Combined evaluation of serum CA 125 and CAM 29 in patients with epithelial ovarian cancer.

We examined 92 patients with epithelial ovarian cancer and 262 patients with benign ovarian diseases undergoing laparotomy. On the basis of a nonparametric method, antigen levels corresponding to prefixed 95% specificity values in a group of 674 women with benign gynecologic diseases were taken as cutoff limits (88.8 U/ml for CA 125 and 13.7 U/ml for CAM 29). Moreover, CA 125 and CAM 29 levels were measured serially during and after chemotherapy in 26 women selected from the patients with advanced epithelial ovarian cancer. At diagnosis, serum CA 125 was as sensitive as serum CAM 29 for nonmucinous tumors, but more sensitive than serum CAM 29 for mucinous tumors. The association of the two markers seemed to give no advantage over the CA 125 assay alone in the diagnosis of epithelial ovarian cancer. In monitoring the response to chemotherapy and follow-up of patients with epithelial ovarian cancer, changes in CA 125 levels correlated with the clinical course of disease better than changes in CAM 29 levels, and the serum CA 125 assay was more reliable than the serum CAM 29 assay in the early detection of tumor progression. In conclusion, serum CAM 29 did not seem to represent a complementary assay to serum CA 125 in the management of patients with epithelial ovarian cancer.     

Tissue CA125 and HE4 Gene Expression Levels Offer Superior Accuracy in Discriminating Benign from Malignant Pelvic Masses

Background: Ovarian cancer remains a major worldwide health care issue due to the lack of satisfactory diagnostic methods for early detection of the disease. Prior studies on the role of serum cancer antigen 125 (CA125) and human epididymis protein 4 (HE4) in detecting ovarian cancer presented conflicting results. New tools to improve the accuracy of identifying malignancy are urgently needed. We here aimed to evaluate the diagnostic utility of tissue CA125 and HE4 gene expression in comparison to serum CA125 and HE4 in discriminating benign from malignant pelvic masses. Materials and Methods: One-hundred Egyptian women were enrolled in this study, including 60 epithelial ovarian cancer (EOC) patients and 20 benign ovarian tumor patients, as well as 20 apparently healthy women. Preoperative serum levels of CA125 and HE4 were measured by immunoassays. Tissue expression levels of genes encoding CA125 and HE4 were determined by quantitative real time polymerase chain reaction (qRT-PCR). The diagnostic performance of CA125 and HE4, measured either as mRNA or protein levels, was evaluated by receiver operating characteristic (ROC) curves. Results: The serum CA125+HE4 combination and serum HE4, with area under the curve (AUC) values of 0.935 and 0.932, respectively, performed significantly better than serum CA125 (AUC=0.592; P<0.001). Tissue CA125 and HE4 (AUC=1) performed significantly better than serum CA125 (P<0.001), serum HE4 (P=0.016) and the serum CA125+HE4 combination (P=0.018). Conclusions: Measurement of tissue CA125 and HE4 gene expression not only improves discriminatory performance, but also broadens the range of differential diagnostic possibilities in distinguishing EOC from benign ovarian tumors.     

超声检查联合血清糖类抗原125及甲胎蛋白检测在卵巢肿瘤良、恶性的诊断和预后评估中的应用价值

目的探讨超声检查联合肿瘤标志物糖类抗原125(CA125)及甲胎蛋白(AFP)在卵巢肿瘤良、恶性诊断及预后评估中的应用价值。方法依据病理学诊断结果将219例卵巢肿瘤患者,分为良性组(n=139)和恶性组(n=80),所有患者均接受彩色超声多普勒检查,均采用放射免疫法和化学发光法检测血清CA125和AFP水平,以病理诊断为金标准,超声及血清肿瘤标志物诊断卵巢肿瘤良恶性的一致性采用Kappa值,分析超声和血清肿瘤标志物单独及联合检测对卵巢肿瘤良恶性的诊断价值,并观察恶性肿瘤患者治疗前后超声评分、CA125和AFP水平变化。结果治疗前,恶性组患者超声评分及血清CA125、AFP水平均高于良性组患者,差异均有统计学意义(P﹤0.05)。治疗后,恶性组患者超声评分及血清CA125、AFP水平均低于本组治疗前,差异均有统计学意义(P﹤0.05)。超声检查、CA125检测、AFP检测和超声+CA125+AFP检测诊断卵巢肿瘤良恶性的准确度分别为85.39%、74.89%、58.45%和90.87%,其中超声+CA125+AFP诊断卵巢肿瘤良恶性的准确度最高,差异有统计学意义(P﹤0.01)。超声检查、超声+CA125+AFP与病理检查具有高度一致性(Kappa=0.691、0.807),CA125与病理检查的一致性中等(Kappa=0.507),AFP与病理检查的一致性极低(Kappa=0.062)。结论超声+CA125+AFP诊断卵巢良恶性肿瘤的灵敏度、特异度、准确度均较高,是诊断卵巢良恶性肿瘤的有效方法,也是监测卵巢恶性肿瘤患者预后的重要指标。     

