FR-α联合KELIM评分在预测晚期卵巢高级别浆液性腺癌铂耐药复发中的应用研究

FR-α Combined with KELIM Score in the Prediction of Advanced Ovarian High-Grade Serous Study on the Application of Platinum Resistance Recurrence in Adenocarcinoma

摘要: 目的：探究叶酸受体(Folate receptor alpha, FR-α)蛋白联合消除速率常数K (the modeled CA125 ELIMination rate constant K, KELIM)在预测晚期卵巢高级别浆液性腺癌(ovarian high-grade serous adenocarcinoma, HGCS)铂类药物化疗后铂耐药复发中的应用。方法：收集行满意肿瘤细胞减灭术，以术后联合铂类为基础，规范化疗的40例患者，根据患者停止化疗后6个月复发情况，分为铂敏感复发组和铂耐药复发组(各20例)，分析总结HGCS铂耐药的因素。结果：FR-α在HGCS中高表达，阳性率为75%；两组患者年龄、BMI、术前CA125等一般资料比较差异无统计学意义(P > 0.05)，KELIM评分、FR-α、ROMA比较差异具有统计学意义(P < 0.05)；Logistic多因素分析显示：KELIM评分、FR-α是晚期卵巢高级别浆液性腺癌铂耐药复发独立的预后因素(OR：0.181，95%CI：0.033~0.982，P = 0.048；OR：0.030，95%CI：0.002~0.475，P = 0.013)；将Logistic多因素分析有意义的指标，绘制ROC曲线，结果：FR-α联合KELIM评分曲线下面积为0.818 (95%CI：0.683~0.952，P = 0.001)，灵敏度为0.80%。结论：FR-α在HGCS中高表达，FR-α、KELIM值是HGCS铂耐药复发独立的预后因素，二者联合检测对HGCS铂类耐复发具有一定预测价值。

Abstract: Objective: To explore the application of folate receptor alpha (FR-α) protein combined with the modeled CA125 ELIMination rate constant K (KELIM) in predicting platinum-resistant recurrence after platinum-based chemotherapy in advanced ovarian high-grade serous adenocarcinoma (HGCS). Methods: Forty patients who underwent satisfactory tumor cytoreductive surgery and postoperative platinum-based chemotherapy were collected. According to the recurrence of patients 6 months after chemotherapy, they were divided into platinum-sensitive recurrence group and platinum-resistant recurrence group (20 cases each). The factors of platinum resistance in HGCS were analyzed and summarized. Results: FR-α was highly expressed in HGCS, with a positive rate of 75%. There was no significant difference in age, BMI, preoperative CA125 and other general data between the two groups (P > 0.05). There were significant differences in KELIM score, FR-α and ROMA between the two groups (P < 0.05). Logistic multivariate analysis showed that KELIM score and FR-α were independent prognostic factors for platinum-resistant recurrence of advanced ovarian high-grade serous adenocarcinoma (OR: 0.181, 95%CI: 0.033~0.982, P = 0.048; OR: 0.030, 95%CI: 0.002~0.475, P = 0.013); logistic multivariate analysis was used to analyze the meaningful indicators, and the ROC curve was drawn. Results: The area under the curve of FR-α combined with KELIM score was 0.818 (95%CI: 0.683~0.952, P = 0.001), and the sensitivity was 0.80%. Conclusion: FR-α is highly expressed in HGCS. FR-α and KELIM values are independent prognostic factors for platinum-resistant recurrence of HGCS. The combined detection of the two has a certain predictive value for platinum-resistant recurrence of HGCS.