卵巢肿瘤雌孕激素受体、雌二醇、孕酮测定及其临床意义

本文测定了５０例卵巢肿瘤患者手术前后血浆雌二醇（Ｅ＿２）和孕酮（Ｐ）水平。并用葡聚糖─活性碳吸附法（ＤＣＣ）测定了５０例卵巢肿瘤和６例正常卵巢组织胞浆雌（ＥＲｃ）、孕（ＰＲｃ）激素受体和胞核雌（ＥＲｎ）、孕（ＰＲｎ）激素受体。结果表明卵巢恶性肿瘤具有高的ＥＲｃ、ＰＲｃ和低的ＥＲｎ、ＰＲｎ、Ｅ＿２和Ｐ。提示对卵巢肿瘤患者常规进行Ｅ＿２、Ｐ测定，可作为鉴别卵巢恶性肿瘤的参考。对受体含量高的卵巢恶性肿瘤，有用内分泌治疗的可能和推测较好预后。     

彩色多普勒对卵巢肿瘤诊断价值的探讨

为了探讨彩色多普勒超声对卵巢肿瘤良恶性的诊断价值,应用经阴道彩色多普勒超声观察56例卵巢良恶性肿瘤的声像图特征及血流情况。56例患者全部经手术及病理确诊为卵巢肿瘤,超声诊断符合率为94.64%;恶性肿瘤阻力指数(resistance index,RI)、搏动指数(pulse index,PI)明显低于良性肿瘤,差异有统计学意义,P<0.01。初步研究结果提示,彩色多普勒血流显像鉴别卵巢囊性肿瘤良恶性有可靠的诊断价值。     

Prostanoids and cyclic nucleotides in malignant and benign ovarian tumors

The concentrations of prostaglandin E2 (PGE2), 6-keto-PGF1 alpha, thromboxane B2(TxB2), cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) in ovarian tumor tissue were measured in 38 post-menopausal women with malignant or benign ovarian tumor and in six women without ovarian neoplasm. PGE2 and TxB2 contents in ovarian cancer tissue were significantly (P less than 0.05) higher than in normal ovarian tissue. The prostanoids were also increased in the cyst fluid of epithelial malignant tumors compared to cyst fluids of benign ovarian tumors. Cyclic AMP concentrations in cancer tissue were lower than in non-malignant ovarian tissue, while the levels of cGMP were similar in all groups studied.     

The efficacy of sonographic morphology indexing and serum CA-125 for preoperative differentiation of malignant from benign ovarian tumors in patients after operation with ovarian tumors

Objective

To evaluate the value of sonographic morphology indexing (MI) system and serum CA-125 levels in the assessment of the malignancy risk in patients with ovarian tumors.

Methods

From September 2000 to July 2006, 202 patients who underwent surgery for ovarian tumors were reviewed retrospectively. In all patients, the MI score and serum CA-125 level were measured preoperatively. The association of the final pathologic diagnosis with the MI score and serum CA-125 level were examined.

Results

There were 26 malignant tumors out of 141 ovarian tumors with a MI ≥5 (18%). With a cut-off value of 5, the sensitivity, specificity, PPV, and NPV of MI scores were 0.743, 0.293, 0.181, and 0.845, respectively. There were 22 malignant tumors out of 54 ovarian tumors with serum CA-125 >30 u/ml (41%). With a cut-off value of 30 u/ml, the sensitivity, specificity, PPV, and NPV of serum CA-125 level were 0.667, 0.808, 0.407, and NPV 0.925, respectively. On ROC curve, the optimal cut-off value of MI score was 6.5-7.5 and that of serum CA-125 level was 25.6-28.5 u/ml. With a cut-off value of 7, the sensitivity and 1-specificity of MI score were 0.875-0.917 and 0.023-0.203, respectively. After the exclusion of teratoma cases, the sensitivity and 1-specificity of MI score were 0.875-0.917 and 0.046-0.138, respectively. With a cut-off value of 25.6-28.5 u/ml, the sensitivity and 1-specificity of serum CA-125 level were 0.958 and 0.203-0.215, respectively.

Conclusion

The sonographic MI system is an accurate and simple method to differentiate a malignant tumor from a benign ovarian tumor. The accuracy of the sonographic MI system improved when the serum CA-125 level was considered and ovarian teratomas were excluded.     

