血清基质金属蛋白酶—9测定在诊断卵巢肿瘤和评估预后中的价值

目的：探讨测定血清基质金属蛋白酶－9（MMP－9）的含量对诊断卵巢上皮癌的价值及它与患者预后的关系。方法：将卵巢上皮癌（OEC）43例，卵巢交界性肿瘤（BOT）12例及卵巢良性肿瘤（OBT）24例分为3个研究组，20例正常妇女为对照组，用ELISA法测定各组术前血清中的MMP－9含量。结果：（1）OEC、OBT、BOT及对照组血清MMP－9的中位数分别为534.60、279.19、200.54、55.56ng/L，上述各组的范围分别为111.18-1766.12ng/L、16.38-874.34ng/L、15.10-423.29ng/L、11.01-201.63ng/L。OEC组血清MMP－9水平高于OBT、BOT及对照组，差异有显著性（P＜0.05）；（2）OEC患者按临床分期、级、组织学类型、淋巴或大网膜转移等影响患者预后的因素分组，各组间血清MMP－9水平无显著性差异。结论：患者血清MMP－9水平与卵巢肿瘤的恶性行为有关，对诊断有一定的价值，但用于判断患者预后的价值有限。     

卵巢上皮性癌患者28例血清和腹腔液VEGF测定及其诊断价值初探

目的　测定卵巢上皮性癌 (OEC)患者血清和腹腔液中VEGF蛋白水平 ,并探讨它的诊断价值。方法　采用酶链免疫吸附试验检测 2 8例OEC患者血清和腹腔液中VEGF蛋白水平 ,利用ROC曲线分析灵敏度和特异性。结果　①OEC组血清VEGF蛋白水平分别显著高于健康志愿组 (中位数 4 6 3 2ng/Lvs 194 5ng/L ,P <0 0 5 )及良性肿瘤组 (中位数 4 6 3 2ng/Lvs 2 0 4 1ng/L ,P <0 0 1) ,良性肿瘤组与健康志愿组之间无显著性差异 (P >0 0 5 ) ;OEC组腹腔液VEGF蛋白水平极显著高于良性肿瘤组 (中位数为 2 6 30 5ng/Lvs 2 4 1 1ng/L ,P <0 0 0 1)。②ROC曲线显示 ,OEC血清VEGF测定特异性在 6 0 %～ 70 %范围内 ,其灵敏度可达 70 %～ 80 % ;OEC腹腔液VEGF测定特异性在 90 %～ 10 0 %范围内 ,其灵敏度可达 90 %以上。结论　OEC患者血清和腹腔液VEGF水平显著升高 ;血清和腹腔液VEGF测定 ,尤其是腹腔液VEGF ,可能有望成为OEC诊断的辅助性指标     

细胞图象分析在判断卵巢上皮癌生物学行为及其患者预后中的价值

目的 :探讨细胞图像分析在判断卵巢上皮癌 (OEC)生物学行为及患者预后的价值。方法 :应用细胞图像分析技术 (ICM)测定 4 0份原发性卵巢上皮癌组织的细胞核DNA含量及核形态参数 ,同时以免疫组化LSAB法分析其p53、p16的表达情况。结果 :OEC病例中腹水阳性、腹腔广泛转移、淋巴转移、低分化各组的DNA指数 (DI)、超 5倍体( 5C)细胞比率、核面积 (NA)均明显增高 ,与对照组相比 ,差异有显著性 (P <0 .0 5) ,但在不同临床分期间差异无显著性 (P >0 .0 5)。ICM各项参数中超 5C细胞比率、NA与DI有明显相关性 (P均 <0 .0 1)。在OEC病例中p53阳性、p16阴性的DI、超 5C细胞比率、NA不仅明显高于对照组 (P <0 .0 5) ,而且与OEC患者的预后密切相关 (P <0 .0 1,P <0 .0 5)。结论 :较高的DI、超 5C细胞比率、NA提示OEC具有较高的恶性生物学行为及不良预后 ,且各指标与p53、p16的表达情况均明显相关 ,共同检测可作为诊断卵巢恶性肿瘤的有用指标 ,并有助于指导术后辅助性治疗方案的选择及预测患者预后     

