晚期上皮性卵巢癌NACT-IDS的临床研究进展
Progress in Clinical Research of NACT-IDS in Advanced Epithelial Ovarian Cancer
DOI: 10.12677/ACM.2023.1351119, PDF,   
作者: 张 晴:山西医科大学第二医院妇科,山西 太原;武晓红*:山西省肿瘤医院,中国医学科学院肿瘤医院山西医院,山西医科大学附属肿瘤医院妇二科,山西 太原
关键词: 晚期上皮性卵巢癌NACT-IDSCA125HE4血清白蛋白Advanced Epithelial Ovarian Cancer NACT-IDS CA125 HE4 Serum Albumin
摘要: 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。
Abstract: 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.
文章引用:张晴, 武晓红. 晚期上皮性卵巢癌NACT-IDS的临床研究进展[J]. 临床医学进展, 2023, 13(5): 7992-7998. https://doi.org/10.12677/ACM.2023.1351119

参考文献

[1] Sung, H., Ferlay, J., Siegel, R.L., et al. (2021) Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA, 71, 209-249. [Google Scholar] [CrossRef] [PubMed]
[2] He, R., Zhu, B., Liu, J., Zhang, N., Zhang, W.-H. and Mao, Y. (2021) Women’s Cancers in China: A Spatio-Temporal Epidemiology Analysis. BMC Women’s Health, 21, Article No. 116. [Google Scholar] [CrossRef] [PubMed]
[3] 张国楠. 重视与践行卵巢癌的规范化治疗和全程管理[J]. 肿瘤预防与治疗, 2020, 33(5): 377-382.
[4] Chang, S.J., Hodeib, M., Chang, J. and Bristow, R.E. (2013) Survival Im-pact of Complete Cytoreduction to No Gross Residual Disease for Advanced-Stage Ovarian Cancer: A Meta-Analysis. Gynecologic Oncology, 130, 493-498. [Google Scholar] [CrossRef] [PubMed]
[5] Lim, M.C., Yoo, H.J., Song, Y.J., et al. (2017) Survival Out-comes after Extensive Cytoreductive Surgery and Selective Neoadjuvant Chemotherapy According to Institutional Criteria in Bulky Stage IIIC and IV Epithelial Ovarian Cancer. Journal of Gynecologic Oncology, 28, e48. [Google Scholar] [CrossRef] [PubMed]
[6] Bartels, H.C., Rogers, A.C., McSharry, V., et al. (2019) A Me-ta-Analysis of Morbidity and Mortality in Primary Cytoreductive Surgery Compared to Neoadjuvant Chemotherapy in Advanced Ovarian Malignancy. Gynecologic Oncology, 154, 622-630. [Google Scholar] [CrossRef] [PubMed]
[7] Onda, T., Satoh, T., Saito, T., et al. (2016) Comparison of Treatment Invasiveness between Upfront Debulking Surgery Versus Interval Debulking Surgery Following Neoadjuvant Chemotherapy for Stage III/IV Ovarian, Tubal and Peritoneal Cancers in a Phase III Randomised Trial: Japan Clinical Oncology Group Study JCOG0602. European Journal of Cancer, 64, 22-31. [Google Scholar] [CrossRef] [PubMed]
[8] Kehoe, S., Hook, J., Nankivell, M., et al. (2015) Primary Chemo-therapy Versus Primary Surgery for Newly Diagnosed Advanced Ovarian Cancer (CHORUS): An Open-Label, Ran-domised, Controlled, Non-Inferiority Trial. The Lancet, 386, 249-257. [Google Scholar] [CrossRef
[9] Fagotti, A., Ferrandina, M.G., Vizzielli, G., et al. (2020) Randomized Trial of Primary Debulking Surgery Versus Neoadjuvant Chemotherapy for Advanced Epithelial Ovarian Cancer (SCORPION-NCT01461850). International Journal of Gynecologic Cancer, 30, 1657-1664. [Google Scholar] [CrossRef] [PubMed]
[10] Copur M.S., Gauchan, D., Ramaekers, R., et al. (2017) Neoadjuvant Chemotherapy or Primary Debulking Surgery for Stage IIIC Ovarian Cancer. Journal of Clinical Oncology, 35, 802-803. [Google Scholar] [CrossRef
[11] Wright, A.A., Bohlke, K., Armstrong, D.K., et al. (2016) Neoad-juvant Chemotherapy for Newly Diagnosed, Advanced Ovarian Cancer: Society of Gynecologic Oncology and American Society of Clinical Oncology Clinical Practice Guideline. Gynecologic Oncology, 143, 3-15. [Google Scholar] [CrossRef] [PubMed]
[12] Narasimhulu, D.M., Kumar, A., Weaver, A.L., et al. (2019) Us-ing an Evidence-Based Triage Algorithm to Reduce 90-Day Mortality after Primary Debulking Surgery for Advanced Epithelial Ovarian Cancer. Gynecologic Oncology, 155, 58-62. [Google Scholar] [CrossRef] [PubMed]
[13] Kang, S., Kim, T.J., Nam, B.H., et al. (2010) Preoperative Serum CA-125 Levels and Risk of Suboptimal Cytoreduction in Ovarian Cancer: A Meta-Analysis. The Journal of Surgical Oncology, 101, 13-17. [Google Scholar] [CrossRef] [PubMed]
[14] Chi, D.S., Venkatraman, E.S., Masson, V., et al. (2000) The Ability of Preoperative Serum CA-125 to Predict Optimal Primary Tumor Cytoreduction in Stage III Epithelial Ovarian Carcinoma. Gynecologic Oncology, 77, 227-231. [Google Scholar] [CrossRef] [PubMed]
[15] 李胜霞, 朱晨辰, 张安娜, 等. CA125动力学变化预测新辅助化疗晚期卵巢癌患者满意减瘤临床分析[J]. 现代妇产科进展, 2022, 31(10): 745-750.
