Significance of CA 125 antigen levels in patients with ovarian cancer

CA 125 antigen levels were measured in patients with ovarian cancer (54 cases) by the RIA method using a monoclonal antibody OC 125 and were examined as a marker for ovarian cancer. The upper normal limit of CA 125 of 35 U/ml was derived from the mean value (15.7 U/ml) + 2 SD (9.3 U/ml) of CA 125 in healthy controls. The mean value of CA 125 in patients with ovarian cancer (1160 +/- 1850 U/ml) was statistically (p less than 0.001) higher than those of healthy controls, benign ovarian tumors (28 +/- 20 U/ml) and cervical cancers (226 +/- 526 U/ml). Elevated CA 125 levels were also found in the early stages pregnancy and endometriosis, but these cases did not show such high CA 125 values as those of ovarian cancers. In addition, CA 125 levels were not affected by the menstrual cycle. Among ovarian malignancies, elevated CA 125 values were specifically demonstrated in serous cystadenocarcinoma (positivity 89%) and markedly low in mucinous cystadenocarcinoma (positivity 16%). No positive correlation of CA 125 values with clinical stage (FIGO) were found in any ovarian cancer patients. The rise or fall of CA 125 level was well correlated with the progression or regression observed in cancer patients with positive CA 125 levels. In conclusion, serum CA 125 determinations may be useful in patients with ovarian cancer (except for mucinous type) for diagnosis and for monitoring the results of treatment.     

Tumor-associated mucin-type glycoprotein (CA54/61) defined by two monoclonal antibodies (MA54 and MA61) in ovarian cancers

Two monoclonal antibodies, MA54 and MA61, were established by immunizing with culture medium supernatants of a lung adenocarcinoma cell line, and a double-determinant sandwich enzyme immunoassay system was developed by using these two monoclonal antibodies. The antigen recognized by this assay (CA54/61) was found to be often high in the sera of several cancers. The antigen recognized by MA54 (CA54) or MA61 (CA61) proved to be carbohydrate chain on a high molecular weight mucin-type glycoprotein, and CA54 has NeuAc alpha 2-6galactose in the terminal residue. CA54/61 was frequently found in the sera of ovarian cancer patients, the positive rate being 67, 64, 40, and 78% in serous, mucinous, endometrioid, and mesonephroid cancers, respectively, when the cut off value was set at mean + 4 SD. Since the positive rate of CA125, which is now the most widely used for the diagnosis of ovarian cancers, is rather low (approximately less than 50%) in mucinous cystoadenocarcinoma, CA54/61 will be of clinical value. In addition, CA61 was detected immunohistochemically in the fetal red blood cells with nuclei, indicating its oncodevelopmental character in nature.     

Monoclonal antibody immunoradiometric assay for an antigenic determinant (CA 125) associated with human epithelial ovarian carcinomas

CA 125 is an antigenic determinant expressed by greater than 80% of nonmucinous epithelial ovarian carcinomas. An immunoradiometric assay has been developed using a murine monoclonal antibody (OC125) to quantitate CA 125 in human serum. This immunoradiometric assay was optimized for specificity, sensitivity, and performance characteristics. Using a simultaneous immunoradiometric assay, the mean CA 125 concentration in 56 sera from healthy individuals was 11.2 +/- 5.4 (S.D.) units/ml, with 9.7 +/- 3.2 units/ml for 30 males and 13.1 +/- 6.8 units/ml for 26 females. A reference value of 35 units/ml included all 56 normals and excluded 86 of 105 (82%) ovarian carcinoma patients. This reference value also excluded 9 of 142 patients (6%) with benign diseases, but if the upper limit of normal was set at 65 units/ml, only 3 of 142 (2%) patients with benign diseases had elevated serum CA 125 levels, whereas 77 of 105 (73%) ovarian carcinoma patient sera remained positive. The ability of researchers, with this assay, to discriminate between CA 125 values in sera of patients with ovarian carcinoma and those of healthy individuals and patients with benign disease suggests that the assay deserves continued evaluation for monitoring and early diagnosis of ovarian cancer.     