VEGF、MMP-2、MMP-9在卵巢原发性与转移性癌中表达的研究

目的 :探讨VEGF、MMP 2、MMP 9在卵巢原发上皮癌、库肯勃氏瘤中的表达差异及临床病理意义。方法 :采用免疫组化S P染色技术对 83例卵巢癌 (卵巢原发癌 4 5例、库肯勃氏瘤 38例 )进行分析 ,观察VEGF、MMP 2、MMP 9在卵巢癌中的表达。结果 :VEGF在卵巢原发癌和库肯勃氏瘤组织中的表达显著高于正常卵巢组织 (P <0 .0 5 ) ;MMP 2、MMP 9在正常卵巢组织中表达缺如 ;VEGF、MMP 2、MMP 9在卵巢原发癌与库肯勃氏瘤中表达均有显著差异 (P <0 .0 5 ) ;VEGF、MMP 2、MMP 9在库肯勃氏瘤中及卵巢原发癌中 ,任意两指标阳性表达均有正相关性 (P <0 .0 5 )。结论 :VEGF、MMP 2、MMP 9在库肯勃氏瘤的形成机制中起重要作用 ,与肿瘤的浸润转移密切相关 ,并可为鉴别卵巢原发癌与库肯勃氏瘤提供一定的依据     

测定卵巢恶性肿瘤患者血清基质金属蛋白酶-9的临床价值

目的:探讨测定血清基质金属蛋白酶-9(MMP-9)对卵巢恶性肿瘤诊断、病情监测和预后的价值.方法:采用酶联免疫吸附法(ELISA)对15例健康妇女(对照组)、15例卵巢良性肿瘤(良性组)及55例卵巢恶性肿瘤(恶性组)进行血清MMP-9水平分析.结果:恶性组治疗前血清MMP-9(472.95±169.48ng/ml)显著高于良性组(230.99±91.81 ng/ml)及对照组(72.99±2.57ng/ml)(P＜0.05).恶性组术后血清MMP-9(424.11±175.66 ng/ml)和复发组血清MMP-9(478.13±183.90 ng/ml)也明显高于良性组和对照组,差异有显著性(P＜0.05).恶性配对组中治疗前血清MMP-9(513.82±133.18 ng/ml)高于术后(437.15±144.41ng/ml)(P＜0.05).结论:血清MMP-9含量在卵巢恶性肿瘤中异常升高,可作为卵巢恶性肿瘤有价值的诊断、评价手术效果以及判断复发的指标.     

母血羊水中基质金属蛋白酶-9水平与胎膜早破关系的研究

目的　探讨基质金属蛋白酶 9(MMP 9)水平在胎膜早破孕妇血浆和羊水中的变化及与胎膜早破的关系。方法　 2 0 0 1年 2～ 12月采用酶联免疫吸附法对 2 6例胎膜早破孕妇和 2 0例正常妊娠孕妇血浆、羊水中MMP 9水平进行检测。结果　胎膜早破孕妇血浆与羊水中MMP 9水平分别为 4 2 2 2 7ng/L、187 2ng/L ,均明显高于对照组 ,差异有显著性意义 (P <0 0 1)。结论　MMP 9与胎膜早破有关 ,当MMP 9高于 35 0 0ng/L时 ,易发生胎膜早破 ,需及时采取预防措施。     

