肿瘤预防与治疗2026，Vol.39Issue(9)：725-733,9.DOI:10.3969/j.issn.1674-0904.2026.09.001
CA125值对PARPi一线维持治疗的卵巢癌患者进展风险的预测价值:一项真实世界临床研究
Predictive Value of CA125 for Progression Risk in Ovarian Cancer Pa-tients Receiving First-Line Maintenance Therapy with PARP Inhibitors:A Real-World Clinical Study
摘要
Abstract
Objective:This study aims to analyze the value of serum carbohydrate antigen 125(CA125)in predicting the risk of disease progression in ovarian cancer patients receiving first-line maintenance therapy with poly(ADP-ribose)poly-merase inhibitors(PARPi),and to explore optimized early warning criteria and follow-up strategies under a new treatment paradigm.Methods:Clinicopathological and follow-up data of patients with newly diagnosed advanced ovarian cancer admit-ted to Sichuan Cancer Hospital between January 2015 and March 2025 were collected,and the patients were divided into a PARPi maintenance group(with enrollment commencing in August 2018)and a non-maintenance group based on whether they received first-line PARPi maintenance therapy.Disease progression in the two groups was assessed based on the Gyne-cologic Cancer InterGroup(GCIG)biochemical progression criteria and the Response Evaluation Criteria in Solid Tumors version 1.1.ROC curve analysis was performed to identify an optimized CA125 cut-off value for predicting disease progres-sion.Results:A total of 448 patients were enrolled,including 309 in the PARPi maintenance group and 139 in the non-ma-intenance group.Median progression-free survival was significantly prolonged in the PARPi maintenance group compared with the non-maintenance group(33.4 months vs 16.5 months,P<0.001).In the PARPi maintenance group,89 patients(28.8%)experienced biochemical progression and 149(48.2%)experienced radiologic progression;the corresponding numbers in the non-maintenance group were 84(60.4%)and 127(91.4%),respectively.A proportion of patients with ra-diologic progression did not meet the CA125 biochemical progression criteria(false negatives),with false-negative rates of 44.3%in the PARPi maintenance group and 39.9%in the non-maintenance group(P>0.05).Among these,42 patients(28.2%)in the PARPi maintenance group and 25(19.7%)in the non-maintenance group had CA125 levels within the normal range(<35 U/mL)(P>0.05).The sensitivity of CA125 for predicting ovarian cancer progression was 55.8%in the PARPi maintenance group and 65.4%in the non-maintenance group,with Youden indices of 0.52 and 0.57,respectively(P>0.05),indicating poor predictive efficacy.For the PARPi maintenance group,ROC curve analysis identified two times the nadir CA125 level as a new cut-off value for predicting disease progression,yielding a sensitivity of 85.2%,specificity of 89.4%,false negative rate of 14.8%,and Youden index of 0.75.Conclusion:In the era of maintenance therapy for ovarian cancer,the sensitivity of GCIG biochemical progression criteria for predicting disease progression has declined,underscoring the necessity of scheduled radiographic surveillance in follow-up.Using a CA125 level of 2×nadir as the new criterion for bio-chemical progression can significantly reduce the false negative rate,improve the efficacy of predicting disease progression,and guide the timely implementation of radiographic examinations,thereby preventing delays in diagnosis and treatment.关键词
卵巢癌/维持治疗/复发监测/癌抗原125/预测效能Key words
Ovarian cancer/Maintenance therapy/Recurrence monitoring/Cancer antigen 125/Predictive efficacy分类
医药卫生引用本文复制引用
姚红,裴姣,张国楠,李婷媛,郑静,黄小荞,刘红,王登凤..CA125值对PARPi一线维持治疗的卵巢癌患者进展风险的预测价值:一项真实世界临床研究[J].肿瘤预防与治疗,2026,39(9):725-733,9.基金项目
国家医学高次人才计划(编号:国卫人发[2024]26 号) （编号:国卫人发[2024]26 号）
2024年度电子科技大学医学院临床医学学科发展基金项目(编号:YXYLCJJ202403006) This study was supported by National Medical High-Level Talent Program(No.NHCO[2024]No.26),and by grants from University of Electronic Science and Technology of China(No.YXYLCJJ202403006). （编号:YXYLCJJ202403006）
