血浆溶血磷脂酸及CA125水平与子宫内膜癌临床病理特征的关系

目的:探讨血浆溶血磷脂酸（LPA）及CA125在子宫内膜癌的表达及与临床病理特征之间的关系。方法:利用化学比色法检测65例子宫内膜癌患者和40例子宫内膜非典型增生患者及40例健康献血员（对照组）血浆溶血磷脂酸含量,同时采用电化学发光法检测血浆CA125含量并作对比分析。结果:子宫内膜癌组患者血浆LPA水平为（5.87±2.02）μmol/L,明显高于对照组（2.31±0.45）μmol/L（P<0.01）,子宫内膜非典型增生组与对照组比较,差异无统计学意义（P>0.05）。LPA和CA125对子宫内膜癌诊断的灵敏度分别为69.2%、63.1%,特异度为60.0%、53.8%;LPA对子宫内膜癌早期（0+Ⅰ期）诊断的阳性率明显高于晚期（Ⅱ～Ⅳ期）（P<0.05）。与肿瘤大小无明显的相关性（P>0.05）。其阳性率随病理分级逐渐降低并有显著性差异（P均＜0.05）,且随肿瘤浸润肌层深度及淋巴结转移程度增加亦逐渐降低（P均＜0.05）。而CA125阳性率随着病理分级逐渐升高,并有显著性差异（P均＜0.01）,在深肌层浸润及子宫外转移病例中明显升高（P均＜0.01）。结论:血浆LPA检测对子宫内膜癌的早期诊断及鉴别诊断具有一定的临床应用价值,明显优于CA125,LPA可作为判断子宫内膜癌预后的重要指标。     

64例子宫内膜癌术前血清CA125对子宫外扩散判断的价值

目的：分析子宫内膜癌术前血清CA125值对其宫外扩散的判断价值。方法：前瞻性分析了1998年10月－2001年3月收治的经手术治疗的子宫内膜癌患者64例，术前及术后均检测了血清CA125值以了解与手术分期，病理类型及组织学分级的关系，并对其结果进行统计学处理。结果：64例患者中，血CA125值阳性者17例，与手术分期及病理类型存在着线性关系（P＜0.01）。结论：术前血清CA125值测定可作为病变宫外扩散的重要参考指标。     

血清CA125对子宫内膜癌分期及预后的价值

目的 :通过检测血清CA12 5水平 ,探讨其在判定子宫内膜癌期别、肌层浸润程度及淋巴结转移和术后监测复发的价值。方法 :用微粒子酶免分析法检测 16 3例 (术前或术后或复发后 )子宫内膜癌患者的血清CA12 5水平。结果 :Ⅲ、Ⅳ期子宫内膜癌患者CA12 5水平明显高于Ⅰ、Ⅱ期 (P <0 0 1) ,有深肌层受侵的患者CA12 5水平明显高于浅肌层或无肌层受侵的患者 (P <0 0 1) ,有淋巴结转移患者的CA12 5水平明显高于无淋巴结转移的患者 (P <0 0 1) ,复发有病灶的患者CA12 5明显高于无复发的患者 (P <0 0 1)。结论 :检测血清CA12 5值 ,对早期子宫内膜癌的诊断无价值 ,对晚期子宫内膜癌的诊断、肌层浸润程度、淋巴结转移及监测术后复发有一定的参考价值     

血清CA125监测子宫内膜腺癌的临床价值

作者采用放射免疫测定法监测了１００例子宫内膜腺癌的血清ＣＡ１２６水平。结果表明病人的血清ＣＡ１２５水平显著高于健康妇女及子宫内膜不典型增生者。Ⅰ、Ⅱ、Ⅲ、Ⅳ期的阳性率分别为２９．４％、５４．８％、１００；０％及８０．０％，有显著差异。复发者阳性率为１６．６％，未控者阳性率为８７．０％。ＣＡ１２ｓ值随病情变化而变化。阳性组与阴性组的３年生存率分别为６９．０％、９１．０％，有显著差异。作者认为血清ＣＡ１２５水平主要与肿瘤负荷及播散范围有关，可作为正确估计病期、监测病情变化及指示预后的有效指标。     