Basic and clinical evaluation of an immunoradiometric competitive inhibition assay for sialyl TN antigen: (2). Evaluation of clinical significance. STN Study Group

The clinical significance of serum sialyl Tn antigen as a tumor marker was evaluated using "STN Otsuka" kits. Results indicated that the antigen was frequently elevated in sera from patients with ovarian cancers (43.1%, 140/325), including serous cystadenocarcinoma (51.6%, 63/122), mucinous cystadenocarcinoma (55.6%, 30/54), endometrioid carcinoma (56.5%, 13/23), and mesonephroid carcinoma (40.0%, 6/15). The positive frequency of sialyl Tn antigen in patients with ovarian carcinoma was less than the frequency of CA 125 (75.5%, 194/257) or sialyl SSEA-1 (47.2% 83/176). However, the false positive rate of sialyl Tn antigen in patients with benign gynecological disorders (3.7%, 15/401) was much lower than the false positive rates of other antigens; such as CA 125 (48.4%, 155/320) and sialyl SSEA-1 (19.2%, 51/266). The serum level of sialyl Tn antigen reflected the clinical activity of the disease quite well in patients with ovarian cancers. The sialyl Tn antigen was concluded to be a useful serum tumor marker for ovarian cancers.     

Preoperative measurement of cancer antigen 125 (CA 125) in the differential diagnosis of ovarian tumors

The purpose of the present study was to evaluate the information preoperative measurements of cancer antigen 125 (CA 125) may give concerning the nature of an ovarian tumor. Serum samples from 61 patients were analyzed and the results compared with regard to malignancy, FIGO-stage, and histologic type of the tumor. All patients were deemed to have a malignant tumor by clinical examination. Elevated serum levels (greater than 35 U/ml) were found in 44 patients and of these patients 38 had carcinomas, 5 had borderline tumors, and one had a benign tumor (false positive). Normal serum levels (less than or equal to 35 U/ml) were registered in 17 patients. Fourteen of these had benign tumors and 3 had malignant (false negative). The false positive sample and the 3 false negative samples observed in the present study result in a positive and negative predictive value of the CA 125 analysis of 98% (43/44) and 82% (14/17) respectively. The positive predictive value of the clinical examination was 75% (46/61). It is concluded that measurement of CA 125 is a valuable adjunct to the preoperative examination of patients with ovarian tumors.     

Studies on the clinical significance of type III procollagen peptide in sera as a tumor marker in patients with ovarian tumors

Usefulness of type III procollagen peptide (P-III-P) in sera as tumor marker was investigated in patients with ovarian tumors. A concentration of P-III-P in sera was measured by radioimmunoassay. The mean P-III-P values for 72 females as healthy controls were 8.5 +/- 2.7 ng/ml. Therefore, the cut-off value (Mean + 2 SD) was set at 13.9 ng/ml. The positive rates of healthy controls were 4.2%. For patients with benign ovarian tumors, the mean P-III-P values were 8.7 +/- 2.3 ng/ml, and the positive rates were 0%. For patients with ovarian tumors of borderline malignancy, the mean P-III-P values were 8.0 +/- 1.5 ng/ml, and the positive rates were 0%. In both of benign and borderline malignant cases, the false positive rates of tumor markers such as TPA, IAP, CA-125 and CA 19-9 were relatively high. For patients with malignant ovarian tumors, the mean P-III-P values were 19.7 +/- 9.9 ng/ml at pretreatment, 10.4 +/- 1.0 ng/ml at post-treatment and 17.3 +/- 1.9 ng/ml at recurrence. The positive rates were 69.2% at pre-treatment, 0% at post-treatment and 100% at recurrence. In relation of histology, the positive rates were particularly high in patients with serious cystadenocarcinoma and embryonal carcinoma. In conclusion, P-III-P in sera was very useful as tumor marker in diagnosis of malignant ovarian tumors, while it was not aided to detect the early cancers.     

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.     