MMP-9及TIMP-1与胎膜早破关系的研究

目的 :研究胎膜早破 (PROM)孕妇羊水、血清中基质金属蛋白酶 9(MMP 9)、金属蛋白酶组织抑制剂 1(TIMP 1)的含量及在胎膜中的表达 ,探讨其与PROM的关系。方法 :选择临产前足月剖宫产分娩的胎膜早破者 2 5例 (PROM组 )和正常未破膜者 2 0例 (对照组 ) ,用双抗体夹心ELISA法测定羊水、血清中MMP 9、TIMP 1的含量 ,并用免疫组化SABC法检测胎膜中MMP 9及TIMP 1的表达。结果 :①PROM组和对照组羊水中MMP 9含量分别为 (887.2 4± 36 3.2 5 )与(6 6 6 .15± 2 39.5 8)ng/ml,差异有显著性 (P <0 .0 5 ) ;两组血清中MMP 9含量分别为 (38.72± 2 3.4 8)与 (17.4 5± 10 .77)ng/ml,差异有非常显著性 (P <0 .0 0 1) ;两组羊水与血清中TIMP 1含量差异无显著性 (P >0 .0 5 )。②PROM组血清与羊水中MMP 9、TIMP 1的含量无相关性 (r分别为 0 .133与 0 .10 3,P >0 .0 5 )。③PROM组和对照组胎膜MMP 9的阳性表达分别为 10 0 %、85 % ,差异有非常显著性 (P <0 .0 0 1)。结论 :胎膜早破孕妇羊水、血清中MMP 9含量明显升高 ,且MMP 9在胎膜中高表达 ,可能是胎膜早破发生的原因之一     

基质金属蛋白酶2,9在胎膜早破产妇胎膜的表达变化

目的:探讨基质金属蛋白酶- 2、- 9(MMP - 2、MMP - 9)在胎膜早破(PROM)发病机制中的作用。方法:选择早产PROM(PPROM)产妇1 1例、足月PROM产妇32例及足月临产产妇1 6例作为研究组,1 1例足月未临产产妇作为对照组;采用免疫组织化学法检测胎膜宫颈部和宫体部中MMP 2及MMP - 9的分布与表达。结果:①各研究组宫颈部胎膜MMP 2的表达均高于同组宫体部(P <0 .0 5 ) ;胎膜(宫颈部和宫体部)MMP - 2的表达在两PROM组间无差异(P >0 .0 5 ) ,但均高于足月临产组和对照组(P <0 .0 1 )。②MMP - 9在对照组中未见表达;MMP - 9在研究组胎膜宫颈部的表达均明显高于宫体部(P <0 .0 1 ) ,其中PPROM组宫颈部胎膜MMP 9表达的IH积分明显高于其余各组(P <0 .0 1 )。③胎膜宫颈部MMP - 2的表达与MMP 9的表达呈正相关(P =0 .0 0 0 )。结论:MMP -2和MMP - 9参与了产程中胎膜的破裂,在PROM的发病机制中起着重要的作用,其中MMP - 9在PPROM发病机制中的作用更为重要。     

肿瘤坏死因子α及孕酮对异位子宫内膜间质细胞分泌基质金属蛋白酶-3的调节

目的 :探讨细胞因子、性激素与基质金属蛋白酶 (MMPs)在子宫内膜异位症(EMs)发病机制中的作用及相关性。方法 :以EMs患者 15例作研究组 ,分别取其在位与异位内膜 ,以非EMs患者 10例的正常内膜为对照组。原代培养子宫内膜间质细胞 ,在研究组和对照组内分别设置空白对照组、孕酮组与肿瘤坏死因子 α(TNF α)组。孕酮组分别加入孕酮 10 - 7mol/L、10 - 5mol/L ,各孵育 2 4h ;TNF α组中加入TNF α 10 0ng/L ,分别孵育2 4h、4 8h。ELISA法检测MMP 3含量。结果 :空白对照组MMP 3含量 ,异位组显著高于在位内膜组与对照组 (P <0 .0 1)。加入孕酮后各组MMP 3含量均呈下降趋势 ,异位组下降程度更为显著 (P <0 .0 1) ,高浓度孕酮具有更强的抑制作用 (P <0 .0 5 )。TNF α干扰后 ,各组MMP 3含量均升高 (P <0 .0 1) ,以异位组显著 (P <0 .0 1) ,不同作用时间对MMP 3含量的影响各组间无显著差异 (P >0 .0 5 )。结论 :EMs患者子宫内膜间质细胞分泌MMP 3较正常人高 ,异位病灶分泌能力更强。TNF α和孕酮对MMP 3的分泌分别有升调与降调的作用 ,二者可能通过此途径参与了EMs的发生发展过程。     