Expression differences of serum prealbumin in benign and malignant colorectal tumors

Objective： The aim of the study was to investigate the expression differences of serum prealbumin in patients with benign and malignant colorectal tumors and its clinical significance. Methods： The concentrations of total protein, albumin, prealbumin, hemoglobin of 113 colorectal cancer patients （cancer group） and 87 colorectal adenomas （adenoma group） were tested in Yixing Hospital Affiliated to Jiangsu University （China） during August 2013 to December 2013. Then the differences between the two groups were compared. Results： In colorectal cancer patients, the concentrations of serum prealbumin in 39/113 cases, total protein in 16/113 cases, albumin in 38/113, hemoglobin in 32/113 were lower than normal ranges. While, in colorectal adenoma patients, the concentrations of serum prealbumin in 4/87 cases, total protein in 2/87, albumin in 1/87, hemoglobin in 2/87 were below the detection limit. Comparative analysis showed that, average expression levels of serum prealbumin, albumin, total protein, hemoglobin in colorectal cancer patients were lower than those of colorectal adenoma patients, the difference was statistically significant （P 〈 0.05）, and colorectal cancer patients were more likely to have lower levels of above indicators （P 〈 0.05）. Conclusion： Compared to colorectal adenoma patients, patients with colorectal cancer have lower average expression levels, and were easier to have lower expression levels of serum albumin, albumin, total protein and hemoglobin, which suggest that colorectal cancer patients are more likely to have metabolic change, and clinic notable.     

CT联合血清肿瘤标记物诊断及鉴别诊断卵巢良恶性肿瘤

目的:研究CT联合血清肿瘤标记物糖链抗原125（carbohyhr ateantigen 125,CA125）诊断及鉴别诊断卵巢良恶性肿瘤的价值,为临床诊治提供参考。方法:选取我院于2015年11月至2017年11月收治的92例卵巢恶性肿瘤患者作为恶性组。另选取同期收治的108例卵巢良性肿瘤患者作为良性组。两组术前均进行CT检查及血清CA125水平检测。以病理结果为标准,对比两组患者的CT诊断阳性率,CA125水平及阳性率,联合诊断的敏感度、特异度、阳性预测值及阴性预测值,并研究联合诊断不同分期卵巢癌阳性率。结果:两组对比,恶性组患者的CT阳性率明显高于良性组,且CA125水平和阳性率均高于良性组,差异均有统计学意义(P<0.05)。CT联合CA125诊断的特异度、敏感度、阴性预测值及阳性预测值均高于单一检测,差异均有统计学意义(P<0.05)。且CT联合CA125诊断Ⅲ-Ⅳ期的阳性率差异不明显(P>0.05),但对诊断Ⅰ-Ⅱ期卵巢癌的阳性率高于单一诊断(P<0.05)。结论:卵巢恶性肿瘤患者血清CA125升高,CT诊断阳性率高,且联合诊断敏感性及特异性均较好,尤其是对Ⅰ-Ⅱ期卵巢癌,值得临床借鉴。     

Fas and Fas ligand in cyst fluids, serum and tumors of patients with benign and (borderline) malignant ovarian tumors

Drug resistance in ovarian cancer treatment urges the exploration of new targets for drugs against this malignancy. Fas is a cell membrane receptor which, after engagement with Fas ligand (FasL), triggers apoptotic death. In this study Fas and FasL levels in cyst fluids and sera of patients with benign, borderline and malignant ovarian tumors and in corresponding tumors are determined. Fas and FasL were determinded by ELISA and immunohistochemistry in 30 patients with benign, 5 patients with borderline and 24 patients with malignant epithelial ovarian tumors. In serum there were no differences in median Fas levels, while median FasL levels were higher in healthy women (p=0.02). In malignant cyst fluids, median Fas levels where higher compared to benign cyst fluids (p<0.01). FasL immunostaining was more frequent in malignant ovarian tumors (p=0.002). In conclusion, serum Fas or FasL levels do not seem useful markers. Elevated Fas and equal FasL levels in malignant cyst fluids, suggest an increased production of Fas, and not of FasL by malignant cells. High expression of both Fas and FasL, in malignant ovarian tumors present Fas/FasL as an interesting route to explore for innovative cancer therapy.     