Ovarian tumors of low malignant potential (borderline tumors): immune morphology and current status

CA 125, CA 19-9 and CEA were demonstrated in tissue samples of 30 ovarian borderline tumors by immunohistochemistry. Of the 21 serous and 9 mucinous borderline tumors, 23 were in stage I and 7 stage III. None of the patients died of disease. All mucinous borderline tumors were CA 125 negative, 89% CA 19-9 positive and 44% CEA positive. 62% of the serous borderline tumors were CA 125 positive, 52% CA 19-9 and 19% CEA positive. Tumors of low malignant potential responded to CA 19-9 like invasive carcinomas. The incidence of positive responses to CA 125 ands CEA fell between that of benign and malignant tumors. The marker pattern did not correlate with tumor stage and cytological grading. The biological behavior of ovarian borderline tumors ranges between that of benign tumors and invasive carcinomas and cannot be classified as definitely belonging to either group. It is plausible that they are primarily of the borderline type, and not benign tumors that undergo malignant degeneration.     

Clinical value of a new serum tumor marker CA602 in ovarian cancers

We investigated the usefulness of CA602, a newly developed serum tumor marker, for ovarian cancer. When the cut-off value was set at 60 U/ml, the overall positive rate of this marker in ovarian cancer was 92%, a slightly high rate relative to CA125 measured at the same time (88%). Considering tumor histology, CA602 revealed a high positive rate of 100% in serous adenocarcinoma, whereas the positive rate was 67% in mucinous adenocarcinoma. However, the positive rate was relatively high in benign diseases such as endometrial cysts (64%) and benign ovarian tumors (29%). It is concluded that CA602 is a tumor marker with low specificity and high sensitivity in general. The definite correlation between CA602 and CA125 in ovarian tumors (R = 0.96) suggests that these markers have certain similarities. Thus, CA602 may be a useful serum tumor marker for ovarian cancer as a substitute for CA125.     

A New CA125-like Antigen (CA602) Recognized by Two Monoclonal Antibodies against a Newly Established Ovarian Clear Cell Carcinoma Cell Line (RMG-II)

A cell line designated RMG-II was established from the ascites of a patient with ovarian clear cell carcinoma. The chromosomal analysis revealed aneuploidy with a hypertetraploid modal numher and 8 marker chromosomes. Radioimmunoassay and immunocytochemical staining showed that RMG-II cells produced some tumor markers such as CA125 and TPA. Two monoclonal antibodies, designated MA602-1 and MA602-6, were generated by immunization of mice with an extract prepared from the culture supernatant of RMG-II cells. The epitopes recognized by these two monoclonal antibodies were proved to differ from the CA125 epitope, but to exist on the molecule bearing CA125. We developed a double-determinant sandwich enzyme imnnmoassay using these two monoclonal anti-bodies, and the antigen defined by this assay was termed CA602. CA602 was frequently found in the sera of ovarian cancer patients; the positive rates were 92%, 38%, 60%, and 80% for serous, mucinous, clear cell, and endometrioid ovarian carcinomas, respectively, when the cut-off value was set at 60 U/ml (=mean + 3SD of healthy females). CA602 levels in serum were also high in endometriosis patients and in early pregnancy, as is the case for CA125, and the correlation coefficient between CA602 and CA125 was high ( r =0.88). Our preliminary evidence suggests that this CA602 assay system has higher sensitivity than the CA125 one.     

Ca 125 Assay Used in Conjunction with Ca 15-3 and Tag-72 Assays for Discrimination Between Malignant and Non-Malignant Diseases of the Ovary

