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晚期上皮性卵巢癌NACT-IDS的临床研究进展
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Abstract:
卵巢癌(ovarian cancer, OC)作为女性生殖系统三大恶性肿瘤之一，病死率居妇科恶性肿瘤之首。由于早期卵巢癌缺乏典型的临床表现，导致约70%的患者在确诊时已属晚期。目前对于经预测无法达到满意肿瘤细胞减灭术以及术后可能发生高并发症的晚期卵巢癌患者实施新辅助化疗(neoadjuvant chemotherapy, NACT)联合间歇性肿瘤细胞减灭术(interval debulking surgery, IDS)，它是除初次肿瘤细胞减灭术(primary debulking surgery, PDS)以外的有效补充治疗措施。但是如何筛选出适合NACT-IDS治疗的晚期卵巢癌患者以及在NACT期间何时施行IDS成为目前研究的热点话题。研究显示，CA125、HE4不仅是晚期卵巢癌初次肿瘤细胞减灭术(primary debulking surgery, PDS)术后达R0的预测因子也是晚期卵巢癌NACT-IDS术后达R0的预测因子。血清白蛋白水平是评估晚期上皮性卵巢癌(advanced epithelial ovarian cancer, AEOC)患者术后并发症风险和预后的可靠指标。本文将就CA125联合HE4及血清白蛋白在晚期上皮性卵巢癌NACT-IDS治疗模式的应用价值进行综述。
Ovarian cancer (OC), as one of the three major malignant tumors of the female reproductive system, has the highest mortality rate among gynecological malignancies. Due to the lack of typical clinical manifestations of early ovarian cancer, about 70% of the patients were in advanced stage at the time of diagnosis. At present, neoadjuvant chemotherapy (NACT) combined with intermittent tu-mor cell reduction surgery (IDS) is an effective supplementary treatment besides primary tumor cell reduction surgery (PDS) for patients with advanced ovarian cancer who cannot achieve satis-factory tumor cell reduction surgery and may have high complications after surgery. However, how to screen patients with advanced ovarian cancer who are suitable for the treatment of NACT-IDS and when to implement IDS during NACT have become hot topics in current research. The research shows that CA125 and HE4 are not only the predictive factors of R0 after primary tumor reduction surgery (PDS) for advanced ovarian cancer, but also the predictive factors of R0 after NACT-IDS surgery for advanced ovarian cancer. Serum albumin level is a reliable indicator to evaluate the risk of postoperative complications and prognosis in patients with advanced epithelial ovarian cancer (AEOC). This article will review the application value of CA125 combined with HE4 and serum al-bumin in the treatment mode of NACT-IDS for advanced epithelial ovarian cancer.
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