老年卵巢上皮癌患者的治疗及预后分析

目的 :研究老年卵巢上皮癌患者的治疗及预后。方法 :卵巢上皮癌 84例接受瘤体减灭术及CAP化疗 [环磷酰胺 (CTX)、阿霉素 (ADR)、卡铂 (CP) ]。按年龄将患者分为 <4 0岁、4 1～ 50岁、51～ 60岁、≥ 61岁 4组 ,再按临床分期分为Ⅰ～Ⅳ期 4小组 ,比较不同年龄组 ,不同临床分期患者的 3年复发率及生存率。结果 :4年龄组 3年生存率依次为 :Ⅰ～Ⅱ期 75.0 %、10 0 .0 %、87.5%、66.7% (P >0 .5) ;Ⅲ～Ⅳ期 50 .0 %、54.9%、71.4 %、64.0 % (P >0 .5)。 3年复发率Ⅰ～Ⅱ期为 2 5.0 %、0、4 1.7%、33.3% (P >0 .5) ;Ⅲ～Ⅳ期为 66.7%、57.4 %、73.2 %、32 .0 % (P >0 .5)。结论 :年龄对卵巢上皮癌患者的复发率及生存率无显著影响。老年卵巢上皮癌患者在一般情况下 ,仍应积极手术及化疗。老年患者可承担手术及化疗的毒性作用 ,其生存率及复发率与年轻患者差异无显著性。支持治疗对一般情况较差的患者很重要。老年卵巢上皮癌患者与年轻患者比可能复发率高 ,预后差     

NGAL和MMP-9在卵巢上皮性癌中的表达及相关性研究

目的:检测中性粒细胞明胶酶相关载脂蛋白(NGAL)和基质金属蛋白酶-9(MMP-9)在卵巢上皮性肿瘤组织和血清中的表达,了解两者与卵巢癌临床病理特征的关系。方法:应用半定量RT-PCR和ELISA法检测50例上皮性卵巢癌、21例卵巢良性肿瘤和18例正常对照的卵巢组织和血清中NGAL和MMP-9的表达水平。结果:(1)卵巢癌组的组织及血清中NGAL和MMP-9表达明显高于卵巢良性肿瘤组和正常对照组(P均<0.05);二者的高表达与临床分期、淋巴结转移正相关(P均<0.05);卵巢癌患者的组织及血清中NGAL与卵巢癌的组织分化程度正相关(P均<0.05),MMP-9则与卵巢癌的组织分化程度负相关(P均<0.05)。(2)卵巢癌患者的组织或血清中,NGAL表达均与MMP-9表达呈正相关(r=0.740,r=0.676,P均<0.05)。结论:NGAL和MMP-9在卵巢上皮性癌中表达上调,可能与卵巢上皮性癌的发生、发展有关。     

上皮性卵巢肿瘤患者血清中YKL-40、HE4的表达及临床意义

目的:探讨血清甲壳质酶蛋白40(YKL-40)、人附睾蛋白4(HE4)在上皮性卵巢肿瘤的表达及临床意义。方法:用酶联免疫吸附试验,检测健康妇女、上皮性良性卵巢肿瘤、交界性卵巢肿瘤及卵巢癌患者血清中YKL-40、HE4的水平。结果:(1)健康妇女、上皮性良性卵巢肿瘤、交界性卵巢肿瘤及卵巢癌患者术前血清中,YKL-40表达中位数分别为35.56、41.42、44.34和130.25μg/L;HE4的表达中位数分别为41.10、43.98、65.21和260.90pmol/L;在术前卵巢癌组YKL-40、HE4的表达水平均高于前3组,差异有统计学意义(P<0.05),前3组之间差异无统计学意义;卵巢癌患者术后血清中YKL-40、HE4中位数分别为58.57μg/L、124.32pmol/L,术前血清水平明显高于术后(P<0.05);(2)卵巢癌患者术前血清YKL-40浓度与FIGO分期、血清CA125浓度呈正相关(P<0.05);术前血清HE4浓度与病理类型、血清CA125浓度、年龄相关。结论:血清YKL-40、HE4有望成为卵巢癌标志物,用于早期诊断和预后分析。     