It has previously been suggested by the authors that elevated serum CA 125 levels may be of value in discriminating malignant from non-malignant pathologies among women with pelvic masses. Enhancement of this discrimination capacity might be achieved by utilizing additional serum assays. to test this hypothesis CA 125, CA 15-3 and TAG-72 levels were determined in double-blind fashion on 219 sera from patients undergoing diagnostic laparotomy for pelvic masses at six gynecological departments in the Stockholm area. Patient diagnoses were verified by chart review. of the 219 patients, 27 (12%) had non-mucinous ovarian carcinoma, of whom 26 (96%) had CA 125 levels of 35 U/ml or greater 23 (85%) had levels in excess of 65 U/ml. of 27 patients with mucinous or borderline ovarian carcinoma and patients with other malignancies 18 (67%) had CA 125 levels greater than 35 U/ml. of 165 women with non-malignant diagnoses 26 (16%) had CA 125 levels in excess of 35 U/ml and 8 (5%) greater than 65 U/mL Using reference values of 35 U/ml, 30 U/ml and 10 U/ml for the CA 125, CA 15-3 and TAG-72 assay respectively, only 3 of 165 (2%) of non-malignant patients were categorized as positive, compared to 23 of 27 (85%) of those with non-mucinous ovarian carcinoma. Moreover, an analysis of post-menopausal women revealed that the combination of assays—in a model controlling for the effect of CA 125—-increased the specificity for diagnosis of benign diseases in women with pelvic masses.     

Simple laboratory score improves the preoperative diagnosis of adnexal mass

We assessed the diagnostic accuracy of a newly developed laboratory score—based on CA125, platelet count (PLT), C-reactive protein (CRP), and fibrinogen levels—in the preoperative diagnosis of adnexal mass. In this retrospective single-center study, we analyzed records of 142 patients with 54 malignant (38 %) and 88 benign (62 %) ovarian tumors. Preoperative levels of CA125, PLT, CRP, and fibrinogen were dichotomized according to the common cutoff values (CA125, 35 U/ml; PLT, 350/nl; CRP, 5.0 mg/l; fibrinogen, 400 mg/dl), resulting in “1” for results above the cutoff and “0” for results within the normal ranges. The values (1 or 0) were summarized to a “low” (0–2) or “high” (3–4) score. Its diagnostic accuracy was compared to the “gold standard,” CA125. All parameters differed significantly between malignant and benign cases. The score was false positive in 5/88 (5.7 %) and false negative in 13/54 (24 %) of cases. Conversely, CA125 was false positive in 18/88 (20.4 %) and false negative in 4/54 (7.4 %). The diagnostic accuracy of CA125 (>35 U/ml) was sensitivity 0.93, specificity 0.80, positive predictive value (PPV) 0.74, negative predictive value (NPV) 0.95, and positive likelihood ratio (weighted by prevalence) (+LH/p) 2.78. The diagnostic accuracy of the score was sensitivity 0.76, specificity 0.94, PPV 0.89, NPV 0.86, and +LH/p 8.2. In conclusion, the score is easy to use and generates no additional costs. It provides a better specificity, PPV, and +LH/p than CA125. The sensitivity and NPV are lower, but acceptable. A validation of the score in a large patient cohort is needed.     

A new CA125-like antigen (CA602) recognized by two monoclonal antibodies against a newly established ovarian clear cell carcinoma cell line (RMG-II).

A cell line designated RMG-II was established from the ascites of a patient with ovarian clear cell carcinoma. The chromosomal analysis revealed aneuploidy with a hypertetraploid modal number and 8 marker chromosomes. Radioimmunoassay and immunocytochemical staining showed that RMG-II cells produced some tumor markers such as CA125 and TPA. Two monoclonal antibodies, designated MA602-1 and MA602-6, were generated by immunization of mice with an extract prepared from the culture supernatant of RMG-II cells. The epitopes recognized by these two monoclonal antibodies were proved to differ from the CA125 epitope, but to exist on the molecule bearing CA125. We developed a double-determinant sandwich enzyme immunoassay using these two monoclonal antibodies, and the antigen defined by this assay was termed CA602. CA602 was frequently found in the sera of ovarian cancer patients; the positive rates were 92%, 38%, 60%, and 80% for serous, mucinous, clear cell, and endometrioid ovarian carcinomas, respectively, when the cut-off value was set at 60 U/ml (= mean + 3SD of healthy females). CA602 levels in serum were also high in endometriosis patients and in early pregnancy, as is the case for CA125, and the correlation coefficient between CA602 and CA125 was high (r = 0.88). Our preliminary evidence suggests that this CA602 assay system has higher sensitivity than the CA125 one.     

