Clinical Value Discussion Of Three Tumor Markers Changes In Monitoring Adjuvant Therapy With Ovarian Cancer Patients

Objective: To detect serum changes of tumor marker CA125, HE4, CA199 in ovarian cancer patients in the process of adjuvant chemotherapy after the initial postoperative and explore its clinical monitoring value.Methods: Enrolling fifty-one patients from January 2013 to August 2015 at the First Hospital of Lanzhou University gynecology department,detecting serum level of CA125, HE4,CA199 and the three in all of the clinical patients by pathological diagnosis of ovarian cancer after each cycle of postoperative chemotherapy and during follow-up after treatment, analyzing significance of levels changes.Results: 1 The levels of CA125, HE4 ovarian cancer patients before chemotherapy after surgery had no significant difference with age, performance status patients(P> 0.05), both were significant difference with lymph node metastasis, clinical stage, histological type, the degree of differentiation(P <0.05), while the CA199 only with significant difference in surgical pathology(P<0.05),the higher the clinical stage, the higher the expression level;2 After three courses of chemotherapy, fifty-one patients in complete remission [CR] 9patients(17.6%), partial response [PR] 24 cases(47.1%), stable [SD] 14 cases(27.5%),progression [PD] 4 patients(7.8%);3 33 cases of CR+PR group, there was a statistically significant difference(P<0.05) with the level of CA125, HE4 and CA125+HE4+CA199 before and after chemotherapy; 18 patients of SD+PD group, there had significant difference(P<0.05) with the level of CA125, HE4, CA199 and combined detection before and after chemotherapy; however, CR+PR group and SD+PD group,there was no significant difference(P> 0.05) with three tumor markers and combineddetection before and after chemotherapy;4 The median level of CA125 tends to be normal after the end of the two courses, the median level of HE4 tended to be normal at the end of the first course, while CA199 had no significant changes before and after chemotherapy;5 The susceptibility of early diagnosis of the recurrent ovarian cancer of CA125,HE4,CA199 respectively are 45.4%, 63.6%, 9.1% and the specificity respectively are87.1%, 93.5%, 80.6%, the sensitivity and specificity of the three joint detection separately are66.6%, 96.3%.ROC curve shows that HE4 value of early predictionof the recurrence ovarian cancer is higher than CA125, CA199, combined detection is higher than any single detection.Conclusion: 1 CA125 and HE4 high level or positive are related to factors affecting the prognosis of patients with ovarian cancer, such as lymph node metastasis, clinical stage, the degree of differentiation, histological type association, which may indicate that it is closely related to the biological behavior of the erosion and distant metastasis of ovarian cancer,but positive rate of CA199 levels only is related to the patient’s pathology staging and can not fully reflect the biological behavior of ovarian cancer progress;2 The subsequent chemotherapy course of dynamic monitoring of serum CA125, HE4 levels in ovarian cancer patients can be good for assessing prognosis and monitoring clinical job;3 Regular testing of CA125, HE4, CA199 and combined detection level with ovarian cancer patients have better clinical significance of determining its clinical efficacy and prediction of recurrence;4 With prediction of recurrence ovarian cancer after surgery, the sensitivity and specificity of HE4 is superior to CA125 and CA199, the three combined detection can improve the sensitivity and specificity of early recurrence diagnosis of ovarian cancer after surgery.