间皮素和CA125在卵巢上皮性肿瘤中的共定位表达及临床意义

目的:研究上皮性卵巢癌OVCAR-3等细胞株和人卵巢肿瘤组织中间皮素(mesothelin,MSLN)和CA125的表达及定位,探讨2者之间的共定位关系及临床意义.方法:利用免疫组织化学法和间接免疫荧光双标记染色法检测人卵巢癌细胞株和卵巢上皮性肿瘤组织中间皮素和CA125的定位及表达.结果:免疫组织化学法和双标记免疫荧光细胞化学染色结果提示,间皮素和CA125在卵巢癌细胞及组织中均主要分布在细胞膜上,二者完全重叠,为共定位表达.卵巢上皮性癌组织中间皮素蛋白表达的荧光值为1 639.20±181.92,显著高于交界性卵巢上皮性肿瘤(590.85±126.95)、卵巢良性上皮性肿瘤(227.69±26.54)和正常卵巢皮质表面上皮(213.00±24.37),差异有统计学意义(P＜0.05);病理分级中G2、G3级的蛋白表达量分别为1 642.63±44.58和1 701.57±54.73,明显高于G1级的1 553.99±57.20 (P＜0.05);组织学类型中浆液性囊腺癌和子宫内膜样癌的蛋白表达量分别为1 723.81±33.20和1 673.81±70.27,明显高于黏液性囊腺癌的1 466.12±94.93(P＜0.05);间皮素的蛋白表达与患者年龄、病理分期及血清CA125的水平均无显著相关性(P＞0.05 ).结论:卵巢上皮性癌组织中间皮素和CA125高表达,且存在共定位表达关系.间皮素表达与卵巢肿瘤的良恶性以及卵巢癌的分级和类型有关.     

血清肿瘤相关物质在卵巢上皮性癌诊断中的临床价值

目的：评价血清肿瘤相关物质（TSGF）在卵巢上皮性癌诊断中的临床价值。方法：以28例卵巢良性病变患者及61例正常女性血清TSGF的含量作对照，测定了69例不同分期，不同恶性程度的卵巢上皮性癌患者血清TSGF的含量，并测定了卵巢上皮性癌，卵巢良性病变患者血清中血管内皮生长因子（VEGF）和CA125的含量，比较三者的诊断价值。同时对TSGF和VEGF，CA125的相关关系作了分析。结果：卵巢上皮性癌患者血清TSGF的水平较卵巢良性病变患者及正常女性显著升高（P＜0．01），且其血清TSGF的含量与肿瘤的分期及恶性程度有关，Ⅲ期最,IV人之，I，Ⅱ期最低；分化好的卵巢上皮性癌患者TSGF水平较低，分化差的则较高，血清TSGF，VEGF和CA125对卵巢上皮性癌及卵巢良性病变的诊断价值无显著差异（P＞0．05），卵巢上皮性癌患者血清TSGF水平与VEGF，CA125均呈显著正相关（P＜0．01，P＜0．05），结论：TSGF与VEGF、CA125的诊断价值相近，对卵巢上皮性癌的诊断有一定的价值，是鉴别卵巢上皮性癌和卵巢良性病变的可靠指标。     

血清CA125在卵巢上皮性癌诊断和预后中的价值

目的　探讨血清CA12 5测定在卵巢上皮性癌诊断及判断预后中的价值。方法　用放射免疫法测定 82例卵巢上皮性癌术前血清CA12 5水平。结果　以血清CA12 5>35u .ml-1为异常值 ,卵巢上皮性癌检出的阳性率 ( 95 .12 % )与以>2 0 0～ 30 0u .ml-1为异常值的阳性率 ( 92 .6 8%～ 90 .2 4% )无差异 (P >0 .0 5 ) ;在卵巢上皮性癌组织类型中 ,浆液性囊腺癌和未分化癌血清CA12 5水平高于其它类型 (P均 <0 .0 5 ) ;卵巢浆液性囊腺癌临床Ⅲ -Ⅳ期、病理Ⅱ -Ⅲ级血清CA12 5明显高于临床Ⅰ -Ⅱ期和病理Ⅰ级 (P <0 .0 0 5～ <0 .0 2 )。结论　血清CA12 5>2 0 0～ 30 0u .ml-1,卵巢上皮性癌的可能性极大 ;血清CA12 5的测定有助于卵巢上皮性癌组织类型的鉴别及预后的判断。     

