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Epitelyal over kanserlerinde operasyon öncesi ve sonrası CA-125 değerlerinin karşılaştırılması

Comparison of preoperative and postoperative CA 125 levels in epithelial over carcinomas

Journal Name:

  • Süleyman Demirel Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi

Publication Year:

  • 2013

Key Words:

Keywords (Original Language):

Author Name
Abstract (2. Language): 
Objective: Retrospective evaluation of cancer antigen (CA) 125 levels in epithelial ovarian cancer patients. Material and Method: Among 580 ovarian cancer cases; one-hundred eighty seven epithelial ovarian cancer patients at Republic of Turkey, Ministry of Health, Aegean Obstetrics and Maternity Training and Research Hospital between the dates of January 1st 1998 and December 31st 2007 were included in this study. Age of the patients, histopathological type of the cases, type of operation, pre-operative&post-operative CA-125 levels, also after the first and sixth dose of chemotherapy CA-125 levels were investigated. While assessing the findings of the study, SPSS (Statistical Package for Social Sciences) for Windows 16.0 program was used for statistical analyses. Chi-square test was employed to compare qualitative data Results: The average age of the patients was 51.7±11. The most frequent (83 patients) histopathological type was serous epithelial ovarian cancer (44.4%) and musinous epithelial ovarian cancer (31 patients-16.6%). Generally, as the patients were evaluated according to the type of surgical procedure, optimal surgery was the most frequently preferred one (70.6%), however, among patients aged <30 suboptimal surgery was used more commonly. CA-125 levels of 187 cases preoperatively, after the first and sixth dose of chemotheraphy were recorded, but only 40 patients’ post-operative CA-125 levels were reached. The threshold (cutoff) level of CA-125 as a predictive of surgery type was found to be 613. In this case, the sensitivity and specificity were found to be 85% and 66%, respectively. The regression rates of CA-125 levels of pre&postoperative and after the first dose of chemotherapy were recorded and 2-fold regression according to the preoperative levels of CA-125 was found to be significant (p<0.001). However, 2-fold regression of CA-125 levels showed no significant relationship with age, histopathological type and applied surgical type (p>0.05).Discussion a) Failure of regression of postoperative CA-125 levels lower than 35 U/mL supports that surgery may not be enough to treat ovarian cancer alone. b) Additional studies are needed to assess the impact of the type of surgery according to the levels of pre-operative CA-125 at survival and disease-free period.
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Abstract (Original Language): 
Amaç: Epitelyal over kanserli hastalarda kanser antijen (CA) 125 değerlerinin geriye dönük incelenmesi. Materyal-Metot: Bu araştırmaya 01.01.1998 ile 31.12.2007 tarihleri arasında Türkiye Cumhuriyeti Sağlık Bakanlığı İzmir Ege Doğumevi ve Kadın Hastalıkları Eğitim ve Araştırma Hastanesinde tedavi edilmiş 580 over kanserli hastadan 187 epitelyal over kanserli hasta alınmıştır. Hastaların yaşları, histolojik tipleri, operasyon şekli, operasyon öncesi ve sonrası, kemoterapinin (KT) birinci seansı ve altıncı seansı sonrası CA-125 değerleri incelenmiştir. Toplanan verilerin istatistiksel olarak değerlendirilmesi SPSS (16) ve Ki-kare testi kullanılarak yapılmıştır. Bulgular: Hastaların ortalama tanı yaşı 51,7 ± 11 yıl olarak bulunmuştur. Hastaların histopatolojik tiplerine göre dağılımı incelendiğinde 83 hasta ile en sık seröz tipe rastlanırken (% 44,4), diğer tiplerden müsinöz karsinom 31 (% 16,6) hasta ile ikinci sırada izlenmiştir. Hastaların yapılan cerrahi işlemin tipine göre değerlendirilmesinde % 70,6 ile en sık optimal cerrahi uygulandığı görülürken, 30 yaş altında suboptimal cerrahinin daha çok uygulandığı saptanmıştır. 187 olgunun operasyon öncesi, KT’nin 1. ve 6. Seans (firstline KT) sonrası CA-125 değerlerine ulaşılırken, sadece 40 hastada operasyon sonrası bakılan CA-125 değerlerine ulaşıldı. CA-125 değerinin cerrahinin tipini öngörmesine yönelik yapılan kesme değeri 613 olarak bulundu. Bu durumda duyarlılık (Sensitivite) %85, seçicilik (Spesifite) ise %66 olarak bulundu. Preoperatif CA 125 değerinin postoperatif CA-125 ve KT’nin 1. dozu sonrası CA-125 değerlerine göre bakılan azalma katının bakılan her iki istatistik analizinde 2 kat düşüşün en anlamlı değer olduğu görülmüştür (p<0,001). Ancak CA-125 değerindeki düşüş katının yaş, histopatolojik tip ve cerrahi tipi ile ilişkileri 2 kat düşüşe göre incelenmesinde anlamlı bir fark gözlenmemiştir(p>0.05).Sonuç: a) CA-125’in ameliyat sonrası hedef değere dönmeyişi over kanserlerinde cerrahinin tek başına yetersiz olduğu düşüncesini desteklemektedir. b) Operasyon öncesi CA-125 değerine göre uygulanması planlanan cerrahi tipinin, sağ kalım ve hastalıksız yaşam süresine etkisini değerlendirmek için ek araştırmalara gereksinim duyulmaktadır.
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