CA125、CA199、CEA和AFP检测在卵巢肿瘤诊断中的价值

目的：探讨血清CA125、CA199、癌胚抗原（CEA）和甲胎蛋白（AFP）的检测在卵巢肿瘤诊断中的价值。方法：采用化学发光法检测卵巢恶性肿瘤、良性肿瘤患者血清CA125、CA199、CEA及AFP水平。结果：卵巢恶性肿瘤患者血清CA125、CA199水平明显高于卵巢良性肿瘤患者（P〈0.01）,CEA和AFP值在卵巢恶性肿瘤与卵巢良性肿瘤患者间的差异无统计学意义（P〉0.05）。结论：CA125、CA199的检测有助于对卵巢恶性肿瘤诊断,而CEA及AFP的检测对卵巢恶性肿瘤的诊断无明显价值。     

Clinical significance of cancer antigen 125 (CA 125) in ovarian cancer

Cancer antigen 125 (CA 125), a new ovarian cancer-associated antigen, was studied by radioimmunological determination of serum concentrations in 58 healthy blood donors, in 31 women with benign tumors, and 100 patients with malignant tumors of the ovary. Elevated CA 125 levels were found in 5% of normal controls, in 13% of women with benign tumors, and in 78% of patients with ovarian cancer. After successful antineoplastic treatment, false positive CA 125 values were observed in 4% of tumor-free patients. The incidence of pathological CA 125 serum levels was found to depend on the histogenetic origin of the ovarian tumors and was highest in patients with epithelial serous cystadenocarcinomas (85%). Sequential determinations of CA 125 in 27 patients with ovarian cancer under therapy showed a concordance in 89% of cases between serum concentrations and clinical courses. Elevations of CA 125 were already observed 1-6 months before objective evidence of recurrence. Therefore, the determination of serum CA 125 is recommended in the surveillance of patients with ovarian cancer.     

Clinical value of serum tumor supplied group of factor in diagnosis of epithelial ovarian cancer

Tumor supplied group of factor (TSGF), whose original name was tumor specific growth factor, is a new tumor marker associated with vascular proliferation of malignant tumor. We investigated the correlation of the serum level of TSGF with VEGF and CA125 in patients with epithelial ovarian cancer and benign ovarian lesion, and compared their clinical diagnostic value for epithelial ovarian cancer. MATERIALS AND METHODS Clinical Materials During the period from Sep. 1997 to Sep…     

血清人附睾分泌蛋白4(HE4)和CA125在卵巢癌患者围手术期的变化及临床意义

目的:监测卵巢癌手术前后血清人附睾分泌蛋白4 (human epididymis secretory protein 4,HE4)、CA125(即糖类抗原125)的变化,分析HE4和CA125在卵巢癌诊治中的价值.方法:选取180例卵巢癌患者,根据临床分期分为早期组90例和中晚期组90例,选取90例卵巢良性疾病者作为良性组、90例健康成年女性作为对照组,在手术前后分别监测各组血清HE4和CA125表达水平,统计分析不同检测方法的诊断价值,同时随访卵巢癌患者12个月,对卵巢癌复发患者与未复发患者在手术前后的血清HE4和CA125进行统计分析.结果:血清HE4联合CA125特异度(98.89％)、阳性预测价值(99.27％)显著高于HE4单独检测及CA125单独检测,P＜0.05,组间有统计差异;手术后,卵巢癌患者血清HE4、CA125显著下降(P＜0.05),但是,在相同监测点,卵巢癌者血清HE4和CA125显著高于对照组和良性组(P＜0.05),且中晚期组血清HE4显著高于早期组(P＜0.05),良性组血清HE4、CA125略高于对照组,组间无显著差异(P＞0.05);卵巢癌复发者血清HE4、CA125显著高于未复发组者,P＜0.05,有统计学差异.结论:卵巢癌患者血清CA125和HE4显著异常升高,联合检测血清HE4和CA125不仅对于提高卵巢癌诊断特异性、阳性准确率具有重要价值,而且能够为预后评估提供可靠信息.     

