血清Cyfra21-1诊断卵巢恶性肿瘤的研究

目的 :研究细胞角蛋白片段抗原 2 1- 1(Cyfra2 1 1)对卵巢恶性肿瘤诊断及疗效判断的临床意义。方法 :应用免疫放射分析法 (IRMA)测定 10 2例卵巢肿瘤患者及 2 0例正常妇女血清中Cyfra2 1 1和CA12 5的水平 ,并对 12例Cyfra2 1 1阳性的恶性组患者于术后 1周开始 ,每月 1次 ,进行 4个月血清水平的动态观察。结果 :Cyfra2 1 1诊断卵巢恶性肿瘤的敏感性、特异性、准确性分别为 80 0 %、10 0 0 %、89 0 % ,CA12 5分别为 85 0 %、6 2 .0 %、76 .0 % ,Cyfra2 1 1诊断的特异性和准确性明显高于CA12 5(P <0 .0 1,P <0 .0 5 )。上皮性癌和转移性腺癌患者血清Cyfra2 1 1含量显著高于其他组织类型 (P <0 .0 5 ) ,分化程度不同的肿瘤血清Cyfra2 1 1水平差异有非常显著性 (P <0 .0 1) ,血清Cyfra2 1 1值与临床分期显著相关 (P <0 .0 0 1)。Cyfra2 1 1浓度在术后 1周明显下降 ,术后 1个月内恢复至正常范围。下降不明显或下降后再升高者 ,提示病情进展或复发。结论 :血清Cyfra2 1 1测定对卵巢恶性肿瘤患者的早期诊断、病情监测和疗效评估有重要的临床应用价值。     

血清CYFRA21-1与宫颈癌患者临床病理特征及预后的关系

目的:探讨治疗前血清CYFRA21-1水平与宫颈癌患者临床病理特征及预后的关系。方法:对90例FIGOⅠB1～ⅡB期宫颈癌患者行治疗前CYFRA21-1检测,结合临床资料及随访结果对其与临床病理特征及预后的关系进行分析。结果:90例患者CYFRA21-1的检测值为0.61～30.30mg/L(3.15±3.57mg/L)。以3.30mg/L为阈值,CYFRA21-1升高者占26.7%。不同FIGO期别、肿瘤大小、大体类型、病理类型,术后有或无盆腔淋巴结转移、宫颈深肌层浸润、淋巴血管间隙浸润的患者间的CYFRA21-1均值及升高率比较,差异均无统计学意义(P>0.05)。经过42个月中位随访期,不同CYFRA21-1值(0.10～3.30mg/Lvs>3.30mg/L)患者间的复发率(19.7%vs25.0%)比较,差异均无统计学意义(P>0.05)。治疗前血清CYFRA21-1值对预测治疗后复发无价值,曲线下面积(AUC)为0.456±0.087。CYFRA21-1升高与否患者间的总生存率(79.0%vs82.0%)比较,差异无统计学意义(P>0.05)。结论:FIGOⅠB1～ⅡB期宫颈癌患者血清CYFRA2...     

上皮性卵巢癌患者血清FOLR1、Smac水平与患者临床病理特征及预后的关系

目的 分析上皮性卵巢癌(EOC)患者血清叶酸受体1(FOLR1)、第2个线粒体衍生半胱氨酸蛋白酶激活因子(Smac)水平与病理参数及预后的关系.方法 选择148例经病理确诊为EOC的患者作为EOC组,卵巢良性肿瘤50例及体检健康女性50例作为对照1组、对照2组,分析EOC患者血清FOLR1、Smac水平与病理特征及近期...     