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.     

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.     

Prospective multicenter study on the clinical utility of ca-72.4 in postmenopausal patients with pelvic mass

The study objective was to evaluate the sensitivity and specificity as well as the positive predictive value and negative predictive value of CA 72.4 and CA 125 determination, separately and in combination, for diagnosing ovarian tumors in post-menopausal women with pelvic mass. The 299 patients recruited in this study underwent gynecological examination, plasma determination of CA 72.4 and CA 125, and laparotomy with histological definition of pelvic mass. CA 72.4 assay values were under 3.9 U/ml in 194 cases (70.8%); values ranged from 3.9 to 4.5 U/ml in 7 cases (2.5%) and were greater than 4.5 U/ml in 73 cases (26.6%). CA 72.4 assay was positive (>4.5 U/ml) in 56 cases (57.1%) of malignant ovarian pathology, in 4 cases (25%) of malignant extra-ovarian pathology as well as in 9 cases (7.1%) of benign ovarian pathology and in 4 cases (11.8%) of benign extra-ovarian pathology. With a cut-off at 3.9 U/ml, CA 72.4 showed a specificity of 91.3% and a sensitivity of 62.2%, whereas with a cut-off at 4.5 U/ml specificity was 92.9% and sensitivity 57.1%. Results of CA 125 assay for diagnosing a pelvic neoplasia (ovarian or extra-ovarian), showed a specificity of 85.3% and sensitivity of 68.8%. The agreement of the two markers (CA 125 and CA 72.4) as negative or positive shows a specificity of 77% and a sensitivity of 84.7% for ovarian cancer and a specificity of 73.5% and sensitivity of 75% for the diagnosis of pelvic neoplasias.     

Use of serum tumor markers in the differential diagnosis between ovarian and colorectal adenocarcinomas.

In the search for a method to facilitate the preoperative discrimination of ovarian carcinomas from colorectal carcinomas serum levels of 6 tumor markers were measured in 47 patients presenting with ovarian cancer and compared to levels found in 24 female patients with advanced, untreated colorectal cancer. The markers studied were CA 125, CA 15.3, CA 19.9, CEA and two recently developed mucin markers, CA M29 and CA M26. Levels of CA 125, CA 15.3, CEA and CA M29 showed significant differences between both groups. In predicting ovarian cancer, sensitivity was highest for CA 125 at 94% (35 U/ml cutoff level). However, the specificity of CA 125 was at 71% low. Specificity increased significantly by using a combination of a CA 125-positive score (greater than 35 U/ml) and a simultaneous negative CEA score (less than or equal to 5 ng/ml) (specificity 100%, sensitivity 81%). A CA 125/CEA serum ratio greater than 25 resulted in the highest discriminative power with a specificity of 100% and a sensitivity of 91% resulting in an overall test accuracy of 94%. It is concluded that the serum tumor markers used, especially a combination of CA 125 and CEA, are helpful in the preoperative differential diagnosis between adenocarcinomas of ovarian and colorectal origin.     

Clinical significance of the tumour markers CA 125 II and CA 72-4 in ovarian carcinoma

In a retrospective study we compared the usefulness of the tumour marker CA 72-4 with the established marker CA 125 II (both EIA on Cobas-Core, Hoffmann LaRoche, Basel Switzerland) at the time of primary diagnosis of ovarian carcinoma (n = 123) in order to discriminate between ovarian carcinomas of different histological type. We compared their diagnostic value, behaviour in follow-up care and evaluated possible combinations. Fixing specificity at 95% vs. benign gynaecological diseases (n = 37) as the clinically relevant reference group, we found cut-off values of 160 U/mL for CA 125 II and 3.0 U/mL for CA 72-4. On the basis of this specificity, we found comparable sensitivity for CA 125 II and CA 72-4 for all kinds of ovarian carcinoma at the time of primary diagnosis. With regard to histology, we found best sensitivity for CA 125 II in serous ovarian cancer and for CA 72-4 in mucinous ovarian cancer. Additional sensitivities were found in ovarian carcinoma in general but little in serous ones. No additive sensitivity was found in mucinous ovarian carcinomas with CA 72-4 as leading marker. In follow-up care, CA 72-4 was the leading marker in II cases and CA 125 II in 16, while in one case both markers were negative. In 6 cases the change of values reflecting clinical follow-up-care was within the so-called reference range. According to our results, at the time of primary diagnosis because of lack of histological findings the combined determination of CA 125 II and CA 72-4 can be recommended. In follow-up care and control of efficacy of therapy the preoperative positive or leading marker is generally sufficient. The determination of both markers in follow-up care is indicated only if they both are negative at primary diagnosis and until one of them becomes clearly positive. © 1996 Wiley-Liss, Inc.     