CLINICAL DIAGNOSIS AND TREATMENT OF SMALL OVARIAN TUMOR IN POSTMENOPAUSAL WOMEN

Objective： To investigate the clinical symptom, ultrasonographic scan finding, serum CA125 value, histopathological type and treatment of small ovarian tumor （〈5 cm） in postmenopausal women. Methods： Retrospective analysis was carried out for 52 clinical materials of ovarian tumor cases in women more than one year after menopausal between Jan 1997 and Dec 2004. The largest diameter of the ovarian mass is less than 5 cm. Results： There were 11 ovarian cancers and 1 borderline ovarian tumor among 52 small ovarian tumors （23.1%）. 10 ovarian cancers were epithelial neoplasms and 2 were sex cord-stromal tumors, and 8 cases were in late stage according to FIGO staging system （33.3%）. Compared with benign tumor, there is no significant difference in the onset age, interval after menopausal and duration of history. The main clinical feature is abdominal symptoms, such as abdominal pain and distension in the malignant cases. The patients with benign tumors often showed the ovarian mass during the annual screening or admitted into hospital for other causes. The ultrasonography finding and serum CA125 level showed much difference between benign and malignant cases. Unilocular smooth-walled ovarian cysts mostly were found in benign tumor and the CA125 values were always less than 35 U/ml; but the solid or complex sonographic structures （multilocular, or with a papillary projections on the wall） often indicated a high risk of cancer, especially there was ascites in the pelvic cavity. Serum CA125 level in many cancer cases was elevated （〉35 U/ml）, over 300 U/ml in more than half of the patients. Surgery is still the first choice to treat ovarian cancer, and chemotherapy would be an auxiliary method. Till now, 3 ovarian cancer patients died of complications of cancer and 2 cases had recurrence. Conclusion： Small ovarian tumor in postmenopausal women has a comparatively low malignant occurrence but more in later stage. Many are epithelial carcinoma. If there is complex or parenchymal sonographic structure accompanied with a high serum CA125 level, operation should be considered, while it can be followed up when the ultrasound shows a smooth cyst with normal CA125 value.     

93例复发性卵巢癌疗效分析

目的 预测卵巢癌易复发因素，分析复发性卵巢癌（ROC）患者的疗效与预后。方法 回顾性分析93例ROC患者的临床资料。采用单变量分析ROC患者无瘤生存期（DFI）影响因素。评估不同治疗方法对ROC患者无进展生存期（PFS）和复发后总生存时间（OS）的影响。结果 初次治疗后DFI单变量分析显示：肿瘤的组织分化程度、临床分期、初次术后残留肿瘤大小、初次手术后化疗疗程数与DFI有关（均P<0.05）。93例ROC患者中，手术组：44例患者行二次肿瘤细胞减灭术(SCS)，并联合化疗和（或）靶向治疗；非手术组：49例患者行单纯化疗和（或）靶向治疗。手术组PFS和复发后OS均较非手术组有所延长；手术组中：CA125≤150 U/L的患者OS和PFS较CA125>150 U/L的患者均有所延长（均P<0.05）；术前影像学检查提示复发肿瘤个数≤3的患者术后OS和PFS较复发肿瘤个数>3的患者均有所延长（P<0.05）。结论 肿瘤病理分化程度越高、临床分期越早、初次术后残余病灶越小以及术后化疗疗程越规范足量的卵巢癌患者DFI越长、复发越晚。卵巢癌复发时CA125≤150 U/L、影像学检查复发肿瘤个数≤3的患者可能会从SCS术中获益。     

Clinical evaluation of serum sialosyl-Tn antigen levels in comparison with CA 125 levels in gynecologic cancers.

