Cíl studie: Cílem naší studie bylo zjistit souvislost mezi hladinou CA125, hladinou hemoglobinu a vznikem recidivy a délkou přežití u pacientek s karcinomem ovaria. Materiál a metodika: Jedná se o retrospektivní studii, do které bylo zahrnuto celkem 53 pacientek s histologicky potvrzeným karcinomem ovaria. Pacientky byly diagnostikovány a následně léčeny na GPK FN MU Brno v letech 2000–2002. Výsledky: V naší studii se hladina CA125 jevila jako statisticky signifikantní prognostický faktor (ß = 0,44, p = 0,02) pro přežití. Význam plazmatické hladiny hemoglobinu jako prognostického faktoru jsme v této studii neprokázali. Z dalších hodnocených faktorů ovlivňujících přežití pacientek se významným prognostickým faktorem stal počet gravidit (ß = -0,96, p = 0,002), přičemž přežívání bylo nižší u pacientek s nižším počtem gravidit. Závěr: Ovariální karcinom je nádor s vysokou mortalitou. Proto je nutné hledat nové markery, které by přispěly k časnější diagnostice tohoto onemocnění a mohly ovlivnit jeho prognózu.

Aim of the study: Aim of the study was to investigate connection between the level CA125, level of haemoglobin and emergence of recurrence and survival time for patients with ovarian cancer. Material and methods: This concerns of retrospective study in which total 53 patients with histology confirmed ovarian cancer were included. These patients were diagnosed and subsequently treated in the GPK FN MU Brno during 2000-2002 period. Results: The level of CA125 in our study appeared to be statistically significant prognostic factor (ß = 0,44, p = 0,02) for survival. Signification of the plasma level of haemoglobin to be any prognostic factor was not proved in this study. Among other assessed factors influencing survival time of the patients was the number of gravidity to be important prognostic factor (ß = -0,96, p = 0,002). Survival time was shorter for patients with less number of pregnancies. Conclusion: Ovarian cancer is tumour with high mortality. That is why it is necessary to look for new markers, which would contribute to earlier diagnostic of this disease, and which could influence its prognosis.

• Klíčová slova
• karcinom ovaria, tumormarker CA125, hemoglobin,
• MeSH
• anemie MeSH
• antigen CA-125 krev   MeSH
• hemoglobiny diagnostické užití   MeSH
• lidé MeSH
• nádorové biomarkery krev   MeSH
• nádory vaječníků diagnóza   klasifikace   MeSH
• pacienti klasifikace   MeSH
• přežití MeSH
• recidiva MeSH
• retrospektivní studie MeSH
• statistika jako téma MeSH
• věkové faktory MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH

Nejzhoubnější gynekologický nádor, karcinom ovaria, je příčinou více než 50 % úmrtí v této skupině nádorů. Více než 60 % případů je diagnostikováno až v pokročilých stadiích s výrazně sníženou pravděpodobností přežití pacientek. Diagnostické nástroje pro efektivní časnou detekci nebo screening zatím neexistují. Terapeutické možnosti (chirurgická operace, chemoterapie) jsou nedostatečně efektivní, neboť karcinom ovaria se vyznačuje silnou tendencí k recidivě spojenou s chemorezistencí. Jedním z nejdéle a nejrozsáhleji používaným markerem pro diagnostiku primárních nádorů i recidivy je CA125/MUC16. Tento glykoprotein je znám již od 80. let 20. století, ale teprve nejnovější studie odhalují jeho biologické funkce v karcinogenezi a interakcích s buňkami imunitního systému. V tomto článku se blíže podíváme na jeho biologický význam a především na současný stav použití CA125 jako významného diagnostického markeru u karcinomu ovaria. V diagnostice primárních nádorů se totiž začínají objevovat nové markery, navíc je význam monitoringu CA125 z hlediska detekce recidivy zpochybňován rozsáhlými klinickými studiemi, které nenalezly přínos pro dlouhodobé přežití pacientek. Také potenciální význam CA125 v imunoterapii karcinomu ovaria se nezdá být tak velký, jak se předpokládalo.