卵巢上皮性癌患者血清CA125值的临床分析

卵巢上皮性癌患者血清ＣＡ１２５值的临床分析刘金玲邬谨慧李君马堪悦徐世杰焦书竹天津医科大学总医院（天津市３０００５２）卵巢癌是危及妇女生命的主要疾病之一。卵巢上皮性癌约占５０％，尽早诊断仍是一难题。血清ＣＡ１２５值是诊断卵巢上皮性癌和术后监测的主要标记...     

间皮素在恶性肿瘤诊治中的研究进展

间皮素是一种细胞表面糖蛋白,在胸、腹膜和心包膜等正常组织低表达,但在卵巢癌、胰腺癌和恶性间皮瘤等多种恶性肿瘤组织中高表达.间皮素在肿瘤侵袭转移过程中发挥重要作用,且由于其在肿瘤组织和正常组织中的差异表达,使间皮素成为肿瘤诊断的指标和潜在的治疗靶点.目前,针对高表达间皮素的恶性肿瘤,多种以间皮素为靶点的抗体类药物、嵌合抗...     

间皮素、糖类抗原125单独及联合检测对卵巢癌的诊断价值及临床意义

目的 探讨间皮素、糖类抗原125(CA125)单独及联合检测对卵巢癌的诊断价值及临床意义。方法选取58例卵巢癌患者（卵巢癌组）,其中30例患者行紫杉醇联合铂类药物化疗,选取45例健康体检者为对照组。检测所有受试者血清、尿液间皮素水平,检测卵巢癌患者血清CA125水平,化疗患者化疗前后行影像学检查。绘制受试者工作特征（ROC）曲线,计算曲线下面积（AUC）,评估间皮素、CA125单独及联合检测对卵巢癌的诊断价值。结果 卵巢癌组患者血清、尿液间皮素水平均明显高于对照组（P﹤0.01）;化疗后,卵巢癌化疗患者血清间皮素水平明显高于本组化疗前（P﹤0.01）。Ⅱ期与Ⅲ～Ⅳ期卵巢癌患者血清、尿液间皮素水平比较,差异均无统计学意义（P﹥0.05）。尿液间皮素诊断卵巢癌的AUC为0.861(95%CI:0.794～0.929),高于血清间皮素的0.701,尿液间皮素诊断卵巢癌的特异度较高,诊断价值较高。血清间皮素+CA125联合检测对卵巢癌的阳性检出率为75.9%,高于二者单独检测（P﹤0.05）。化疗后,卵巢癌患者血清CA125水平明显低于本组化疗前,可测量病灶长径明显短于本组化疗前（P﹤0.01...     

THY1基因在卵巢上皮性癌组织中的表达

目的 检测人正常卵巢组织、卵巢浆液性囊腺瘤和浆液性囊腺癌组织中THY1蛋白的表达,探讨其表达变化与卵巢浆液性囊腺癌患者临床病理因素间的关系.方法 应用免疫组化法,检测25例人正常卵巢组织、25例卵巢浆液性囊腺瘤组织和53例浆液性囊腺癌组织中THY1蛋白的表达.结果 THY1蛋白在正常卵巢、卵巢浆液性囊腺瘤和浆液性囊腺癌组织中的阳性表达率分别为60.0%(15/25)、72.0%(18/25)和34.0%(18/53),IOD值分别为288 449.2±60 087.3、271 655.6±66 588.7和252 087.6±45 559.4.卵巢浆液性囊腺癌中,THY1蛋白的阳性表达率明显低于正常卵巢和卵巢浆液性囊腺瘤组织(P<0.05),且THY1蛋白的表达量与卵巢浆液性囊腺癌的手术-病理分期、组织学分级及淋巴结转移呈显著负相关(均P<0.05).结论 THY1基因的缺失可能与卵巢浆液性囊腺癌的发生、发展相关.     