血清CA125、CA19-9、CEA及SCC水平在子宫内膜癌患者中的诊断意义

目的：探讨血清CA125、CA19－9、CEA及SCC联合测定在子宫内膜癌患者中的诊断及对病情评估的意义。方法：测定107例子宫内膜癌患术前血清CA125、CA19－9、CEA及SCC水平，分析不同临床期别与4项标志物之间的关系。结果：4例肿瘤标志物中以血清CA125在子宫内膜患者中阳性率最高，达30．3％，联合测定阳性率升高，以CA125、CA19－9及CEA联合为最佳，阳性率可提高到48．5％，随着患者临床期别的增高，各项肿瘤标志物的中位数值及阳性率有升高趋势，Ⅱ-Ⅳ期患者显著高于Ⅰ期患者，血清CA125和（或）CA19－9≥40U/ml者，有50．3％的可能临床期别已达Ⅲ期。结论：子宫内膜癌患者术前联合测定CA125、CA19－9、CEA及SCC可协助正确诊断，有利于子解病情程度，制定合适的治疗方案。     

CA—125与子宫内膜抗体测定在子宫内膜异位症诊断中的价值

测定２８例子宫内膜异位症患者及１４例正常健康妇女血清ＣＡ－１２５和子宫膜抗体（ＥＭＡｂ）水平。结果，血清ＣＡ－１２５浓度与子宫内膜异位症临床分期呈正相关，Ⅲ、Ⅳ期子宫内膜异位症患者血清ＣＡ－１２５明显高于对照组；子宫内膜异位症患者血清ＥＭＡｂ明显高于对照组。两者用于子宫内膜异位症诊断的敏感性分别为７１．４３％和８２．１４％，特异性分别为５７．２１％和５７．１４％。     

胰腺癌患者血浆溶血磷脂酸的临床意义

目的:检测胰腺癌患者血浆溶血磷脂酸(lysphosphaticlic acid,LPA)的水平,评价LPA在胰腺癌诊治中的临床意义。方法:采用定磷法检测2006年6月至2010年10月南京第一医院收治的胰腺癌患者50例、胰腺良性疾病患者32例及健康志愿者36人的血浆LPA水平,同时测定血清CA19-9、AFP和CEA的水平;免疫组化法检测胰腺癌组织及癌旁胰腺组织LPA2受体的表达。分析血浆LPA水平与胰腺癌临床病理特征的关系。结果:胰腺癌患者血浆LPA水平明显高于胰腺良性疾病患者和健康志愿者[(4.10±2.03)vs(3.28±1.26)、(2.27±1.02)μmol/L,P<0.05],胰腺癌患者血浆LPA水平和血清CA19-9水平密切相关(r=0.9070,P<0.01)。胰腺癌组织LPA2受体表达阳性率显著高于癌旁正常胰腺组织(88%vs 4%,P<0.05)。血浆LPA水平的升高与胰腺癌浸润和淋巴结转移等相关。结论:血浆LPA检测为胰腺癌诊断和预后判断增加了一项潜在的评价指标。     

CA125联合CA199检测在子宫内膜异位诊断中的价值及临床意义

目的探讨CA125联合CA199检测在子宫内膜异位(EMs)诊断中的价值及临床意义。方法以2013年3月至2014年2月收治的EMs患者48例、卵巢上皮癌(EOC)患者44例、卵巢良性肿瘤(BOT)36例为研究对象,检测其血清CA125和CA199水平。结果 Ems患者血清CA125、CA199水平明显高于BOT患者(均P<0.05),而低于EOC患者(均P<0.05)。血清CA125、CA199从BOT组、Ems组到EOC组均呈明显增加趋势,且两者呈正相关(r=0.7587,P<0.05)。血清CA125和CA199联合检测对Ems、EOC的诊断灵敏度明显高于单项检测(均P<0.05),但特异度、准确度较单项指标略有下降。结论 CA125联合CA199可提高Ems诊断灵敏度,但特异度低,可作为Ems的辅助诊断指标。     

Relationship between CA 125 and progesterone production in women with ovarian carcinoma

CA 125 and steroid production is compared in a group of 48 women with ovarian epithelial carcinoma. The histologic types were I C (n = 20), II C (n = 5), III C (n = 11), or V (n = 12). The number of patients in Stage I was six; Stage II, 11; Stage III, 16; and Stage IV, 15. All patients were naturally or surgically postmenopausal. Blood samples were taken at the first admission to the hospital and 14 cases with large tumors were followed with monthly sampling during chemotherapy, and in 13 cases until a recurrence of the tumor. CA 125 and steroid production were analyzed using radioimmunoassay. The results show a high correlation between initial CA 125 and especially progesterone plasma concentration. Both decreases during chemotherapy parallel the shrinkage of the tumor and increase 1 to 4 months before recurrence. Progesterone and CA 125 together predicted all recurrences but none of the factors alone. The prognostic value for 5-year survival was somewhat higher for progesterone than CA 125. CA 125 correlated highly with sex hormone binding globulin (SHBG) and negatively with albumin. The correlation may be due to the intercorrelation with tumor burden.     