Preoperative discrimination between benign and malignant ovarian tumors by multivariate analysis

To obtain a precise preoperative diagnosis of benign and malignant ovarian tumors, multivariate analysis was performed using a combination of tumor markers, diagnostic imagings, clinical findings and epidemiological data. Twenty-eight factors were selected for a discriminant analysis, which included 10 factors for tumor markers, 8 for diagnostic imagings, 4 for clinical features and 6 for epidemiological data. On 235 patients (malignant: 100, benign: 135), the usefulness of the discriminant analysis was evaluated retrospectively. As a results, an accuracy of preoperative discrimination was 82% for a discriminant analysis of tumor markers alone, 91% for diagnostic imagings, 84% clinical findings and 65% for epidemiological data. Twenty-one factors were selected by chi-square test or T-test. When 21 factors were used, the sensitivity and the specificity for the diagnosis of malignant ovarian tumor were 98% and 88% respectively. The results indicate that the discriminant analysis is valuable for preoperative discrimination of patient with ovarian tumors.     

超声检查诊断卵巢良恶性肿瘤的临床价值分析

目的探究超声检查诊断卵巢良恶性肿瘤的临床价值。方法选取2013年3月至2016年3月间琼中黎族苗族自治县人民医院收治的90例卵巢肿瘤患者,按照检测方法不同分为观察组与对照组,每组45例。观察组采用超声检查,对照组采用X线检查,结合病理检查对照,观察分析两组患者卵巢肿瘤良恶性诊断符合率和良恶性病变类型。结果观察组患者超声检测出恶性肿瘤患者23例,符合率为100.0%(23/23),良性肿瘤患者22例,符合率为95.5%(21/22)。观察组中良性肿瘤病理诊断病变类型有卵巢囊肿4例,浆液性囊肿腺瘤3例,黏液性囊肿腺瘤2例,输卵管炎症3例,闭锁黄体3例,红体1例,黄体囊肿2例,副输卵管囊肿2例,子宫内膜异位症1例;恶性肿瘤病理诊断病变类型有腺癌2例,卵巢癌6例,透明细胞癌3例,子宫内膜样癌2例,成熟囊性畸胎瘤3例,乳头状癌2例,梭形细胞肿瘤3例,浆液性囊腺癌2例。对照组患者X线片检测出的恶性肿瘤符合率为80.0%(16/20),良性肿瘤符合率为76.0%(19/25),其良恶性肿瘤的病变类型未有明确辨别,两组患者的良恶性诊断符合率和病变类型差异均有统计学意义(均P<0.05)。结论采用超声检查对卵巢肿瘤患者进行诊断,可较好地提高卵巢肿瘤患者的诊断符合率,对临床诊断和治疗具有较大意义。     

磁共振成像-弥散加权成像诊断良恶性卵巢肿瘤的临床价值

目的 探讨磁共振成像-弥散加权成像(MRI-DWI)诊断良恶性卵巢肿瘤的临床价值.方法 对经手术病理确诊为卵巢占位性病变的100例患者的MRI常规扫描参数及DWI图像表现进行分析.比较良恶性病变的病变最大径、表观扩散系数(ADC)值、肿瘤位置、边界、囊实性、囊壁/分隔、T1及T2信号均匀性,并进行Logis-tic回归...     

卵巢恶性肿瘤相关危险因素分析

对３９６例卵巢包块病人进行回顾性分析，结果发现，恶性肿瘤６５例（１６％），良性肿瘤１５９例（４０％），子宫内膜异位囊肿１３０例（３３％），生理性囊肿２０例（５％），炎性包块７例（１％）。４０岁以上妇女卵巢恶性肿瘤的相对危险性显著增加（Ｐ〈０．００１），腹水、腹胀、泌尿道症状和体重，食欲降低是恶性肿瘤的重要危险因素。超声影像混合性包块与恶性肿瘤明显相关。     