间皮素在乳腺癌中的表达及其临床意义

目的 研究间皮素（MSLN）在乳腺癌组织中的表达及其与临床病理特征的关系。方法 收集56例手术切除的乳腺癌组织及其相应的癌旁组织标本,应用免疫组化法分别检测乳腺癌组织和癌旁组织中MSLN的表达情况。结果 56例乳腺癌组织的MSLN阳性表达率为42.9％ （24／56）,高于癌旁组织的10.7％（6／56）,差异有统计学意义（P＜0.05）。MSLN的表达与乳腺癌患者的肿瘤分化程度、肿瘤大小及雌激素受体（ER）表达相关（P＜0.05）,肿瘤直径较大、中低分化及ER阴性者的MSLN阳性表达率高;MSLN的表达与年龄、有无淋巴结转移及人表皮生长因子受体（HER-2）表达情况均无关（P＞0.05）。 结论 检测MSLN在乳腺癌组织中的表达有助于乳腺癌的诊断,并可作为判断其恶性程度的重要指标。     

上皮性膜抗原在甲状腺乳头状腺癌中的诊断价值

上皮性膜抗原在甲状腺乳头状腺癌中的诊断价值福建省立医院施作霖，葛毅峰在常规外科病理工作中，大多数甲状腺乳头状腺癌均能明确诊断，但少数良性病例，由于在组织形态学上表现为乳头增生或假乳头形成，在诊断上有时很难与乳头状腺癌区别。本文作者应用上皮性膜抗原（Ｅ...     

血清CA125、HE4和影像学检查在上皮性卵巢癌术后复发诊断中的应用价值

背景与目的：人附睾蛋白4(human epididymis protein 4,HE4)是一种新型上皮性卵巢癌(epitheli-al ovarian cancer, EOC)的血清免疫标志物。本研究旨在评价其与卵巢最常用的血清标志物—糖类抗原125(cancer antigen-125,CA125)和腹、盆腔CT/MRI检查对卵巢癌术后复发的诊断价值。方法：回顾性分析EOC术后复发患者92例,其中二次手术48例,化疗44例。统计治疗前血清CA125、HE4和腹、盆腔CT/MRI检查诊断的灵敏度,并与手术病理和临床随访结果进行对照。结果：血清CA125和HE4的灵敏度分别为58.7%和61.9%。两者差异无统计学意义(P>0.05);联合两者的灵敏度为80.4%,较单一应用显著提高(P<0.05)。腹、盆腔CT/MRI的灵敏度为88.0%,显著高于血清CA125和HE4(P<0.01)。与两者联用相比,差异无统计学意义(P>0.05)。三者联合应用的灵敏度最高(97.8%),显著高于血清CA125和HE4联用(P<0.01),以及单用腹、盆腔CT/MRI(P<0.05)。结论：血清HE4对于EOC术后复发的检出与CA125同样有效,两者联合应用可显著提高诊断的灵敏度。与腹、盆腔影像学检查三者联用的灵敏度最高,是EOC术后监测较佳的策略。     

The value of serum bcl-2 levels in advanced epithelial ovarian cancer

The present study was conducted to investigate the value of serum bcl-2 levels in advanced epithelial ovarian cancer patients. Twenty-two patients with advanced ovarian carcinoma pathologically verified were investigated. Serum samples were obtained on the first admission before the chemotherapeutic treatment were given. Serum bcl-2 protein was determined by using ELISA. The baseline serum bcl-2 levels were significantly higher in patients with ovarian cancer than in the control group (p<0.001). The sensitivity and specificity of serum bcl-2 were determined as 100% and 78%, respectively. None of the prognostic parameters analyzed such as age of patient, stage of disease, serum CA-125, albumin, hemoglobin, LDH, and response to chemotherapy was significantly correlated with bcl-2 serum concentrations. No prognostic value of serum bcl-2 was determined. In conclusion, the results of the present study suggest that decreased apoptosis occurred due to the effect of serum bcl-2 elevation in advanced ovarian cancer patients. Also, serum bcl-2 level was a diagnostic but not a prognostic value in ovarian cancer. However, much researchs still continues in this field, and exciting new knowledge will ultimately emerge.     