子宫内膜异位症相关性卵巢癌临床病理特征及预后分析

目的:探讨子宫内膜异位症相关性卵巢癌(EAOC)患者的临床资料及预后特点。方法:选择2011年1月至2014年1月于武汉大学人民医院妇科手术确诊为卵巢透明细胞癌(OCCC)及卵巢子宫内膜样腺癌(OEC)患者共181例,依据卵巢癌与卵巢子宫内膜异位症(卵巢EMT)间的关系分为卵巢EMT恶变组(EAOC组,35例)、合并卵巢EMT组(31例)、未合并卵巢EMT组(115例)。回顾性分析3组在临床、病理特征以及化疗、预后方面的异同点。结果:(1)3组患者在发病年龄、产次、合并不孕症、CA_(125)值升高比例、病理分期、淋巴结转移方面差异有统计学意义(P0.05)。(2)3组患者在化疗耐药、肿瘤复发方面差异无统计学意义(P0.05)。5年累积生存率分别为74.3%(EAOC组)、48.4%(合并卵巢EMT组)、47.8%(未合并卵巢EMT组),差异有统计学意义(P0.05)。生存曲线比较:EAOC组优于合并卵巢EMT组、未合并卵巢EMT组(P0.05),合并卵巢EMT组略优于未合并卵巢EMT组,差异无统计学意义(P0.05)。(3)预后影响因素分析:在EAOC组与合并卵巢EMT组中,EMT恶变是唯一影响因素(P0.05);EAOC组与未合并卵巢EMT组中,病理分期、EMT恶变是影响预后的独立重要因素(P0.05)。结论:EAOC患者具有一些特有的临床病理特征,病理分期、EMT恶变是影响卵巢癌预后的重要因素,与EMT相关的卵巢癌预后相对较好。     

卵巢癌谷胱甘肽转移酶-π的表达及与预后的关系

目的观察卵巢恶性肿瘤组织中谷胱甘肽转移酶-π的表达及与临床病理及预后的关系。方法采用免疫组化技术(S-P法)对30例卵巢恶性肿瘤组织中的谷胱甘肽转移酶(GST-π)的表达进行检测，分析其与病理类型、组织学分级、临床及预后的关系。结果(1)30例卵巢恶性肿瘤组织中谷胱甘肽转移酶的阳性表达率为强阳性6例，阳性5例弱阳性9例，阴性为10例，GST-π在卵巢癌中表达阳性率在病理分期G1、G2、G3分别为10％、16．7％、40％，GST-π的阳性表达率与临床分期及细胞分化程度有关。结论本研究结果表明测定卵巢恶性肿瘤组织中的谷胱甘肽转移酶，其结果对选择化疗用药具有指导意义，并可作为一个临床预后的参考指标。     

正常大小卵巢癌综合征的原发性浆液性癌临床病理特征及其预后影响因素

目的 探讨正常大小卵巢癌综合征的原发性卵巢浆液性癌临床病理特征及预后影响因素.方法 回顾性分析2007年1月1日至2015年12月31日就诊于中国医科大学肿瘤医院的正常大小卵巢癌综合征的原发性卵巢浆液性癌81例患者为研究组,同期入院的原发性大卵巢癌149例患者为对照组,比较两组临床病理特征及预后影响因素.结果 研究组占...     

ALDH1与卵巢癌关系的研究进展

ALDH1已被证实为肿瘤干细胞的表面标志物。其突变可引起细胞的生长、分化障碍,从而导致肿瘤的发生。近年来研究表明,ALDH1在卵巢癌中表达升高,并在卵巢癌的发生、发展和预后中作用,因而ALDH1有望成为卵巢癌早期诊断、预后分析的指标和基因治疗的靶点。本文就ALDH1与卵巢癌关系的进展作一综述。     

卵巢癌中p27kip1和Cyclin D1的表达与预后因素的相关性研究

目的　探讨 p2 7kip1、CyclinD1在卵巢癌发生、发展方面的意义。 方法　应用免疫组化染色及半定量分析的方法 ,检测 5 0例卵巢癌、19例卵巢良性上皮肿瘤、13例正常卵巢组织中的p2 7kip1、CyclinD1表达 ,及它们与上皮组织的良恶性、病理组织分级、临床分期的相关性。结果　正常卵巢组和卵巢良性肿瘤组间 ,p2 7、CyclinD1表达无明显差异 ;p2 7在正常卵巢组织和卵巢良性上皮肿瘤中高表达 ,在卵巢癌中表达降低 (P <0 0 5 ) ,且随着肿瘤分级、分期增高 (恶性程度增高 ) ,阳性表达率逐渐下降 ;而CyclinD1的表达则相反 ;两者在肿瘤中的表达呈负相关。结论　p2 7kip1表达下降、CyclinD1过表达可能在卵巢癌的发生发展中起重要作用 ,检测 p2 7kip1、CyclinD1在卵巢癌中的表达可预测该肿瘤生物学行为特征 ,可以作为预后指标     

