卵巢肿瘤患者血清、腹水、瘤液中血管内皮生长因子的含量及其意义

目的：测定卵巢肿瘤患者血清、腹水及瘤液中血管内皮生长因子（VEGF）的含量,评价在诊断卵巢恶性肿瘤及术后监测中的价值。方法：采用酶联免疫吸附法测定卵巢肿瘤患者血清（64例）、腹水（18例）、瘤液（13例）中VEGF的含量。结果：卵巢恶性肿瘤患者治疗前血清VEGF含量明显高于交界性肿瘤、良性肿瘤及正常对照;卵巢恶性肿瘤（包括交界性肿瘤）治疗前血清VEGF界值定为100pg/ml时,其敏感度为70%,特异度为87%;卵巢恶性肿瘤患者治疗前VEGF含量,淋巴结转移组明显高于未转移组（P＜0.05),腹水细胞学阳性组明显高于阴性组（P＜0.05),而与临床分期、组织学分级、组织类型及残留灶大小无关（P＜0.05)。术后随访复发组血清VEGF含量显著高于未复发组,术后监测卵巢恶性肿瘤复发的血清VEGF界值定为120pg/ml时,其敏感度可为100%,特异度则为87.5%。卵巢恶性肿瘤患者腹水中VEGF含量显著高于良性肿瘤;卵巢恶性肿瘤患者瘤液中VEGF含量亦显著高于良性肿瘤患者（P＜0.05)。结论：血清VEGF可能成为卵巢恶性肿瘤的一种标记物,在诊断、鉴别诊断及术后监测中有应用价值;并有可能与恶生腹水的形成有关。     

卵巢恶性肿瘤端粒酶活性与C-myc基因mRNA表达的研究

目的　研究端粒酶活性、C -myc基因在卵巢恶性肿瘤中的表达和相互关系。方法　在卵巢恶性肿瘤、交界性肿瘤、良性肿瘤和正常卵巢组织中 ,采用PCR -ELISA方法检测端粒酶活性 ,RT -PCR方法检测C -myc基因的mRNA表达。结果　恶性卵巢肿瘤端粒酶活性值及阳性率 (91 30 % ) ,明显高于交界性卵巢肿瘤(2 0 0 0 % ,P <0 0 1 )、良性卵巢肿瘤 (7 1 3% ,P <0 0 1 )和正常卵巢 (0 0 0 % ,P <0 0 1 )。交界性卵巢肿瘤端粒酶表达率与后两者的端粒酶活性表达率也存在显著差异 (P <0 0 1 ) ;卵巢良性肿瘤与正常卵巢组织之间端粒酶活性无差别 (P >0 0 5 )。端粒酶活性值在恶性卵巢肿瘤Ⅲ、Ⅳ期明显高于Ⅰ、Ⅱ期 (P <0 0 5 ) ;分化程度低者高于分化高者 (P <0 0 5 ) ;但在组织类型和组织起源上差异无显著性 (P >0 0 5 )。恶性卵巢肿瘤组织中端粒酶活性值明显高于癌旁组织 (P <0 0 5 )。端粒酶阳性率在恶性卵巢肿瘤临床分期、组织类型和组织起源上均无差异 (P >0 0 5 )。利用RT -PCR检测C -myc基因的表达 ,发现 1 2例 (5 2 1 7% )恶性卵巢肿瘤C -myc基因有mR NA表达 ,而在良性、交界性和正常卵巢组织中均未见表达。C -myc基因阳性组端粒酶活性值显著高于阴性组。结论　端粒酶活化可以作为恶性肿瘤的分子生物     

彩色多普勒超声鉴别良恶性卵巢肿瘤的研究

目的　探讨经腹部、阴道二维超声及彩色多普勒鉴别良、恶性卵巢肿瘤的特点及意义。方法　自2 0 0 0年 1月至 2 0 0 2年 1月 ,对 2 5 0例卵巢肿瘤进行二维超声及彩色多普勒检测 ,并对良恶性卵巢肿瘤的形态、包膜、腹水、周边、内部血流阻力指数及血清CA12 5进行比较。结果　良恶性卵巢肿瘤的形态、包膜差异有显著性(P <0 0 1)。 6 4 %的恶性肿瘤可测出腹水 ,而良性肿瘤腹水仅占 0 7%。两者周边血流差异无显著性 ( P >0 0 5 ) ,内部血流差异有显著性 (P <0 0 1) ;17例中晚期恶性卵巢肿瘤病人的血清CA12 5均增高。结论　超声形态学和彩色多普勒探查卵巢肿瘤的动脉血流阻力指数 ,辅助血清CA12 5测值 ,是鉴别良恶性卵巢肿瘤的有效方法     