Elevated serum RANTES levels in patients with ovarian cancer correlate with the extent of the disorder

OBJECTIVE: To assess the clinical relevance of serum regulated upon activation, normal T-cell expressed and secreted (RANTES) levels in distinguishing patients with ovarian cancers from those with benign ovarian cysts, we measured its concentration with reference to the disease stage, pathological grading, histological subtype, and the residual tumor mass. METHODS: Preoperative serum RANTES levels were measured in women with invasive epithelial ovarian cancer (n = 52), borderline ovarian tumor (n = 6), benign ovarian cysts (n = 28), or normal controls (n = 12) using an enzyme-linked immunosorbent assay. RESULTS: The serum RANTES concentration was significantly elevated in the ovarian cancer patients (median 53 ng/ml, interquartile range 23-104 ng/ml) compared to the benign ovarian cyst patients as controls (38 ng/ml, 5-72 ng/ml) values correlating with the stage of disease and the extent of residual tumor mass. No significant correlation between CA125 and RANTES in the serum was observed in either the controls or the ovarian cancer patients. Using a RANTES cutoff of 45 ng/ml and a CA125 cutoff of 35 units/ml, when either marker was elevated, the specificity improved 94%. CONCLUSION: Our study suggest that preoperative serum RANTES levels may be useful in differentiating benign ovarian tumors from malignancy correlating with the extent of the disorder.     

卵巢上皮性癌患者术前血清血管内皮生长因子与CA125水平的相关性及其预测预后的价值

目的分析卵巢上皮性癌（卵巢癌）患者术前血清血管内皮生长因子（VEGF）与CA125水平的相关性,探讨术前血清VEGF水平在卵巢癌患者预后判断中的价值。方法采用酶联免疫吸附试验（EHSA）测定41例卵巢癌患者（研究组）库存的术前血清中VEGF的水平,采用化学发光法测定同一份血清的CA125水平;以同期20例盆腔检查正常的妇女作为对照组。结合随诊资料,分析卵巢癌患者术前血清VEGF水平与CA125水平的相关性,并分析术前血清VEGF水平与患者复发和生存时间的关系。结果（1）研究组术前血清VEGF和CA125水平均明显高于对照组（VEGF中位数分别为415和165ng／L,CA125分别为611和16kU／L）,差异均有统计学意义（P〈0．01）;（2）Spearman等级相关分析显示,卵巢癌患者术前血清VEGF水平与血清CA125水平间无明显相关性（P=0．989）;（3）卵巢癌患者术前血清VEGF水平与其复发相关,复发者术前VEGF水平明显高于无复发者（中位数分别为490和315ng／L,P=0．035）;（4）单因素Kaplan-Meier法分析显示,卵巢癌患者术前血清VEGF水平与其生存时间呈负相关,高血清VEGF水平者的生存时间明显短于低血清VEGF水平者（中位数生存时间分别为18个月和〉35个月,P=0．010）;（5）多因素Cox回归模型分析显示,卵巢癌患者术前血清VEGF水平是与其生存时间有关的独立预后因素（P=0．042）。结论卵巢癌患者术前血清VEGF水平与CA125水平无明显相关性,VEGF水平变化是影响患者预后的独立因素。     