卵巢癌患者血清唾液酸含量检测的价值

背景与目的：目前临床上用于辅助诊断卵巢癌的血清标志物相对缺乏。该研究旨在探讨血清唾液酸(sialic acid,SA)含量检测在卵巢癌患者的辅助诊断、疗效监测等中的临床应用价值。方法：采用酶法检测332例妇科恶性肿瘤患者、230例妇科良性疾病患者及194名健康对照者的血清SA含量;同时采用化学发光法检测上述标本的血清CA125及HE4含量。结果：妇科恶性肿瘤患者的血清SA含量为584.0(499.8,702.5) mg/L,明显高于妇科良性疾病组［497.0(454.0,559.0) mg/L］及健康对照组［475.0(443.8,505.0)mg/L,P<0.05］;其中卵巢癌组血清SA含量最高［675.0(582.0,816.0) mg/L］;血清SA联合CA125检测对卵巢恶性肿瘤的灵敏度高达95.17%,阴性预测值为94.37%;卵巢癌患者随访测定过程中,血清SA含量随着病情的好转,其浓度逐步降低。结论：血清SA含量检测可应用于卵巢癌的早期筛查、鉴别诊断及疗效监测。     

叶酸结合蛋白1、间皮素在卵巢癌组织中的表达及临床病理意义

目的 分析叶酸结合蛋白1(FOLR1)、间皮素(MSLN)在卵巢癌组织中表达的变化及临床病理意义.方法 回顾性分析2014年7月至2019年9月西平县人民医院收治的90例卵巢癌患者的临床资料,收集术后切除的癌组织制成标本,同时选择交界性卵巢肿瘤组织标本15例、正常卵巢组织标本30例作为对照.采用免疫组化染色检测并比较分...     

Difference in mesothelin‐binding ability of serum CA125 between patients with endometriosis and epithelial ovarian cancer

The epithelial ovarian carcinoma (EOC) is an aggressive malignant tumor, and is currently the leading cause of gynecologic cancer death. CA125 is the most commonly used serum marker for EOC, but shows a high‐false‐positive rate for several benign diseases such as endometriosis. The purpose of our study is therefore to identify a useful biochemical tool for detecting qualitative differences between CA125 from patients with endometriosis and EOC, and to facilitate differential diagnosis of these diseases. In our study, using two different CA125‐binding molecules, i.e., recombinant mesothelin and an anti‐CA125 monoclonal antibody, a novel sandwich ELISA for determining the serum levels of CA125 with mesothelin‐binding ability (CA125^meso) was developed, and tested for patients with endometriosis (n = 59) and EOC (n = 36). We found that both the serum CA125^meso level and the ratio of the serum CA125^meso to CA125 levels (CA125^meso/CA125) were significantly higher in patients with EOC than in patients with endometriosis (p < 0.00005 and p < 0.000001, respectively). Furthermore, receiver operating characteristic analysis showed that the CA125^meso assay was superior to the conventional antibody‐based CA125 assay in discriminating endometriosis from EOC. Thus, mesothelin‐binding ability may be a useful indicator for qualitatively evaluating CA125 in patients with endometriosis and EOC.     

粒细胞肉瘤十例临床特点分析

 目的　探讨粒细胞肉瘤（GS）的临床表现、病理诊断、治疗方法及预后。方法　回顾性分析10例GS患者的临床资料。结果　10例确诊为GS的患者中,5例为原发性GS,1例为急性早幼粒细胞白血病,3例为慢性髓细胞白血病,1例为骨髓增生异常综合征。所有患者采用手术、化疗或者伊马替尼治疗。1例失访;2例生存,其中1例使用含大剂量阿糖胞苷化疗方案的患者生存66个月;7例死亡,死亡患者的生存期为4～17个月。结论　GS临床罕见,细胞形态学检查及免疫组织化学检查对其准确诊断非常必要。GS临床预后差,急性髓细胞白血病样化疗方案为该病的主要治疗方法,高强度的化疗及造血干细胞移植治疗可以延长患者生存期。     

The role of serum CA-125 levels in early-stage epithelial ovarian cancer on preoperative CT and MRI

Background

We sought to identify the role of serum CA-125 levels in early-stage epithelial ovarian cancer (EOC) on preoperative CT and MRI.