The serum levels of sialosyl-alpha 2,6GalNAc alpha 1-0-serine/threonine (S-Tn) antigen and CA 125 antigen were measured in 205 patients with gynecologic tumors, including 48 ovarian cancers, 20 endometrial cancers, 29 cervical cancers, 57 benign ovarian tumors, 37 uterine leiomyomas, and 14 adenomyosis. Using a cutoff value of 41 U/ml for S-Tn and 35 U/ml for CA 125, positive findings were obtained in ovarian cancers in 31 of 48 (64.6%) patients with S-Tn antigen, and in 36 of 48 (75%) patients with CA 125. In uterine malignancies, positive findings were obtained in 11 of 49 (22.4%) patients and in 8 of 49 (16.3%) patients with the serum S-Tn and CA 125 antigens, respectively. In ovarian benign tumors, false-positive findings with CA 125 were observed in 16 of 57 (28.1%) patients, but with S-TN antigen in only 3 of 57 (5.3%) patients (P less than 0.01). For the ovarian tumors, excluding patients with recurrent disease, the specificity, positive predictive value, and accuracy of the serum S-Tn antigen level for detecting cancer exceeded that of the serum CA 125. The combined assay of serum S-Tn and CA 125 antigens gave positive results in 38 of 48 (79.2%) patients with ovarian cancers; most of the negative findings were obtained in Stage I disease. A significant decreases in serum S-Tn level was observed after cytoreductive surgery in 14 patients with ovarian cancer (P less than 0.01). Four patients with a subsequent recurrence showed a concomitant rise in serum S-Tn. The cyst fluid and ascitic fluid showed high levels of S-Tn antigen in patients with ovarian cancer, in contrast to findings in patients with benign ovarian tumors. In conclusion, serum S-Tn antigen has limited use in diagnosing early stage ovarian cancer and uterine malignancies, but it can detect with accuracy ovarian cancers when used in a combination assay with CA 125 and can monitor the status of disease after therapy.     

TPS和CA125在卵巢癌患者血清中的表达及其临床意义

目的　检测卵巢良性及恶性肿瘤患者血清TPS和CA12 5水平及卵巢癌患者两疗程化疗前后二者水平的变化。为卵巢癌的临床诊断、病情监测提供新方法。方法　用ELISA法分别检测血清TPS和CA12 5水平。结果　卵巢癌患者血清TPS和CA12 5水平均较良性肿瘤患者高 ,差异有显著性。血清TPS和CA12 5诊断卵巢癌的敏感度和特异度无差别。卵巢癌患者两疗程化疗后血清TPS和CA12 5水平显著下降。结论　血清TPS和CA12 5均可作为卵巢癌诊断、病情监测的临床指标 ,二者联合检测可提高其临床应用价值。     

Measurement of a monoclonal-antibody-defined antigen (90K) in the sera of patients with ovarian cancer

Serum levels of CA125 and 90K, a new tumor-associated antigen, were measured in 73 ovarian cancer patients and 70 patients with benign gynecological conditions. Abnormally high serum CA 125 and 90K levels were found in 49% and 78% of these patients, respectively. When a combination of the two markers was used, the sensitivity increased to 86%. The percentage of 90K positivity did not significantly correlate with stage of disease or with histological type. A statistically significant correlation was found between 90K positivity rate and grade of tumor differentiation. Elevated serum CA 125 and 90K levels were present in 32% and 29% of patients with benign ovarian tumors, respectively. Only 1 case out of 26 with endometriosis had high 90K levels, compared to 7 patients with abnormal CA 125 levels. Serial measurements of 90K concentrations were found to be correlated with the clinical behaviour of the disease during chemotherapy. Moreover, rising levels of 90K preceded the clinical detection of recurrence with a median lead-time of 3 months. In 2 of these cases the serial changes in 90K values were better correlated with the course of disease than changes in CA 125 levels. Our data suggest that 90K combined with CA 125 may be applied for the detection and monitoring of ovarian cancer.     