The most fatal gynecologic malignancy, ovarian cancer, causes more than 50% deaths in this tumor group. Most of cases (>60%) are diagnosed in advanced stages with poor 5-year survival prognosis. Diagnostic tools for an effective early detection or screening have not been found yet. Treatment possibilities (surgery, chemotherapy) are insufficient while high tendency to recurrence and chemoresistance occurs. CA125/MUC16 has been one of the most extensively used markers for a detection of primary tumors, or recurrence for a long time since its discovery in 80´s. However, the structure and biological functions of CA125 have been discovered relatively recently. CA125 may play an important role in carcinogenesis and interactions with cells of immune system. We reviewed the known biological functions and particularly the current state of using this marker as the diagnostic tool in ovarian cancer. Recently, many new markers emerged ambitiously to replace CA125; moreover, the importance of monitoring CA125 for the recurrence detection has also been questioned in large clinical trials. These studies have not found an impact for overall survival/mortality of patients. Also a potential of using CA125 targeted antibodies has not brought previously expected results so far.

• Klíčová slova
• RECAF, HE4, léčba, diagnostika,
• MeSH
• alfa-fetoproteiny diagnostické užití   izolace a purifikace   MeSH
• analýza přežití MeSH
• antigen CA-125 izolace a purifikace   MeSH
• diagnostické techniky porodnicko-gynekologické trendy   využití   MeSH
• epididymální sekreční proteiny diagnostické užití   izolace a purifikace   MeSH
• financování organizované MeSH
• imunoterapie metody   využití   MeSH
• lidé MeSH
• lokální recidiva nádoru diagnóza   komplikace   MeSH
• membránové proteiny diagnostické užití   izolace a purifikace   MeSH
• nádorové biomarkery izolace a purifikace   MeSH
• nádory vaječníků diagnóza   prevence a kontrola   MeSH
• statistika jako téma MeSH
• Check Tag
• lidé MeSH

Patients with high-grade endometrial carcinoma (EC) have an increased risk of tumor spread and lymph node metastasis (LNM). Preoperative imaging and CA125 can be used in work-up. As data on cancer antigen 125 (CA125) in high-grade EC are limited, we aimed to study primarily the predictive value of CA125, and secondarily the contributive value of computed tomography (CT) for advanced stage and LNM. Patients with high-grade EC (n = 333) and available preoperative CA125 were included retrospectively. The association of CA125 and CT findings with LNM was analyzed by logistic regression. Elevated CA125 ((>35 U/mL), (35.2% (68/193)) was significantly associated with stage III-IV disease (60.3% (41/68)) compared with normal CA125 (20.8% (26/125), [p < 0.001]), and with reduced disease-specific-(DSS) (p < 0.001) and overall survival (OS) (p < 0.001). The overall accuracy of predicting LNM by CT resulted in an area under the curve (AUC) of 0.623 (p < 0.001) independent of CA125. Stratification by CA125 resulted in an AUC of 0.484 (normal), and 0.660 (elevated). In multivariate analysis elevated CA125, non-endometrioid histology, pathological deep myometrial invasion ≥50%, and cervical involvement were significant predictors of LNM, whereas suspected LNM on CT was not. This shows that elevated CA125 is a relevant independent predictor of advanced stage and outcome specifically in high-grade EC.

• Publikační typ
• časopisecké články MeSH

AIM: The aim of the present study was to compare the use of cancer antigen 125 (CA125) and human epididymis protein 4 (HE4) biomarkers in patients with endometrial cancer for preoperative management and to particularly focus on relationship between CA125 and HE4 and disease stage in predicting myometrial invasion or intrauterine tumor spread. PATIENTS AND METHODS: Thirty-four patients diagnosed with endometrial cancer and 32 healthy controls were enrolled into the pilot study in the period between May 2012 and March 2013. Blood from all the females was collected and examined for CA125 and HE4. Based on standardized ultrasound examination, including gynecological examination, the clinical disease stage was determined. RESULTS: We found a significant difference (p<0.0001) for means of serum levels of HE4: females with endometrial cancer, 75.5 pmol/l, versus healthy females, 40.0 pmol/l. A non-significant statistical difference was found for mean serum CA125 levels (p=0.4442): females with endometrial cancer 19.0 IU/l, versus healthy females, 15 IU/l. A significant correlation with histopathological disease stage was found for both biomarkers (Spearman correlation). Sensitivity and specificity, and the related cut-off for HE4 suggest that HE4 would be a more appropriate biomarker for differential diagnosis between benign and malignant states. CONCLUSION: Based on our pilot study, we found that parallel examination of HE4 and CA125 may support endometrial ultrasound finding verification prior to biopsy. This study is ongoing and we expect that results on a larger population may enable HE4 measurement to be implemented in routine practice.

