, with inter-group, time and interaction effects (P<0.05). The median PFS of Olaparib group was 18.41 months (95% CI:16.80~20.02), longer than that of the conventional chemotherapy group (P<0.05). Before operation, CA125, HE and IL-6 in the progression group were higher than those in the non-progression group (P<0.05). The sensitivity and specificity of HE4 in predicting ovarian cancer progression were 63.24% and 96.08%, which of CA125 were 72.06% and 84.31%, of IL-6 were 77.94% and 58.82%, respectively. The value of CA125 and HE4 was higher than that of IL-6 in predicting progression of ovarian cancer (P<0.05). Conclusion Olaparib maintenance treatment can increase the benefit rate of ovarian cancer, prolong PFS, and reduce levels of tumor-specific growth factors CA125, HE4 and IL-6. Besides, CA125 and HE4 have high value in predicting progression of ovarian cancer.
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