Methods

Clinical data of 101 patients with early-stage EOC on preoperative CT and MRI were collected between January 2000 and December 2007. Clinical stage I (n = 59) was defined as tumor limited to the ovaries with or without ascites, whereas clinical stage II (n = 42) was defined as tumor within the pelvis with or without ascites. The primary endpoint was to investigate the efficacy of serum CA-125 levels for the prediction of advanced-stage disease, and secondary endpoints were to evaluate the accuracy of preoperative CT and MRI, and to examine the role of serum CA-125 levels as a prognostic factor for survival.

Results

The results of preoperative CT and MRI were concordant with no peritoneal implants outside the pelvis in 50/101 (50%) and no lymph node metastasis in 71/101 (70%) patients. The receiver operating characteristic curves showed that best cut-off values of serum CA-125 levels were 320 U/ml (71% sensitivity, 84% specificity) and 510 U/ml (67% sensitivity, 80% specificity) for the prediction of peritoneal implants outside the pelvis and lymph node metastasis. The serum CA-125 level (≥320 U/ml) was a significant factor for the prediction of advanced-stage disease (adjusted OR, 7.43; 95% CI, 2.39–23.04). However, it was not an independent prognostic factor for survival.

Conclusions

Serum CA-125 levels may be very useful for the prediction of advanced-stage disease in early-stage EOC on preoperative CT and MRI.     

超声检查与血清CA125检测在卵巢恶性肿瘤诊断中的价值

目的 探讨超声检查与血清肿瘤标志物CA125检测在卵巢恶性肿瘤诊断中的价值。方法 收集我院2012年10月至2013年12月收治的卵巢肿瘤患者113例,其中恶性53例,良性60例,于术前1周内均行超声检查及血清CA125检测。采用倾向得分匹配法（propensity score matching,PSM）均衡组间协变量,获得34对匹配成功的患者并对其诊断结果与病理检查进行比较。结果 CA125检测在卵巢恶性肿瘤诊断中的灵敏性、特异性、阳性预测值（positive predictive value,PPV）、阴性预测值（negative predictive value,NPV）、准确性分别为88.2%、61.8%、69.8%、84.0%、75.0%;超声检查在卵巢恶性肿瘤诊断中的灵敏性、特异性、PPV、NPV、准确性分别为85.3%、88.2%、87.9%、85.7%、86.8%;超声检查联合CA125检测在卵巢恶性肿瘤诊断中的灵敏性、特异性、PPV、NPV、准确性分别为94.1%、64.7%、72.7%、91.7%、79.4%。超声检查单独应用的特异性明显高于CA125检测及二者联合检查的特异性,差异有统计学意义（P均〈0.05）;而灵敏性、PPV、NPV及准确性在两两检查比较中的差异均无统计学意义（P均〉0.05）。结论 CA125检测联合超声检查并不能提高卵巢恶性肿瘤的诊断符合率。     

Intravenous genetic mesothelin vaccine based on human adenovirus 40 inhibits growth and metastasis of pancreatic cancer