血清CA125、CEA、AFP联合检测在卵巢恶性肿瘤诊断中的临床价值

目的 探讨血清CA125、CEA、AFP联合检测在卵巢恶性肿瘤诊断中的临床价值.方法 将卵巢恶性肿瘤患者86例作为研究对象,另选取同期于我院进行上述指标检测的卵巢良性肿瘤患者45例以及健康女性40例作为对照.观察卵巢恶性肿瘤患者血清CA125、CEA、AFP表达水平,并对不同分期、病理类型以及淋巴结转移情况患者情况进行比较,考察联合检测对比单项检测的阳性率.结果 卵巢癌组、卵巢良性肿瘤组患者以及健康体检女性CA125、CEA、AFP表达水平存在统计学差异(P＜0.05).不同临床分期卵巢癌患者CA125、CEA、AFP表达水平存在差异(P＜0.05).不同病理类型卵巢癌患者CA125及AFP表达水平存在差异,但CEA表达水平差异不明显(P＞0.05);有淋巴结转移的卵巢癌患者CA125、CEA、AFP表达量明显高于无淋巴结转移患者.3种标志物联合检测可提高阳性率(P＜0.05).结论 血清CA125、CEA、AFP对于卵巢恶性肿瘤具有诊断价值,联合检测可提高诊断阳性率,但同时也提高了假阳性率.     

上皮性卵巢癌患者手术及化疗前后血清中人附睾蛋白4和糖类抗原125的变化

目的探讨上皮性卵巢癌患者手术及化疗前后血清中人附睾蛋白4(HE4)和糖类抗原125(CA125)的变化。方法选取2012年3月至2013年3月间收治的50例上皮性卵巢癌患者,采用酶联免疫吸附试验(ELISA)检测50例上皮性卵巢癌患者(研究组)手术及化疗前后、正常健康人群(健康组)及卵巢良性肿瘤患者(对照组)血清中HE4和CA125水平,探讨其在疾病预后的的价值。结果对照组患者CA125和HE4水平显著高于健康组,差异有统计学意义(P<0.05)。研究组患者术前CA125和HE4水平明显高于对照组和健康组,其中化疗3个疗程后血清CA125水平降至正常水平,化疗2个疗程后血清HE4水平降至正常水平。CA125阴转符合率为41.5%,HE4阴转符合率为75.6%,CA125+HE4联合检测阴转符合率则增至85.4%;联合检测阳转符合率高达100%。结论血清CA125和HE4联合检测对卵巢癌预后判断有重要指导意义,可作为卵巢癌病情检测指标之一。     

Diagnosis and follow-up of ovarian cancer by a combination assay of serum sialyl SSEA-1 antigen and CA125 levels

We used a combination assay of serum sialyl SSEA-1 antigen (SLX) and CA125 levels, and evaluated the clinical usefulness of this technique for a diagnosis of ovarian cancer and follow-up of the patient with ovarian cancer. In 28 patients with ovarian tumors, the sera of 8 (66.7%) of 12 with ovarian cancer and 5 (71.4%) of the 7 with endometriosis (endometrial cyst) were positive for both SLX and CA125, but serum SLX level was 50 U/ml or less in all these 5 SLX-and-CA125 positive patients with endometriosis. The sera of all 9 patients with benign ovarian tumor were negative for both tumor markers. No patient with endometriosis was negative for both markers. The diagnostic accuracy (true positive rate X true negative rate) of the combination assay for ovarian cancer was 50.3% when the cut-off value of the serum SLX was 38 U/ml but improved to 81.8% when the value was set at 50 U/ml. From the above observations, a combination assay of serum SLX and CA125 is promising method for the differential diagnosis of malignant and benign ovarian tumors. Our results also suggest that to improve the diagnostic accuracy, the cut-off value of the serum SLX level should be 50 U/ml for ovarian tumors alone. We found following-up two cases of ovarian cancer that the serum SLX level is not affected by the ascites and inflammation. We expect that this combination assay of serum SLX and serum CA125 will be beneficial for diagnosis and follow-up of ovarian cancer.     