彩色多普勒超声联合肿瘤标志物CA125、CA724对卵巢良恶性肿瘤的鉴别诊断价值

目的:探讨彩色多普勒超声检查联合肿瘤标志物血清CA125、CA724对卵巢良恶性肿瘤的鉴别诊断价值.方法:收集绵阳市第三人民医院2014年1月至2016年3月手术治疗的卵巢肿瘤患者212例,分析患者的彩色多普勒超声各项指标及血清CA125、CA724水平.以病理诊断作为金标准,计算超声诊断及三项指标联合诊断的准确率、灵敏度及特异度等.结果:超声诊断结果显示,在卵巢恶性肿瘤组中,超声诊断与病理诊断符合率为56.5%(26/46),卵巢良性肿瘤组诊断符合率为88.0%(146/166),良性卵巢肿瘤组超声病理诊断符合率高于恶性肿瘤组,差别有统计学意义(P<0.001).卵巢恶性肿瘤组患者的血清CA125和CA724水平均高于良性肿瘤组,差别有统计学意义(P<0.05).卵巢恶性肿瘤组三项指标联合检测诊断阳性率明显高于良性组(78.3% vs 37.3%,P<0.001).三个单项检测指标中,CA125的灵敏度最高,CA724的特异度最高,超声检查的准确度、阳性预测值、阴性预测价值最高.联合检测中,彩色多普勒超声检查联合CA125诊断卵巢癌的准确度、灵敏度、特异性、阳性预测值、阴性预测价值高于三项指标的联合诊断,亦高于两项肿瘤标志物的联合诊断.结论:超声联合血清肿瘤标志物一定程度上可以提高卵巢良恶性肿瘤的鉴别诊断率.     

Mutant epidermal growth factor receptor in benign, borderline, and malignant ovarian tumors

PURPOSE: Dysfunction of the epidermal growth factor (EGF) complex is essential to the growth and development of many human tumors. Overexpression of the EGF receptor (EGFR) is a characteristic finding in a considerable number of solid tumors and often signalizes poor prognosis. There is a major disagreement among researchers about both the frequency and possible clinical importance of EGFR overexpression in ovarian cancer. The type III variant of EGFR (EGFRvIII) is a mutant with a deletion. Contrary to the wild-type, it is constitutively active. EGFRvIII has not been found in normal tissue, and consequently, it is an attractive tumor-specific candidate for molecular targeted treatment. The literature dealing with this mutation in ovarian cancer has been very sparse. EXPERIMENTAL DESIGN: Tissue from 225 patients who underwent surgery for a pelvic mass was collected consecutively. The samples included 99 ovarian/peritoneal/tuba cancers, 17 ovarian borderline tumors, 66 benign ovarian tumors, 15 other cancer types, 24 normal ovarian biopsies, and 4 miscellaneous. The presence of EGFRvIII was investigated both by PCR analyses for EGFRvIII gene expression and with protein analysis by Western blots. RESULTS: None of the tissue samples was positive for the EGFRvIII mutation neither at the mRNA level nor at the protein level. CONCLUSIONS: The EGFRvIII mutation seems to be very rare in ovarian tissue. Our data indicate that EGFRvIII is not a part of the malignant phenotype in ovarian cancer and should not be pursued as a therapeutic target for treatment of this disease.     

Differential expression of progesterone receptor isoforms A and B in the normal ovary, and in benign, borderline, and malignant ovarian tumors.

Human epithelial ovarian neoplasm is well-known to be sex steroid-related, but the possible biological significance of progesterone actions in these tumors remains controversial. In this study, we examined the differential expression patterns of the two progesterone receptor (PR) isoforms, PRA and PRB, using immunohistochemistry and real-time quantitative RT-PCR in normal and neoplastic ovarian tissues, and in cell lines derived from a normal ovarian surface epithelium and an ovarian epithelial carcinoma in order to further elucidate the possible involvement of progesterone in the development of ovarian neoplasms. The median H scores for PR isoforms in normal (n = 8), benign (n = 10), borderline (n = 8) and malignant (n = 24) ovarian tissues were as follows; PRA: 194.0, 171.0, 49.5, 0 (P < 0.05), and PRB: 175.0, 180.5, 251.5, 168.5, respectively. In ovarian cancer cell lines (OVCAR-3 and Caov-3), the PRB / PRAB mRNA ratio was increased by 17beta-estradiol, both time- and dose-dependently. However, this ratio was unaltered following the addition of 17beta-estradiol in a normal ovarian epithelial cell line (NOV-31). Immunoblotting analysis demonstrated that PRB protein expression was markedly up-regulated in OVCAR-3, whereas the PRA and PRB isoforms both appeared to be increased in NOV-31. These results suggest that down-regulation of PRA is associated with the development of ovarian epithelial carcinoma.     