血清前梯度蛋白2水平与鼻咽癌患者临床病理特征的关系

目的 通过检测鼻咽癌患者治疗前后血清前梯度蛋白2(AGR2)的水平,探讨其与鼻咽癌临床病理特征的关系.方法 采用酶联免疫吸附试验(ELISA)检测55例鼻咽癌患者(鼻咽癌组)治疗前后、30例鼻咽喉部炎症患者(炎症组)和20例健康志愿者(健康对照组)的血清AGR2水平,并分析治疗前后AGR2与鼻咽癌临床病理特征的关系.鼻咽癌患者均给予放疗,治疗结束后随访6个月,进行近期疗效评价.结果 治疗前鼻咽癌组、炎症组和健康对照组血清AGR2水平分别为(22.92±5.24)μg/L、(9.50±4.15)μg/L和(8.75±2.18)μg/L,3组间差异有统计学意义(F=268.400,P=0.000),其中鼻咽癌组患者血清AGR2水平明显高于炎症组和健康对照组(t=14.241,P=0.000;t=15.254,P=0.000).鼻咽癌组患者治疗后血清AGR2水平较治疗前明显降低[(15.15±10.33)μg/L∶(22.92±5.24)μg/L,t=12.774,P=0.000)];Ⅲ~Ⅳ期鼻咽癌患者治疗前及治疗后血清AGR2水平明显高于Ⅰ~Ⅱ期(t=5.938,P=0.000;t=0.759,P=0.032);有淋巴结转移患者治疗前及治疗后血清AGR2水平明显高于无淋巴结转移者(t=6.879,P=0.000;t=2.700,P=0.009);有颈动脉鞘、颅底受累者治疗前血清AGR2水平分别高于无受累者(t=8.342,P=0.000;t=8.255,P=0.009);颅神经受累者治疗前后血清AGR2水平均明显高于无受累者(t=7.743,P=0.000;t=3.021,P=0.004).治疗完全有效患者治疗后血清AGR2水平[(13.86±2.93)μg/L]明显低于部分有效患者[(15.85±3.24)μg/L,t=2.267,P=0.028]和无效患者[(20.65±6.59)μg/L,t=4.935,P=0.000],部分有效患者血清AGR2水平明显低于无效患者(t=3.196,P=0.004).结论 鼻咽癌患者血清AGR2增高,在鼻咽癌发生发展过程中起到重要的作用,有望成为鼻咽癌患者临床疗效及预后判断的一个新指标.     

宫颈癌患者血浆溶血磷脂酸表达临床意义的探讨

目的:探讨血浆溶血磷脂酸(LPA)在宫颈癌中的表达及临床意义。方法:利用化学比色法检测135例宫颈癌和85例宫颈良性疾病患者及40位健康体检者(对照组)血浆溶血磷脂酸含量,同时采用电化学发光法检测血浆CYFRA21-1含量并作对比分析。结果:宫颈癌组患者血浆LPA水平为(5.11±1.92)μmol/L,明显高于对照组的(2.31±0.45)μmol/L,P<0.01;宫颈良性疾病组患者血浆LPA水平为(2.46±1.05)μmol/L,与对照组比较差异无统计学意义,P>0.05。血浆LPA对宫颈癌诊断的灵敏度和特异度分别为67.4%和97.5%,CYFRA21-1的灵敏度和特异度分别为41.5%和95.0%,LPA均优于CYFRA21-1。血浆LPA和CYFRA21-1在宫颈鳞状上皮癌的表达分别为71.0%和43.5%,均高于腺癌+腺角化癌的27.3%和18.2%,P值均<0.05。宫颈癌晚期(Ⅲ+Ⅳ期)CYFRA21-1阳性率53.2%,明显高于早期(Ⅰ+Ⅱ期)的14.6%;有远处转移的宫颈癌患者血浆LPA阳性率91.9%,明显高于无远处转移者的24.5%,P<0.05。结论:LPA可能与宫颈癌的浸润和转移有关;血浆LPA检测对宫颈癌的诊断及鉴别诊断具有一定的临床应用价值。     