人附睾蛋白4与糖类抗原125联合检测在卵巢癌诊断中的应用价值

目的 探讨患者血清人附睾蛋白4(HE4)与糖类抗原125(CA125)联合检测及卵巢恶性风险计算法(ROMA)在卵巢癌诊断中的价值.方法 采用酶联免疫吸附试验(ELISA)检测119例卵巢癌患者(卵巢癌组)、36例交界性卵巢肿瘤(交界性组)、96例卵巢良性肿瘤患者(良性组)及53例女性健康对照者(健康对照组)的血清HE4浓度,同时用电化学发光法检测患者的血清CA125浓度,综合评价HE4与CA125组合的检测效能.结合女性的月经状态,采用ROMA方法计算卵巢癌预测概率(PP),评价PP值的诊断效果.结果 根据受试者工作特性曲线(ROC)分析,HE4的临界值为67.3 pmol/L,灵敏度和特异度分别为80.7%和94.6%.治疗前卵巢癌组患者血清HE4和CA125的中位浓度分别为227.3 pmol/L和444.0 U/ml,与交界性组、良性组和健康对照组差异均有统计学意义(均P＜0.01).手术治疗后,卵巢癌患者的血清HE4和CA125水平明显降低(均P＜0.01).HE4与CA125联合检测时,灵敏度和特异度分别为92.7%和72.5%.未绝经和绝经女性PP值的临界值分别为9.3%和27.3%,诊断未绝经患者的灵敏度和特异度分别为84.6%和77.0%,阳性预测值和阴性预测值分别为70.2%和88.7%;诊断绝经患者的灵敏度和特异度分别为86.3%和77.1%,阳性预测值和阴性预测值分别为94.5%和71.1%.结论 血清HE4是一种良好的血清肿瘤标记物.HE4与CA125联合检测并借助ROMA判定卵巢癌的患病风险有助于提高卵巢癌诊断的准确度.

Abstract：

Objective To investigate the clinical value of combination of human epididymis protein 4 (HE4), CA125 and the Risk of Ovarian Malignancy Algorithm (ROMA) in diagnosis of ovarian carcinoma. Methods To detect the serum concentration of HE4 using ELISA and CA125 using ECL in patients of ovarian carcinoma group (n=119), borderline ovarian tumor group (n=36), benign ovarian neoplasm group (n=96) and female healthy control group (n=53). The ROMA based on the serum level of CA125, HE4 and a woman′s menopausal status was used to calculate the predicted probability (PP) and diagnostic results of ovarian cancers. Results The receiver operating characteristic (ROC) analysis showed the cut-off value was 67.3 pmol/L (the AUC was 0.906, the sensitivity was 80.7% and specificity was 94.6%). The serum levels of HE4 and CA125 in the ovarian carcinoma group were significantly higher than that in the borderline ovarian tumor group, benign ovarian neoplasm group and female healthy control group (P<0.01). The serum levels of CA125 and HE4 showed statistically no significant difference between the borderline ovarian tumor group and benign ovarian neoplasm group (P>0.05). The levels of HE4 and CA125 were reduced significantly in ovarian patients after surgery therapy (P＜0.01). The sensitivity and specificity of HE4 + CA125 combination was 92.7% and 72.5%. The ROMA that can classify patients into high and low risk groups was established as 9.3% in premenopausal and 27.3% in postmenopausal women. Conclusions HE4 is a helpful biomarker for ovarian carcinoma diagnosis. Biomarker combination of HE4 and CA125, and applying of the ROMA are helpful to improve the accuracy in diagnosis of ovarian cancers.     

Explanation of the limited correlation between tumor CA 125 content and serum CA 125 antigen levels in patients with ovarian tumors

The concentration of the tumor marker CA 125 in tumor tissue, cyst fluid, ascites fluid, and serum from patients with epithelial ovarian tumors was quantitated. Immunohistologic studies showed that CA 125 was present in 90% of the nonmucinous epithelial ovarian tumors. Quantitative analysis of the fluid from 57 cysts revealed that CA 125 was present in concentrations of up to 2140,000 U/ml in samples from malignant nonmucinous epithelial ovarian lesions, and up to 116,000 U/ml in mucinous tumors, but also in concentrations of up to 371,000 U/ml in benign serous cystadenomas. In contrast, pre-operative serum CA 125 levels were elevated in almost all of the patients with malignant ovarian tumors but not in most of those with benign ovarian tumors. These findings suggest that in benign ovarian tumors there is an effective barrier between the cyst fluid and the circulation that prevents the appearance of CA 125 in the serum, whereas in malignant tumors infiltrative growth leads to the release of antigen into the circulation. Furthermore, CA 125 values in ascites fluids were up to 130 times higher than the serum antigen levels, which indicates that the peritoneum serves as a barrier for high molecular weight tumor antigens. The current results show that tumor basement membranes and peritoneal barriers play a notable role in the transit of tumor antigens, one which must be taken into account in the monitoring of serum marker levels of cancer patients.     