[16] Fleming, N.D., Westin, S.N., Rauh-Hain, J.A., et al. (2021) Factors Associated with Response to Neoadjuvant Chemotherapy in Advanced Stage Ovarian Cancer. Gynecologic Oncology, 162, 65-71. [Google Scholar] [CrossRef] [PubMed]
[17] Shen, Y. and Li, L. (2016) Serum HE4 Superior to CA125 in Predicting Poorer Surgical Outcome of Epithelial Ovarian Cancer. Tumor Biology, 37, 14765-14772. [Google Scholar] [CrossRef] [PubMed]
[18] Aithal, A., Rauth, S., Kshirsagar, P., et al. (2018) MUC16 as a Novel Target for Cancer Therapy. Expert Opinion on Therapeutic Targets, 22, 675-686. [Google Scholar] [CrossRef] [PubMed]
[19] Felder, M., Kapur, A., Gonzalez-Bosquet, J., et al. (2014) MUC16 (CA125): Tumor Biomarker to Cancer Therapy, a Work in Progress. Molecular Cancer, 13, Article No. 129. [Google Scholar] [CrossRef] [PubMed]
[20] Galgano, M.T., Hampton, G.M., Frierson, H.J. (2006) Compre-hensive Analysis of HE4 Expression in Normal and Malignant Human Tissues. Modern Pathology, 19, 847-853. [Google Scholar] [CrossRef] [PubMed]
[21] Desbene, C., Maiga, R.Y. and Gaillard, O. (2018) Caractéristiques Immunoanalytiques de la protéine HE4. Annales de Biologie Clinique, 76, 225-233. [Google Scholar] [CrossRef] [PubMed]
[22] Hellstrom, I., Raycraft, J., Hayden-Ledbetter, M., et al. (2003) The HE4 (WFDC2) Protein Is a Biomarker for Ovarian carcinoma. Cancer Research, 63, 3695-3700.
[23] Buamah, P. (2000) Benign Conditions Associated with Raised Serum CA-125 Concentration. Journal of Surgical Oncology, 75, 264-265. [Google Scholar] [CrossRef
[24] Olsen, M., Lof, P., Stiekema, A., et al. (2021) The Diagnostic Accuracy of Human Epididymis Protein 4 (HE4) for Discriminating between Benign and Malignant Pelvic Masses: A Systematic Review and Meta-Analysis. Acta Obstetricia et Gynecologica Scan-dinavica, 100, 1788-1799. [Google Scholar] [CrossRef] [PubMed]
[25] Tangjitgamol, S., Manusirivithaya, S., Laopai-boon, M., et al. (2013) Interval Debulking Surgery for Advanced Epithelial Ovarian Cancer. Cochrane Database of Sys-tematic Reviews, 4, D6014. [Google Scholar] [CrossRef
[26] Harter, P., Muallem, Z.M., Buhrmann, C., et al. (2011) Impact of a Structured Quality Management Program on Surgical Outcome in Primary Advanced Ovarian Cancer. Gyne-cologic Oncology, 121, 615-619. [Google Scholar] [CrossRef
[27] Pelissier, A., Roulot, A., Guéry, B., Bonneau, C., Bellet, D. and Rouzier, R. (2016) Serum CA125 and HE4 Levels as Predictors for Optimal Interval Surgery and Platinum Sen-sitivity after Neoadjuvant Platinum-Based Chemotherapy in Patients with Advanced Epithelial Ovarian Cancer. Journal of Ovarian Research, 9, Article No. 61. [Google Scholar] [CrossRef] [PubMed]
[28] Ataseven, B., du Bois, A., Reinthaller, A., Traut, A., et al. (2015) Pre-Operative Serum Albumin Is Associated with Post-Operative Complication Rate and Overall Survival in Patients with Epithelial Ovarian Cancer Undergoing Cytoreductive Surgery. Gynecologic Oncology, 138, 560-565. [Google Scholar] [CrossRef] [PubMed]
[29] 赵云平, 张国楠. 血清白蛋白对晚期卵巢癌NACT-IDS治疗模式的影响[J]. 肿瘤预防与治疗, 2017, 30(3): 232-237.
[30] Parker, D., Bradley, C., Bogle, S.M., et al. (1994) Se-rum Albumin and CA125 Are Powerful Predictors of Survival in Epithelial Ovarian Cancer. British Journal of Obstetrics and Gynaecology, 101, 888-893. [Google Scholar] [CrossRef] [PubMed]