卵巢癌组织中SDF-1/CXCR4的表达与临床病理因素相关性分析

目的:探讨SDF-1及其受体CXCR4蛋白在卵巢癌组织中的表达及其与卵巢癌患者临床病理因素之间的相关性。方法:采用免疫组化法检测20例正常卵巢组织、30例卵巢良性组织、50例卵巢癌组织中SDF-1、CXCR4蛋白表达。分析卵巢癌组织中SDF-1、CXCR4蛋白表达水平与临床病理因素的关系。结果:SDF-1、CXCR4在正常卵巢组织、卵巢良性肿瘤和卵巢癌组织中分别呈阴性、低表达和高表达,3者之间的差异具有统计学意义(SDF-1:χ2=58.116,P=0.000;CXCR4:χ2=73.485,P=0.000);且SDF-1、CXCR4蛋白在卵巢癌组织中的表达情况基本一致(χ2=0.061,P=0.806)。卵巢癌中SDF-1、CXCR4表达均与有无淋巴结转移相关(P0.05),SDF-1表达与有无腹水相关(P=0.027),而CXCR4表达与有无腹水无明显相关(P=0.336);SDF-1、CXCR4的表达与组织学分级、FIGO分期均无相关性(P0.05)。结论:SDF-1、CXCR4与卵巢癌相关,可能参与了卵巢癌的转移过程,但与卵巢癌的组织学分化无关。SDF-1/CXCR4可能是卵巢癌的重要致病因子。     

BRCA1基因c.5470＿5477del突变卵巢癌临床病理特征及预后分析

目的 探讨携带乳腺癌易感基因1(BRCA1)c.5470＿5477del突变卵巢癌的临床病理特征及预后情况。方法 采用二代测序技术,对760例于2001年1月至2020年9月在本院接受治疗、组织病理学确诊的上皮性卵巢癌患者的肿瘤组织进行BRCA1/2基因突变检测,对携带致病突变者通过唾液或血液检测确定是否为胚系突变。对BRCA1基因c.5470＿5477del突变卵巢癌诊断年龄、家族史、个人肿瘤史、病理分期、病理类型、化疗敏感性、聚腺苷二磷酸核糖聚合酶（PARP）抑制剂疗效、预后等指标进行分析。结果 760例上皮性卵巢癌患者中,214例患者携带BRCA1/2基因致病性胚系或体系突变,突变频率为28.2%(214/760)。其中BRCA1基因c.5470＿5477del突变频率最高（2.8%, 21/760）,且均为胚系突变,来自不同家系。该突变占BRCA1基因所有突变的13.5%(21/156)。BRCA1 c.5470＿5477del突变卵巢癌患者的中位发病年龄为52岁（36～67岁）。81.0%(17/21)的患者诊断年龄≥50岁,仅1例患者在40岁前发病。9例（42.9%, 9/...     

Serum cytokeratin-19 fragment (Cyfra 21-1) is a prognostic indicator for epithelial ovarian cancer

ObjectivesCytokeratin 19 is significant for indicating cancer cells, and Cyfra 21-1 is a fragment of cytokeratin 19. This retrospective study was designed to define the prognostic value of serum Cyfra 21-1 in epithelial ovarian cancers (EOC).Materials and methodsSerum Cyfra 21-1 concentration was obtained from 42 patients with EOC prior to treatment. Various prognostic aspects were examined using univariable and multivariable analyses. The standard serum marker cancer antigen 125 was measured simultaneously and compared in this analysis.ResultsSerum levels of both Cyfra 21-1 and cancer antigen 125 were associated with positive retroperitoneal lymph nodes and platinum resistance; higher levels of Cyfra 21-1 (3.0 ng/mL as the cut-off) were associated with shorter disease-free survival (16 months vs. 28 months, p = 0.001) and overall survival (29 months vs. 41 months, p = 0.007) than lower levels. Further univariable analysis showed that Cyfra 21-1, poor differentiation, and retroperitoneal lymph node metastasis were related to platinum resistance and mortality. Multivariable analysis indicated retroperitoneal lymph node metastasis and serum Cyfra 21-1 were independent risk factors for both disease-free survival and overall survival.ConclusionThe pretreatment level of serum Cyfra 21-1 had remarkable prognostic significance for EOC, indicating poor survival when it was elevated above 3.0 ng/mL.     