The serum concentration of human kallikrein 10 represents a novel biomarker for ovarian cancer diagnosis and prognosis

Human kallikrein 10 (hK10) is a secreted serine protease that is highly expressed in ovarian tissue. We hypothesized that hK10 might represent a novel serological marker for ovarian cancer. We quantified by immunoassay, hK10 in sera from 97 normal women (controls), 141 patients with benign gynecologic diseases, and 146 patients with ovarian cancer. We then examined the diagnostic and prognostic value of this measurement in ovarian cancer. We found that normal serum hK10 ranged from 50 to 1040 ng/liter (mean = 439 ng/liter). hK10 concentration is significantly elevated in serum of presurgical ovarian cancer patients (range: 106-11,746 ng/liter; mean = 1067 ng/liter) but not in serum of patients with benign gynecologic diseases (range: 120-1200 ng/liter; mean = 447 ng/liter). When a cutoff of 700 ng/liter was selected (diagnostic specificity = 90%), the diagnostic sensitivity for ovarian cancer is 54%. About 35% of CA125-negative ovarian cancer patients (CA125 < 23 kU/liter) were hK10 positive at 90% specificity. In patients with stage I/II ovarian cancer, use of these two markers in combination results in a 21% increase in sensitivity, at 90% specificity, compared with CA125 alone. High serum hK10 was strongly associated with serous epithelial type, late-stage, advanced grade, large residual tumor (>1 cm), suboptimal debulking, and no response to chemotherapy (all Ps < 0.001). In univariate Cox survival analysis, high serum hK10 is associated with increased risk for relapse and death (hazard ratio = 2.59 and 3.15, respectively, P 相似文献   

血清α-羟丁酸脱氢酶联合糖类抗原125检测在卵巢癌诊断中的应用价值

目的探讨卵巢癌患者血清α-羟丁酸脱氢酶、糖类抗原125(CA125)在卵巢癌中的表达情况,分析二者联合检测对卵巢癌的诊断价值。方法选取40例卵巢癌患者、35例卵巢良性病变患者和40例健康者,分别命名为卵巢癌组、卵巢良性病变组、健康对照组。检测血清α-羟丁酸脱氢酶、CA125水平,探讨血清α-羟丁酸脱氢酶水平与卵巢癌患者病理特征的关系。绘制受试者工作特征(ROC)曲线,分析血清α-羟丁酸脱氢酶联合CA125检测对卵巢癌的诊断效能。结果卵巢癌组和卵巢良性病变组患者的血清CA125、α-羟丁酸脱氢酶水平均高于健康对照组受试者,卵巢癌组患者的血清CA125水平高于卵巢良性病变组患者(P﹤0.05)。不同分化程度、国际妇产科联盟(FIGO)分期和淋巴结转移情况的卵巢癌患者的血清α-羟丁酸脱氢酶水平比较,差异均有统计学意义(P﹤0.01)。ROC曲线分析结果显示,血清α-羟丁酸脱氢酶联合CA125检测鉴别诊断卵巢癌与卵巢良性病变的曲线下面积为0.834(95%CI:0.743~0.924),灵敏度和特异度分别为85.46%和90.02%;鉴别诊断卵巢癌与健康者的曲线下面积为0.958(95%CI:0.919~0.997),灵敏度和特异度分别为89.47%和95.83%。结论卵巢癌患者的血清α-羟丁酸脱氢酶和CA125水平较高,有一定的卵巢癌诊断价值,二者联合检测可提高对卵巢癌的诊断效能。     

CEA、CA125在卵巢癌预后检测和复发诊断中的价值分析

目的 检测卵巢癌患者在不同治疗阶段CEA、CA125含量，探讨其在卵巢癌诊断、预后及早期复发转移的临床价值。方法 采用电化学发光法检测血清中CEA、CA125水平。结果 卵巢癌患者血清中CEA、CA125含量明显高于卵巢癌良性疾病组和正常对照组（P〈0．01），化疗后CEA、CA125的水平基本下降到正常，复发后又明显升高。结论 检测不同治疗阶段CEA、CA125的含量可作为卵巢癌患者诊断、预后及复发的敏感指标。