卵巢恶性肿瘤患者测定血清血管内皮生长因子的临床价值

目的　探讨血清血管内皮生长因子 (VEGF)测定对卵巢恶性肿瘤诊断、病程监测和预后的价值。方法　采用酶联免疫吸附法 (ELISA)对 90例健康妇女 (对照组 )、2 5例卵巢良性肿瘤 (良性组 )及 12 0例卵巢恶性肿瘤 (恶性组 )进行血清VEGF含量分析 ,并进一步对其中 2 5例卵巢恶性肿瘤患者进行手术治疗前后血清VEGF含量的动态观察。结果　 ( 1)恶性组术前血清VEGF含量为 ( 766±12 3 7)mg/L ,显著高于良性组的 ( 5 6± 2 3 )mg/L及对照组的 ( 5 5± 19)mg/L(P =0 0 0 6) ,以 10 0mg/L为界值 ,其诊断的特异性为 87% ,敏感性为 77% ;( 2 )恶性组临床分期Ⅰ～Ⅱ期和高～中分化患者术前血清VEGF含量分别为 ( 198± 2 87)mg/L和 ( 2 80± 5 5 2 )mg/L ,明显低于临床分期Ⅲ～Ⅳ期的 ( 95 5±1716)mg/L和低分化患者的 ( 991± 13 49)mg/L (P <0 0 5 ) ;但血清VEGF含量与组织学类型无关 (P>0 0 5 ) ;( 3 )手术治疗后血清VEGF含量为 ( 118± 110 )mg/L ,较手术治疗前血清VEGF含量 [( 10 74±12 11)mg/L]明显下降 ;( 4)初治患者血清VEGF阳性者 (即VEGF≥ 10 0mg/L)平均总生存期为 2 8个月 ,而血清VEGF阴性者平均总生存期为 3 5个月 (P <0 0 5 )。但COX模型分析结果发现 ,VEGF不是与卵巢恶性肿瘤预后相关的独立因素 (P     

基质金属蛋白酶9及其组织抑制物1的水平变化与胎膜早破发病的关系

目的探讨母血、羊水、脐血中基质金属蛋白酶9(MMP-9)及金属蛋白酶组织抑制物1(TIMP-1)的水平变化与胎膜早破发病的关系。方法采用双抗体夹心酶联免疫吸附法,动态检测58例胎膜早破患者(胎膜早破组)及38例正常孕妇(对照组)的母血、羊水、脐血中MMP-9及TIMP-1的水平,同时进行胎膜组织的病理检查,对合并绒毛膜羊膜炎的患者也进行相应的MMP-9及TIMP-1的水平检测。结果(1)胎膜早破组母血、脐血及羊水中MMP-9水平分别为(141·9±84·6)、(138·2±81·4)及(85·6±27·5)ng/L,其水平均明显高于对照组,两组比较,差异有统计学意义(P<0·05、P<0·05及P<0·01);胎膜早破组母血、羊水、脐血中TIMP-1水平分别为(378·1±220·2)、(44·6±24·0)及(257·2±98·8)ng/L,其水平均明显低于对照组,两组比较,差异有统计学意义(P<0·05、P<0·05及P<0·01)。(2)母血、羊水、脐血中MMP-9的水平随破膜时间的延长而升高,尤其破膜时间超过24h时升高更为明显;而TIMP-1则随破膜时间的延长而下降,尤其破膜时间超过24h时降低更为明显。(3)两组共合并绒毛膜羊膜炎患者15例,其中胎膜早破组13例(13/58,22%),绒毛膜羊膜炎患者的母血、脐血、羊水中MMP-9水平分别为(183·8±84·7)、(171·2±92·9)及(95·5±21·1)ng/L,其水平均明显高于非绒毛膜羊膜炎患者(81例),两者比较,差异有统计学意义(P<0·05、P<0·05及P<0·01)。绒毛膜羊膜炎患者的母血、羊水、脐血中TIMP-1水平分别为(269·7±144·4)、(32·1±16·6)及(210·6±81·9)ng/L,其水平均明显低于非绒毛膜羊膜炎患者,两者比较,差异有统计学意义(P<0·05、P<0·05及P<0·01)。(4)胎膜早破组的新生儿Apgar评分≤7分者,其母血、脐血、羊水中MMP-9水平分别为(234·4±79·4)、(222·1±120·1)及(108·5±42·2)ng/L,其水平均明显高于Apgar评分≥8分者,两者比较,差异有统计学意义(P<0·05、P<0·05及P<0·01);与之相反,胎膜早破组的新生儿Apgar评分≤7分者,母血、羊水、脐血中TIMP-1的水平分别为(225·3±121·7)、(25·2±15·8)及(181·7±135·2)ng/L,其水平均明显低于Apgar评分≥8分者,两者比较,差异有统计学意义(P<0·05、P<0·05及P<0·01)。结论MMP-9水平的异常升高及TIMP-1水平的显著下降,是胎膜早破发病的重要机制。MMP-9及TIMP-1的水平检测可作为一种新的生物学标志物用于胎膜早破并绒毛膜羊膜炎感染的诊断,尤其适用于亚临床感染状态的早期诊断,并有助于评估新生儿预后。     