超声造影联合血清CEA、CA72-4对卵巢良恶性肿瘤鉴别诊断的价值

目的:探讨超声造影联合血清癌胚抗原（CEA）、糖类抗原72-4（CA72-4）对卵巢良恶性肿瘤鉴别诊断的价值。方法:选取2017年1月至2018年6月本院肿瘤科收治的128例卵巢肿瘤患者进行研究,进行超声造影和血清CEA、CA72-4水平检测,观察超声造影、CEA、CA72-4及联合检测对卵巢良恶性肿瘤鉴别诊断的价值。结果:在良性肿瘤组中超声造影符合率为72.92%,恶性肿瘤组中超声造影符合率为75.00%,两组比较差异无统计学意义（P>0.05）;恶性肿瘤组患者血清CEA、CA72-4水平高于良性肿瘤组,两组比较差异有统计学意义（P<0.05）;恶性肿瘤组超声造影、CA72-4检测阳性率均高于良性肿瘤组（P<0.05）,两组血清CEA检测阳性率比较差异无统计学意义（P>0.05）,三者联合检测阳性率高于单项指标检测（P<0.05）;通过ROC曲线分析显示,CEA的AUC为0.644,诊断灵敏度为31.25%,特异性为82.29%,CA72-4的AUC为0.702,诊断灵敏度为40.63%,特异性为79.17%,二者联合检测的AUC为0.785,诊断敏感性为56.25%,特异性为73.96%;三项指标单独检测,超声造影检测的灵敏度、阳性预测率、阴性预测率、诊断准确度及误诊率最高,CEA检测的特异性、漏诊率最高,三者联合检测的灵敏度、特异性、阳性预测率、阴性预测率、诊断准确度最高,漏诊率、误诊率最低。结论:超声造影联合血清CEA、CA72-4检测较单独检测诊断效能高,对卵巢良恶性肿瘤鉴别诊断有较高参考价值。     

Phenotypic analysis of ovarian carcinoma: Polypeptide expression in benign,borderline and malignant tumors

Studies of multiple markers in tumors are required for adequate biological characterization. We have characterized the expression of multiple proteins in human ovarian tumors using the technique of 2-dimensional gel electrophoresis (2-DE/PDQUEST). Tumor cells were prepared from the tissue of 22 ovarian tumors. Large variations were observed between tumors in the expression of various polypeptides, indicating heterogeneity in gene expression. An increase in the spot density of 2 cell-cycle-related proteins, PCNA and OP18/stathmin, was observed in carcinomas. Borderline tumors expressed low levels of these proteins. Significant increases in the levels of nm23, GST-π, elongation factor 2 and triose phosphate isomerase were recorded in ovarian carcinomas. Furthermore, decreases in the levels of tropomyosin-2 and lamin C were observed in malignant as compared with benign tumors. The pattern of expression of 9 protein markers was examined in individual tumors. All malignant tumors showed simultaneous alterations in the expression of 5 or more of these proteins, whereas no benign tumor showed alterations in the expression of more than 3 polypeptides. Borderline tumors showed alterations in 0 to 6 markers. We conclude that the simultaneous analysis of multiple polypeptides, which can be achieved by 2-DE, is useful for characterization of gene expression and diagnostic studies in ovarian tumors. Int. J. Cancer 73:678–683, 1997© 1997 Wiley-Liss, Inc.     

超声造影对卵巢良恶性肿瘤鉴别诊断的研究进展

卵巢肿瘤是女性生殖器常见肿瘤, 晚期恶性卵巢肿瘤死亡率较高。目前超声检查已经成为卵巢肿瘤常用的检查方法, 但对于部分囊实性及CA125无明显变化的卵巢肿瘤, 良恶性病变的鉴别还存在一定的困难。超声造影能清晰的显示组织及肿瘤内的血管及微血管, 动态观察正常组织及肿瘤组织血流灌注状态, 同时应用时间-强度曲线进行定量分析, 在卵巢肿瘤良恶性鉴别诊断方面具有一定价值。本文将卵巢肿瘤超声造影的现状及其对临床应用价值的研究进展进行阐述。