Introduction:

At present there is no predictive value univocally associated with the success of chemotherapy. Biomarkers produced by ovarian cancer (HE4 and Ca125) could have a good prognostic significance. The aim of this study is to prove the ability of biomarkers to identify patients with the highest risk of non-optimal response during the chemotherapy, and to predict which patients will most likely develop recurrence of disease.

Methods:

We analyzed 78 patients with epithelial ovarian cancers who underwent surgery in the biennium 2016–2017. All the patients underwent chemotherapy after surgery or interval debulking surgery following neoadjuvant therapy. Serum levels of HE4 and Ca125 were measured at diagnosis and at each cycle of chemotherapy. We established the degree of response to the treatment by computed tomography scan, and the patients were followed up (median: 10 months). The parameters of progression-free survival and disease-free survival were related to serum levels of biomarkers.

Results:

Both CA125 and HE4 values became negative at the fourth cycle in the patients with good response to chemotherapy. HE4 increased earlier than Ca125. The parameters that best correlated with a long progression-free survival were: negativization of the marker after the third cycle of chemotherapy (HE4: odds ratio (OR) 5.5; Ca125: OR 9.1) and biomarker serum levels lower than the mean value in the affected population at the time of diagnosis (HE4: OR 3.4; Ca125: OR 3.7).

Conclusions:

We can conclude that the monitoring of HE4 and Ca125 during chemotherapy, especially at the third cycle, is recommended, because their variation is a good prognostic factor.

中文翻译：

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HE-4和CA-125联合生物标志物在上皮性卵巢癌患者化疗期间的预后和预测价值

介绍：

目前，没有与化疗成功相关的预测价值。卵巢癌产生的生物标志物（HE4 和 Ca125）可能具有良好的预后意义。本研究的目的是证明生物标志物能够识别化疗期间非最佳反应风险最高的患者，并预测哪些患者最有可能出现疾病复发。

方法：

我们分析了 2016-2017 双年度接受手术的 78 名上皮性卵巢癌患者。所有患者均在新辅助治疗后接受化疗或间期减瘤手术。在诊断时和每个化疗周期测量血清 HE4 和 Ca125 水平。我们通过计算机断层扫描确定对治疗的反应程度，并对患者进行随访（中位数：10 个月）。无进展生存期和无病生存期的参数与血清生物标志物水平相关。

结果：

在对化疗反应良好的患者中，CA125 和 HE4 值在第四个周期变为阴性。HE4 的增加早于 Ca125。与长期无进展生存期最相关的参数是：第三周期化疗后标志物的阴性（HE4：优势比（OR）5.5；Ca125：OR 9.1）和生物标志物血清水平低于平均水平诊断时受影响的人群（HE4：OR 3.4；Ca125：OR 3.7）。

结论：

我们可以得出结论，建议在化疗期间监测 HE4 和 Ca125，尤其是在第三个周期，因为它们的变化是一个很好的预后因素。