Comparison of risk of malignancy index (RMI), CA125, CA 19-9, ultrasound score,and menopausal status in borderline ovarian tumor

Objective: The aim of this study was to assess the prognostic values of risk of malignancy index (RMI IV), ultrasound score, menopausal status, and serum CA125 and CA19-9 level in patients with borderline ovarian tumor (BOT). Methods: Fifty women having borderline ovarian tumor (BOT) and 5O individuals with benign adnexal mass were enrolled in this retrospective study. The sensitivity, specificity, positive predictive values, negative predictive values and diagnostic accuracy of preoperative serum levels of the CA125 and CA19-9, ultrasound findings and menopausal status, and RMI IV were calculated for prediction of discrimination between BOTs and benign adnexal masses and the results were compared. Results: The RMI IV was the best method for discrimination between BOTs and benign adnexal masses and was more accurate than the other parameters. When Receiver Operator Characteristic area under the curves for menopausal status was analyzed, serum CA 125 and CA19-9 level, ultrasound score, RMI IV(CA125), and RMI IV(CA19-9) were, 0.580, 0.625, 0.548, 0.694, 0.734 and 0.711, respectively. The best RMI IV cut-off was found to be 200 for discrimination of benign and BOT lesions. In the RMI formulation, replacing CA125 with CA19-9 didn’t affect RMI IV sensitivity and specificity for discrimination. Conclusion: Compared to ultrasound, menopausal status, CA-125, CA19-9, the RMI IV was found to be the best predictive method for differentiation of BOTs from benign adnexal masses. RMI IV cut–off value of 200 is suitable for differentiation of benign and BOT’s.     

LPA、CA125与经阴道彩色多普勒超声联合诊断卵巢上皮癌的临床价值

目的:探讨血浆溶血磷脂酸(LPA)在卵巢上皮癌患者血浆中的表达水平,及其与血清CA125和经阴道彩色多普勒超声(TV-CDUS)联合应用诊断卵巢上皮癌的临床价值。方法:术前检测卵巢上皮癌48例,卵巢良性肿瘤30例的LPA、CA125,以20例健康者作为对照,卵巢肿瘤患者同时经阴道超声评分和TV-CDUS检查。结果:卵巢癌患者LPA水平明显高于卵巢良性肿瘤组和健康对照组,差异有统计学意义(P0.05),LPA水平在良性肿瘤组与健康对照组之间无显著差异(P0.05)。单独应用LPA、CA125、TV-CDUS检测诊断卵巢癌的敏感性和特异性分别为87.5%、79.16%、81.25%和80%、70%、86%,各组间敏感性和特异性比较,无显著差异(P0.05)。LPA、CA125、TV-CDUS 3项联合检测诊断卵巢癌的敏感性和特异性为95.80%和94%,与单独应用CA125检测特异性比较,差异有统计学意义(P0.05)。LPA诊断卵巢癌的敏感性和特异性与卵巢癌分期和病理类型无关(P0.05),CA125诊断卵巢癌的敏感性和特异性与卵巢癌的分期和病理类型有关(P0.05)。结论:卵巢上皮癌患者血浆LPA水平明显升高,有望成为卵巢上皮癌诊断的敏感指标,联合检测血浆LPA、血清CA125与TV-CDUS有助于术前卵巢癌的诊断。     