• MeSH
• antigen CA-125 krev   MeSH
• dospělí MeSH
• invazivní růst nádoru MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádorové biomarkery krev   MeSH
• nádory endometria krev   diagnóza   chirurgie   MeSH
• následné studie MeSH
• pilotní projekty MeSH
• předoperační péče MeSH
• prognóza MeSH
• proteiny metabolismus   MeSH
• ROC křivka MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• staging nádorů MeSH
• studie případů a kontrol MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH

OBJECTIVES: To investigate ultrasound features and the best cut-off value of the cancer antigen 125/carcinoembryonic antigen (CA125/CEA) ratio to discriminate ovarian metastases from benign and primary malignant ovarian neoplasms in two selected groups of morphological ovarian masses, namely multilocular masses with five or more locules and multilocular-solid masses. METHODS: Patients with multilocular (five or more locules) or multilocular-solid ovarian masses, operated on within 3 months of ultrasound examination, and with tumor markers (CEA and CA125) available at diagnosis, were identified retrospectively from three ultrasound centers. The masses were described using the International Ovarian Tumor Analysis (IOTA) terminology. Ultrasound and clinical characteristics were compared between those with an ovarian neoplasm (including benign and primary malignant neoplasms) and those with an ovarian metastasis. Receiver-operating characteristics curve (ROC) analysis was used to evaluate the ability of CA125, CEA and CA125/CEA to differentiate between ovarian neoplasms and ovarian metastases, and their predictive performance was assessed. RESULTS: In total, 350 (88.4%) patients with an ovarian neoplasm (including 99 benign, 43 borderline and 197 primary epithelial ovarian carcinomas, seven malignant rare tumors and four other types of invasive ovarian tumor) and 46 (11.6%) patients with an ovarian metastasis were analyzed. On ultrasound examination, ovarian neoplasms were smaller than ovarian metastases (median largest diameter, 97 (range, 20-387) mm vs 146 (range, 43-259) mm, respectively; P < 0.0001) and presented with a lower number of cysts with > 10 locules (18.9% vs 54.3%; P < 0.0001). ROC curve analysis showed that the best cut-off value of CEA for distinguishing between ovarian neoplasms and ovarian metastases was 2.33 ng/mL. The predictive performance of this CEA cut-off value was: area under the curve (AUC), 0.791 (95% CI, 0.711-0.870); accuracy, 73.7%; sensitivity, 73.1%; specificity, 78.3%; positive predictive value (PPV), 96.2%; and negative predictive value (NPV), 27.7%. The best cut-off value of CA125/CEA for distinguishing between ovarian neoplasms and ovarian metastases was 11.92. The predictive performance of this CA125/CEA cut-off value was: AUC, 0.758 (95% CI, 0.683-0.833); accuracy, 79.8%; sensitivity, 82.3%; specificity, 60.9%; PPV, 94.1%; and NPV, 31.1%. CONCLUSIONS: CA125/CEA ratio and CEA alone did not show any significant difference in their ability to distinguish between ovarian neoplasms (including benign and malignant) and ovarian metastases in masses with multilocular and those with multilocular-solid morphology. Therefore, in this morphological subgroup of ovarian masses, CEA alone is sufficient to differentiate between ovarian neoplasms and ovarian metastases. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.

• MeSH
• antigen CA-125 krev   MeSH
• biologické markery krev   MeSH
• dospělí MeSH
• epiteliální ovariální karcinom krev   diagnóza   diagnostické zobrazování   sekundární   MeSH
• karcinoembryonální antigen krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• metastázy nádorů MeSH
• mladiství MeSH
• mladý dospělý MeSH
• nádory vaječníků krev   diagnóza   diagnostické zobrazování   patologie   MeSH
• prediktivní hodnota testů MeSH
• ROC křivka MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ultrasonografie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• hodnotící studie MeSH