卵巢肿瘤患者血清CA19—9水平升高的临床意义

目的探讨血清CA19-9水平在卵巢肿瘤中的升高情况及临床意义。方法回顾性分析首都医科大学附属北京友谊医院2007年1月至2008年12月间收治的377例卵巢肿瘤患者的血清CA19-9水平及相关的临床资料。结果377例患者中,血清CA19-9水平升高者89例,阳性率23．6％0。主要见于成熟畸胎瘤、卵巢子宫内膜异位囊肿、交界性肿瘤及恶性肿瘤患者,其阳性率分别为27．3％、31．7％、42．9％和28．1％,高于良性肿瘤（19．3％）、卵巢瘤样病变（23．9％）和卵巢转移癌（12．5％）,但差异无统计学意义（P〉O．05）;双侧卵巢成熟畸胎瘤的阳性率为53．3％,高于单侧（19．6％）,差异无统计学意义（P〉O．05）。CA19-9检测卵巢恶性肿瘤的特异度为76．6％,灵敏度为25％,与CAl25联合其灵敏度和特异度分别为82．5％和59．1％。结论CA19-9对卵巢畸胎瘤和子宫内膜异位囊肿的诊断有一定的参考价值,与CA125联用可提高卵巢恶性肿瘤的检出率。     

CA125 parameters in survivors and non-survivors with epithelial ovarian cancer

Abstract. Cruickshank DJ. CA125 parameters in survivors and non-survivors with epithelial ovarian cancer. Int J Gynecol Cancer 1991; 1 : 279–284.
The relationship between different CA125 parameters and survival in patients with epithelial ovarian cancer was investigated in a prospective study. This involved 161 patients of whom 64 died and 97 remained alive. The established prognostic factors of stage and residual disease were controlled for and the population characteristics (age, follow-up/survival duration, histologic subtype, grade) were comparable in the 'dead' and 'alive' groups. For patients with stage I and II disease preoperative serum CA125, pre-chemotherapy serum CA125, plateau serum CA125 and time to reach the plateau level were all higher in the non-survivors when compared with survivors. In contrast, preoperative serum CA125 and pre-chemotherapy serum CA125 were significantly higher in survivors with stage III and IV disease. A possible explanation for these results includes the suggestion that early- and late-stage ovarian cancer may be different 'diseases' with different natural histories rather than being a continuum. Alternatively, the tumor-associated antigen CA125 being a membrane glycoprotein may have a beneficial, perhaps immunologic role in advanced disease.     

TRIF和MyD88指标在卵巢癌中的表达及与肿瘤血管生成的关系#br#

Objective?To explore the expression of TRIF and MyD88 markers in ovarian cancer and their relationship with tumor angiogenesis. Methods?The expressions of TRIF and MyD88 in 30 ovarian cancer tissues and normal ovarian tissues were detected; the relationship between TRIF and MyD88 and clinical case characteristics was analyzed; the correlation between TRIF and MyD88 and tumor angiogenesis was analyzed. Results?The positive expressions of TRIF, MyD88 and VEGF in ovarian cancer tissues were higher than those in normal ovarian tissues, and were correlated with FIGO staging and lymph node metastasis (P<0.05). The expression of TRIF, MyD88 and VEGF were positively correlated in ovarian cancer tissue, and mediate tumor angiogenesis. Conclusion?TRIF and MyD88 are highly expressed in ovarian cancer tissues, and together with VEGF mediate tumor angiogenesis, affecting the occurrence and development of ovarian cancer.     

Immunohistological analysis of stress-induced phosphoprotein 1 in ovarian cancer patients with low serum cancer antigen 125 levels

ObjectiveStress-induced phosphoprotein 1 (STIP1) was recently identified as a potential tumor marker for human ovarian cancer. This study further evaluates the usefulness of STIP1 in ovarian tumor patients with normal CA125 serum levels.Materials and MethodsSTIP1 and CA125 were immunohistochemically analyzed in 84 primary ovarian cancer and 30 benign ovarian tumors in patients with serum CA125 levels < 35 U/mL before surgery. Histoscores (0–300) were calculated as staining intensities (0–3) multiplied by percentage of tumor tissue (0–100%).ResultsThe cell types of the 84 cancers included 11 serous, 10 clear-cell, 51 mucinous, and 12 endometrioid carcinomas. There were 55 patients with invasive cancer and 29 with borderline ovarian tumors. The histoscores of STIP1, but not of CA125, in invasive cancer (mean ± SD, 186.3 ± 82.5) were significantly (p < 0.0001) higher than those seen in borderline ovarian tumors (86.2 ± 85.5). When the STIP1 histoscore was set at 183.8, invasive cancers (n = 55) were identified from benign tumors (n = 30) with a sensitivity of 56.4%, a specificity of 93.3%, a positive predictive value of 93.9%, and a negative predictive value of 53.8%. Results of receiver operating characteristics analysis showed that the area under curve of the STIP1 histoscore was 0.755, which was superior to that of CA125 (0.599).ConclusionSTIP1 histoscores may be useful in detecting invasive human ovarian cancer in patients with low serum CA125 levels.