卵巢浆液性／黏液性囊腺癌中SP1、KLF9的表达及与HPV16／18感染的相关性研究

目的 探讨KLF9、SP1及HPV16／18在卵巢浆液性／黏液性囊腺癌中的表达及临床意义,并进一步探讨三者在浆液性／黏液性卵巢癌发生、发展过程中的作用。方法 制作组织芯片并采用免疫组化SP法及分子原位杂交技术检测60例卵巢浆液性／黏液囊腺癌组织及20例卵巢浆液性／黏液性囊腺瘤组织中KLF9、SP1和HPV16／18的表达情况,分析三者与临床病理特征的关系,并检验三者之间的相关性。结果 SP1、KLF9及HPV16／18在卵巢浆液性／黏液性囊腺癌组织中的阳性表达率分别为71.7％（43／60）、63.3％（38／60）、30.0％（18／60）,而三者在卵巢浆液性／黏液性囊腺瘤组织中分别为15.0％（3／20）、10.0％（2／20）、0（0／20）,差异均有统计学意义（P＜0.01）。KLF9表达与各临床病理特征均无关（P＞0.05）;SP1表达与临床分期有关（P＜0.05）;HPV16／18表达与分化程度有关（P＜0.05）。在卵巢浆液性／黏液性囊腺癌组织中KLF9与SP1的表达呈正相关（r=0.443,P=0.000）,HPV16／18与SP1的表达亦呈正相关（r=0.331,P=0.010）,KLF9与HPV16／18的表达无相关性（P=0.133）。结论 KLF9、SP1及 HPV16／18在卵巢浆液性／黏液性囊腺癌组织中高表达,可能与卵巢浆液性／黏液性囊腺癌的生物学行为有关,在浆液性／黏液性卵巢癌的发生、发展中起重要的促进作用。     

端粒酶反转录酶与CA125在卵巢上皮性肿瘤组织中的原位表达及临床意义

目的:探讨端粒酶反转录酶(TRT)与CA125在卵巢上皮性肿瘤组织中的原位表达及临床意义。方法:收集93例卵巢上皮性肿瘤(良性47例、交界性15例、恶性31例),应用免疫组织化学S蛳P法检测肿瘤组织中TRT及CA125的原位表达,将结果进行统计学分析。结果:TRT的表达在良性(17.02%,8/47)和交界性(46.67%,7/15)以及恶性(90.32%,28/31)间的差异均有显著性意义(P<0.01);CA125的表达在良性(23.40%,11/47)和恶性(67.74%,21/31)间的差异有显著性意义(P<0.01),TRT的表达在浆液性肿瘤与黏液性肿瘤之间差异无显著性意义(P>0.05);CA125在各组浆液性肿瘤均明显高于黏液性肿瘤组,相比较差异有显著性意义(P<0.05);TRT和CA125在浆液性肿瘤的表达有一致性,相关性分析有显著性相关(P<0.01),在黏液性肿瘤中表达不相关(P>0.05)。结论:TRT和CA125的表达与卵巢上皮组织肿瘤的良恶性有关,尤其在卵巢浆液性肿瘤中TRT酶的活性与CA125呈正相关,二者的共同检测对诊断卵巢上皮组织肿瘤的类型和恶性程度有重要的临床意义。