子宫内膜癌临床病理特征与盆腹腔淋巴结转移的相关性分析

目的:探讨子宫内膜癌临床病理特征与盆腹腔淋巴结转移的相关性。方法:选取162例子宫内膜癌患者,分析临床病理资料,探讨盆腹腔淋巴结转移的相关因素。结果:162例子宫内膜癌患者中,9例发生盆腔淋巴结转移,7例发生腹主动脉旁淋巴结转移。非内膜样腺癌、FIGO Ⅲ 期、脉管浸润、治疗前CA125高于正常水平的患者盆腔淋巴结转移率高,差异有统计学意义;FIGO Ⅲ 期、脉管浸润、肿瘤直径>2 cm、治疗前CA125水平高于正常及盆腔淋巴结阳性的患者腹主动脉旁淋巴结转移率高,差异有统计学意义。多因素COX回归分析:FIGO分期、病理类型、脉管浸润为淋巴结转移的高危因素。结论:非子宫内膜样腺癌、FIGO分期、脉管浸润、治疗前CA125高水平与子宫内膜癌盆腔淋巴结转移存在相关性,FIGO分期、脉管浸润、肿瘤直径、治疗前CA125水平、盆腔淋巴结与子宫内膜癌腹主动脉旁淋巴结转移存在相关性。     

肝细胞癌ZIC1基因启动子区甲基化与临床病理特征的关系

目的:探讨肝细胞癌ZIC1基因启动子区甲基化与临床病理特征的关系.方法:采集2008年8月至2014年8月武警陕西总队医院63例肝细胞癌患者手术切除的肿瘤组织标本,通过Real-time PCR法检测肝细胞组织及癌旁组织中ZIC1 mRNA表达水平;用甲基化特异性PCR (methylation specific polymerase chain reaction,MSP)法检测癌组织及癌旁组织中ZIC1基因启动子区甲基化状态.结果:ZIC1 mRNA在肝细胞癌组织中呈低表达与其启动子区甲基化有关;ZIC1基因在肝细胞癌中频发甲基化(P＜0.05),并与肿瘤分化程度及分级显著相关(均P＜0.05).结论:启动子区甲基化是ZIC1基因失活的重要机制,ZICI基因启动子区异常甲基化可能参与了肝细胞癌的发生发展.     

Oestrogens and clinical characteristics in endometrial carcinoma

Serum concentrations of endogenously produced oestrogens were studied in 128 postmenopausal women with endometrial carcinoma. Radioimmunoassays of serum oestrone (E1) and oestradiol (E2) were performed on admission to hospital. Results showed a wide variation in serum concentrations of E1 and E2 in patients with endometrial carcinoma. Some patients had high E1 values and low E2, while none of the patients had low E1 and high E2 values. Hormonal levels were correlated with increasing BMI (E1; p less than 0.000001; E2; p less than 0.000001). Uterine cavity depth was also related to both E1 and E2 (E1; p less than 0.00001; E2; p less than 0.0003). Concentrations of E1 and E2 were higher in diabetic women than in the non-diabetic. (E1; p less than 0.002; E2; p less than 0.01). E2 concentration was higher in hypertensive patients than in the non-hypertensive patients (p less than 0.04). Parameters such as age, menstrual history, clinical stage and histopathology showed no significant correlation with hormone concentrations.     

CA 19-9, CA 125 and CEA in the endometrial mucosa during the menstrual cycle, in atypical hyperplasia and endometrial carcinoma

CA 19-9, CA 125 and CEA were demonstrated by immunohistochemistry in 58 tissue samples of normal mucosa, 21 samples of atypical hyperplasia and 74 samples of endometrial carcinoma. CA 19-9 was mainly detected in the mid phase of secretion (8/11). CA 125 in the mid (6/11) and in the late phase (8/9). As opposed to CEA, both tumor markers are secretion products of the normal endometrium and are not expressed in the endometrial glands during the proliferation phase. CA 125 expression does not correlate with the degrees of differentiation or malignancy. The percentage of CA 19-9 positive cases rises with increasing differentiation. In atypical hyperplasia, however, this percentage is as small as in undifferentiated carcinoma. 93% of the endometrial carcinomas were CA 19-9, 65% CA 125 and 58% CEA positive.