High pancreatic cancer mortality and poor prognosis are caused by the difficulty for early diagnosis and extremely low rates of resection because of metastasis. Mesothelin overexpression in pancreatic cancer is a remarkable biomarker for tumor progression, especially for invasion and metastasis. Here, we generated a novel replication‐defective recombinant adenovirus 40 (rAd40), whose gene delivery properties are totally different from a conventional rAd5. In this study, we have identified intravenous administration with rAd40 expressing mouse mesothelin (Msln) as an effective prophylactic cancer vaccine against metastatic lesions of pancreatic cancer in mice. Intravenous administration of rAd40 (rAd40 i.v.) achieved transgene delivery in wider range of organs compared to rAd5 i.v., while rAd5 was distributed mainly to the liver, spleen, and lungs. Additionally, rAd40 i.v. showed less transduction of the liver or inflammatory responses, resulted in reduced liver toxicity compared to rAd5 i.v. Also, more robust systemic antigen‐specific immune responses were stimulated by rAd40 i.v. Pretreatment with a single ovalbumin‐expressing rAd40 i.v. prevented tumor growth in mouse subcutaneous models of ovalbumin‐expressing pancreatic cancer. When used with Msln‐expressing rAd40 i.v., Msln protein expression and metastases were suppressed in a syngeneic orthotopic mouse model of pancreatic cancer, corresponding to the detection of Msln‐ and tumor‐specific cytotoxic T lymphocyte (CTL). Our novel methods generated antitumor effects against antigen‐expressing tumors through antigen‐ and tumor‐specific CTL‐mediated immunity. Thus, our results indicate that a rAd40‐based intravenous vaccine provides a new strategy for the effective control of metastatic pancreatic cancer and novel therapy against other cancers and infectious diseases.     

Clinical significance of serum tenascin-c levels in epithelial ovarian cancer

Tenascin-C (TNC) is an extracellular matrix protein that is expressed at low levels in normal adult tissue but is highly expressed around many tumors including ovarian tumors. The objective of this study was to determine the clinical significance of the serum levels of TNC in epithelial ovarian cancer (EOC) patients. A total of 50 patients with a pathologically confirmed diagnosis of EOC were included in this study. Serum TNC levels were determined by the solid-phase sandwich enzyme-linked immunosorbent assay (ELISA) method. Age- and sex- matched 28 healthy controls were included in the analysis. Median age of the patients was 56.5 years old, range 22 to 83 years. Majority of the patients had advanced disease (FIGO stage III–IV) (90 %). The median serum TNC levels were found significantly higher in EOC patients (130.5 pg/mL) compared to healthy controls (90.1 pg/mL) (p?=?0.03). We found no correlation between serum TNC levels and any prognostic parameters analyzed, including age of the patients, histology, tumor grade, stage of the disease, and response to chemotherapy. Survival analysis did not show statistically significant effect of serum TNC concentration on progression-free and overall survival (p?=?0.36 and p?=?0.19, respectively). However, patients with high serum TNC levels tend to have poor overall survival. In conclusion, although serum TNC levels are elevated, it has no predictive or prognostic roles on survival in EOC patients.     

三磷酸腺苷-肿瘤体外药敏试验预测复发性卵巢上皮癌化疗敏感性的价值

目的 探讨三磷酸腺苷-肿瘤体外药敏试验(ATP-TCA)在复发性卵巢上皮癌个体化治疗中的价值,评价体外药敏结果与临床化疗敏感性的相关性.方法 回顾性分析69例既往行ATP-TCA检测的复发性卵巢上皮癌患者的临床资料,根据ATP-TCA检测结果将患者分为体外对药物高度敏感组、中度敏感组和耐药组.临床疗效的评估以影像学检查等结果为依据.采用x2检验分析ATP-TCA检测结果与临床化疗敏感性之间的相关性,采用Kaplan-Meier法分析经药敏指导治疗后患者的无进展生存时间(PFS)和总生存时间(OS).结果 ATP-TCA检测结果与临床化疗疗效之间有显著的相关性,即随着体外药物敏感性的增高,体内化疗的疗效越佳(x2=9.066,P=o.004).ATP-TCA检测结果预测药物治疗复发性卵巢上皮癌临床化疗敏感性的灵敏度、特异度、阳性预测值、阴性预测值和准确率分别为87.5%、45.9%、58.3%、80.9%和65.2%.体外高度敏感组、中度敏感组和耐药组患者经药敏指导治疗后的PFS平均值分别为187.1、195.0和60.3 d,OS平均值分别为476.7、335.7和237.5 d,两个体外敏感组患者的PFS和OS均显著长于体外耐药组(P＜0.01).结论 ATP-TCA检测结果与患者的临床治疗反应之间有很好的相关性,是开展肿瘤个体化化疗的一种有效的体外药物筛选方法.