Preoperative plasma osteopontin level as a biomarker complementary to carbohydrate antigen 125 in predicting ovarian cancer

AIM: New biomarkers other than carbohydrate antigen (CA) 125 are needed for the detection of ovarian cancer. Osteopontin (OPN) is one of the candidates identified by high-throughput complementary DNA microarray techniques. We evaluated the preoperative plasma OPN level as a diagnostic biomarker for ovarian cancer in comparison with CA125. METHODS: Preoperative plasma OPN and CA125 levels were measured and compared in 32 patients with ovarian cancer, 34 patients with benign ovarian tumor, 30 patients with other gynecologic cancers and 31 healthy women. Preoperative plasma OPN levels were also assessed according to tumor stage, the volume of ascites and histological types. The sensitivity and specificity for predicting ovarian cancer was compared between OPN and CA125. RESULTS: Preoperative plasma OPN levels were significantly higher in patients with ovarian cancer than in those with benign ovarian tumor, in other gynecologic patients or in healthy women. Stage IV ovarian cancer patients and ovarian cancer patients with ascites had higher plasma OPN levels than those without ascites and in a lower stage. There was no relation between OPN and the histological type. The sensitivity of preoperative plasma OPN in detecting ovarian cancer was 81.3% and almost reached that of CA125. The specificity was moderate. Sensitivity increased to 93.8% with the combination of CA125, compared to 84.4% with CA125 alone. CONCLUSION: Preoperative OPN is a useful biomarker for predicting ovarian cancer. It is especially useful when used complementary to CA125. Larger studies of patients with ovarian cancer showing a low CA125 level or in early stages of ovarian cancer are needed.     

Metastatic colorectal adenocarcinoma involving the ovary with elevated serum CA125: a potential diagnostic pitfall

OBJECTIVES: Elevated serum levels of CA125 are observed not only in association with primary ovarian epithelial neoplasms but also in a variety of other clinical settings, including ovarian involvement by metastatic disease. There is considerable overlap in gross and histologic features between primary ovarian tumors and metastatic colorectal adenocarcinoma, which can make diagnosis particularly challenging in the setting of an increased CA125 level. The aims of this study were to determine how frequently serum CA125 is elevated in women with ovarian involvement by metastatic colorectal adenocarcinoma and to compare the features of cases with and without associated elevations of serum CA125. METHODS: Eighty-nine cases of histologically confirmed ovarian involvement by metastatic colorectal adenocarcinoma were identified by retrospective review. Clinicopathologic data were analyzed, including preoperative serum CA125 level (available in 42 cases). Features of cases with an associated increase in serum CA125 were compared with those of cases with no such elevation. RESULTS: Twenty-nine patients had an elevated serum CA125 level (>35 U/mL) preoperatively (range 39.0-556.3, median 143.0, mean 199.1). Thirteen patients had a serum CA125 level within the reference range, while forty-seven patients had no preoperative testing for serum CA125. Clinical, gross, and histologic features of cases with an associated increase in serum CA125 were generally similar to those of cases with a non-elevated serum CA125 concentration. In three cases, the tumor was initially diagnosed as an ovarian primary. CONCLUSIONS: At least 32.6% of women with ovarian involvement by metastatic colorectal adenocarcinoma have an elevated serum CA125 level prior to oophorectomy. Such cases do not differ significantly from cases lacking such an association with respect to a variety of clinicopathologic features. The possibility of metastasis from a colorectal carcinoma merits consideration in the formation of the differential diagnosis for a woman with an adnexal mass and elevated serum CA125, even in the absence of an established history of gastrointestinal malignancy.