卵巢上皮性肿瘤患者血清与腹水LN、HA含量变化及临床意义

目的 研究卵巢上皮性肿瘤患者血清与腹水细胞外基质成分层粘蛋白(Laminin,LN)、透明质酸(Hyaluronic Acid,HA)含量变化及临床意义。方法采用放射免疫法测定75例卵巢上皮性肿瘤患者及42例对照组血清术前及术后LN、HA含量,并测定其中22例恶性肿瘤腹水LN、HA含量。结果恶性卵巢上皮性肿瘤组术前血清LN、HA含量显著高于对照组及良性肿瘤组(P<0.01,P<0.05),术后明显下降,手术前后血清LN、HA含量差异有显著性意义(P<0.05);卵巢恶性肿瘤患者低度分化组血清LN、HA含量显著高于中度及高度分化组(P<0.05),腹水LN、HA均显著高于血清含量(P<0.05),二者之间呈显著正相关(r分别为0.79、0.82,P<0.05),淋巴结转移组血清LN含量显著高于无淋巴结转移组(P<0.05,P<0.01)。结论LN、HA与肿瘤的生物学特性密切相关,其血清及腹水含量对于病情判断及监测具有重要的临床意义。     

卵巢肿瘤患者外周血乙酰肝素酶测定及临床意义

目的:探讨卵巢肿瘤患者外周血乙酰肝素酶(Hpa)含量测定的临床价值。方法:选择经病理学检查确诊的卵巢肿瘤,采用酶联免疫吸附法(ELISA)检测51例卵巢恶性肿瘤患者血清标本,其中未接受治疗26例(恶性治疗前组)、术后16例(恶性术后组)、复发9例(复发组);17例卵巢良性肿瘤(良性组)及16例正常妇女(对照组)血清中Hpa的表达。并将其与患者临床病理关系及预后进行分析。结果:①恶性治疗前组血清中Hpa含量(39.00±7.26μg/L)显著高于良性组(32.36±6.17μg/L)及对照组(26.22±8.06μg/L),差异有高度统计学意义(P<0.01);复发组、恶性术后组血清中Hpa含量(35.89±4.48μg/L,33.85±6.96μg/L)均高于对照组,差异均有高度统计学意义(P<0.01),与良性组差异均无统计学意义(P>0.05)。卵巢恶性肿瘤患者术后血清Hpa含量明显低于术前(31.58±5.67μg/L与38.02±7.74μg/L),差异有统计学意义(P<0.05)。②卵巢恶性肿瘤患者血清Hpa含量与肿瘤的临床分期、组织学分化程度、腹水量和有无肝转移相关(P<0.05)。③ROC曲线H...     

卵巢恶性肿瘤患者透明质酸的测定

应用放射免疫法对２７例巢良性肿瘤、３１例巢恶性肿瘤患者及３５例对照者的血清、尿及肿瘤组织中透明质酸含量进行测定。结果：卵巢恶性肿瘤患者血清ＨＡ含量高于卵巢良性肿瘤患者及对照者；尿中ＨＡ含量亦明显高于对照者。     

上皮性卵巢肿瘤患者血清和肿瘤组织中VEGF水平的检测

目的　通过对上皮性卵巢肿瘤患者肿瘤组织中血管内皮生长因子 (VEGF)表达的观察以及对术前血清VEGF水平的检测 ,探讨VEGF与上皮性卵巢肿瘤临床病理因素之间的关系。方法　应用免疫组织化学和ELISA方法 ,对 79例上皮性卵巢肿瘤患者 (包括 2 1例卵巢良性囊腺瘤 ,1 2例交界性卵巢肿瘤和 4 6例上皮性卵巢癌 )术前血清VEGF水平和术后组织标本中VEGF的表达进行了检测。结果　①上皮性卵巢癌组织VEGF阳性表达率 (78 2 6 % )显著高于交界性肿瘤 (4 1 6 7% )和良性囊腺瘤 (33 33% ) (P <0 0 1 ) ;上皮性卵巢癌中 ,晚期癌 (Ⅲ、Ⅳ期 )的VEGF阳性表达率 (92 0 0 % )显著高于早期癌 (Ⅰ、Ⅱ期 ) (6 1 90 % ) (P <0 0 1 ) ,且强阳性表达率 (5 2 0 0 % )也显著高于早期癌 (1 4 2 9% ) (P <0 0 5 ) ;有腹水组VEGF阳性表达率 (87 5 0 % )显著高于无腹水组 (5 7 1 4 % ) (P <0 0 5 ) ;②上皮性卵巢癌患者血清VEGF水平也明显高于良性囊腺瘤患者和交界性肿瘤患者 (P <0 0 1 ) ,卵巢癌中 ,低分化患者血清VEGF水平高于高、中分化患者 (P <0 0 1 ) ,血清VEGF水平在临床Ⅲ、Ⅳ期患者明显高于Ⅰ、Ⅱ期患者 (P <0 0 5 ) ,有明显腹水者比无腹水者高 (P <0 0 1 )。结论　VEGF在上皮性卵巢癌肿瘤组织中表达的增加以及血     