Icodextrin peritoneal dialysis (PD) solution has been shown to increase interleukin-6 (IL-6) levels in PD effluent as well as leukocyte and mesothelial cell count. Mesothelial cells release cancer antigen 125 (CA125), which is used as a marker of mesothelial cell mass. This 1-year prospective study was designed to compare peritoneal effluent cell population, its inflammatory phenotype and biocompatibility biomarkers IL-6 and CA125 between icodextrin (E) and glucose bicarbonate/lactate (P) based PD solutions. Using baseline peritoneal ultrafiltration capacity, 19 stable incident PD patients were allocated either to P only (N = 8) or to P plus E for the overnight dwell (N = 11). Flow cytometry was used to measure white blood cell count and differential and the expression of inflammatory molecules on peritoneal cells isolated from timed overnight peritoneal effluents. Compared to P, E effluent showed higher leukocyte (10.9 vs. 7.9), macrophages (6.1 vs. 2.5) and mesothelial cells (0.3 vs. 0.1)×10(6) /L count, as well as expression of HLA DR on mesothelial cells and IL-6 (320.5 vs. 141.2 pg/min) on mesothelial cells and CA125 appearance rate (159.6 vs. 84.3 IU/min), all P < 0.05. In the E group, correlation between IL-6 and CA125 effluent levels (r = 0.503, P < 0.05) as well as appearance rates (r = 0.774, P < 0.001) was demonstrated. No effect on systemic inflammatory markers or peritoneal permeability was found. Icodextrin PD solution activates local inflammation without systemic consequences so the clinical relevance of this observation remains obscure. Correlation between effluent IL-6 and CA125 suggests that CA125 might be upregulated due to inflammation and thus is not a reliable marker of mesothelial cell mass and/or biocompatibility.

• MeSH
• antigen CA-125 metabolismus   MeSH
• dialyzační roztoky chemie   MeSH
• dospělí MeSH
• glukany chemie   MeSH
• glukosa chemie   MeSH
• hydrogenuhličitany chemie   MeSH
• interleukin-6 metabolismus   MeSH
• laktáty chemie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• peritoneální dialýza metody   MeSH
• počet leukocytů MeSH
• prospektivní studie MeSH
• průtoková cytometrie MeSH
• senioři MeSH
• zánět MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• antigen CA-125 krev   MeSH
• antitumorózní látky fytogenní terapeutické užití   MeSH
• dospělí MeSH
• lidé MeSH
• nádory vaječníků farmakoterapie   MeSH
• paclitaxel terapeutické užití   MeSH
• prospektivní studie MeSH
• referenční hodnoty MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH

• MeSH
• alfa-fetoproteiny krev   MeSH
• choriogonadotropin krev   MeSH
• chromozomální aberace MeSH
• dospělí MeSH
• lidé MeSH
• progesteron krev   MeSH
• retrospektivní studie MeSH
• těhotenství MeSH
• vrozené vady diagnóza   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH

AIM: To develop and validate a biomarker-based index to optimize referral and diagnosis of patients with suspected ovarian cancer. Furthermore, to compare this new index with the Risk of Malignancy Index (RMI) and Risk of Ovarian Malignancy Algorithm (ROMA). PATIENTS AND METHODS: A training study, consisting of patients with benign ovarian disease (n=809) and ovarian cancer (n=246), was used to develop the Copenhagen Index (CPH-I) utilizing the variables serum HE4, serum CA125 and patient age. Eight international studies provided the validation population; comprising 1060 patients with benign ovarian masses and 550 patients with ovarian cancer. RESULTS: Overall, 2665 patients were included. CPH-I was highly significant in discriminating benign from malignant ovarian disease. At the defined cut-off of 0.070 for CPH-I the sensitivity and specificity were 95.0% and 78.4% respectively in the training cohort and 82.0% and 88.4% in the validation cohort. Comparison of CPH-I, ROMA and RMI demonstrated area-under-curve (AUC) at 0.960, 0.954 and 0.959 respectively in the training study and 0.951, 0.953 and 0.935 respectively in the validation study. Using a sensitivity of 95.0%, the specificities for CPH-I, ROMA and RMI in the training cohort were 78.4%, 71.7% and 81.5% respectively, and in the validation cohort 67.3%, 70.7% and 69.5% respectively. CONCLUSION: All three indices perform well at the clinically relevant sensitivity of 95%, but CPH-I, unlike RMI and ROMA, is independent of ultrasound and menopausal status, and may provide a simple index to optimize referral of women with suspected ovarian cancer.

• MeSH
• algoritmy MeSH
• antigen CA-125 krev   MeSH
• diferenciální diagnóza MeSH
• dospělí MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• membránové proteiny krev   MeSH
• mladiství MeSH
• mladý dospělý MeSH
• multivariační analýza MeSH
• nádorové biomarkery krev   MeSH
• nádory vaječníků krev   diagnóza   patologie   MeSH
• nemoci ovaria krev   diagnóza   patologie   MeSH
• prospektivní studie MeSH
• proteiny metabolismus   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• statistické modely MeSH
• stupeň závažnosti nemoci MeSH
• věkové faktory MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

• Publikační typ
• abstrakt z konference MeSH