测定卵巢恶性肿瘤患者血清DJ-1蛋白的临床价值

目的:探讨血清中DJ-1蛋白浓度与卵巢恶性肿瘤的关系,以及检测DJ-1蛋白在卵巢肿瘤诊断中的价值。方法:ELISA法测定62例健康妇女(对照组)、60例卵巢良性肿瘤患者(良性组)及138例卵巢恶性肿瘤患者(恶性组)血清中DJ-1蛋白含量。结果:恶性组治疗前平均血清DJ-1蛋白水平[(9.64±4.06)ng/ml]显著高于良性组[(4.87±1.86)ng/ml]和对照组[(4.35±1.44)ng/ml](P=0.000)。恶性组术后和复发组的平均血清DJ-1蛋白水平分别为[(8.62±3.60)ng/ml]和[(9.46±2.98)ng/ml],较对照组及良性组有明显升高,差异有统计学意义(P=0.000)。恶性治疗前及术后配对组中,患者治疗前的平均血清DJ-1蛋白水平[(9.12±3.92)ng/ml]高于术后组[(8.46±3.75)ng/ml](P=0.022)。血清DJ-1蛋白阳性患者的累积生存率与血清DJ-1蛋白阴性者比较,差异有统计学意义(P=0.028)。COX模型结果显示,DJ-1蛋白水平、临床分期及残余灶大小是独立的预后因素(P0.05)。结论:卵巢恶性肿瘤患者中血清DJ-1蛋白含量异常升高,DJ-1蛋白可协助卵巢恶性肿瘤的诊断,同时对患者手术效果的评价、判断预后及复发也提供了相应的参考价值。     

一氧化氮及一氧化氮合酶与卵巢肿瘤凋亡的关系

目的探讨卵巢良、恶性肿瘤患者血清、肿瘤组织、腹水中一氧化氮(nitricoxide,NO)及其合酶(nitricoxidesynthase,NOS)含量与肿瘤凋亡的关系。方法用分光光度计测定NO、NOS、iNOS活性,流式细胞仪检测细胞凋亡。结果恶性卵巢肿瘤患者血清、肿瘤组织中NO、NOS、iNOS高于良性肿瘤患者(P<0.05);腹水或腹腔冲洗液中iNOS亦高于良性(P<0.05),但腹水中NO、NOS与良性无差异(P>0.05)。恶性肿瘤细胞凋亡率高于良性(P<0.05)。结论NO、NOS、iNOS与卵巢肿瘤的恶性行为及凋亡有关,检测患者血清、组织、腹水中的NO、NOS、iNOS对鉴别良、恶性肿瘤有一定参考价值,可作为观测卵巢癌疗效及预后的指标。     

血清Cu、Zn含量及Cu/Zn比值在卵巢肿瘤诊断中的价值

本文测定了33例卵巢癌,41例良性卵巢肿瘤及76例正常人的血清 Cu,Zn 含量及 Cu/Zn比值,结果发现,卵巢癌患者的血清 Cu 含量显著高于良性卵巢肿瘤组及正常对照组;Zn 含量显著低于良性卵巢肿瘤组及正常对照组;Cu/Zn 比值显著高于良性卵巢肿瘤组及正常对照组,并且晚期卵巢癌患者的血 Cu/Zn 比值升高更为显著,用血 Cu/Zn 比值诊断良、恶性卵巢肿瘤的准确性为85%,恶性卵巢肿瘤与正常对照组及良性肿瘤组间阳性预测值分别为92%、92%,特异性分则为97%和95%.本文结果提示血清 Cu、Zn 含量及 Cu/Zn 比值时恶性卵巢肿瘤的辅助诊断,判断预后及在人群中作为卵巢癌的辅助筛选手段具有重要的实用价值.     

Peripheral and ovarian venous concentrations of steroid and gonadotropin hormones in postmenopausal women with epithelial ovarian tumors

Peripheral serum concentrations of estrone (E1), estradiol (E2), testosterone, androstenedione, dehydroepiandrosterone sulfate (DHEAS), cortisol, prolactin, LH, and FSH were measured in 28 postmenopausal women with epithelial ovarian tumors (12 ovarian cancer, 5 borderline malignant, 11 benign neoplasms) and in 15 controls before bilateral salpingo-oophorectomy and 1 and 8 weeks postoperatively. The levels of these hormones were also measured in ovarian venous blood of 15 patients with ovarian tumors. E2 was significantly higher in the tumor group than in controls preoperatively and the levels of E1 and E2 decreased after radical operation. Hormone levels were similar in the benign and malignant tumor groups. Only DHEAS levels in peripheral serum were significantly lower in ovarian cancer patients than in the group with benign neoplasm. This was not the case in testosterone and androstenedione measurements. The measured levels of the hormones in ovarian venous blood were highest in mucinous ovarian tumors. E2 and testosterone levels were higher in mucinous ovarian tumors than in others. LH(hCG)-receptor levels were measured in 24 specimens and none of these showed detectable concentrations of LH(hCG) receptor. The results indicate that of all epithelial tumors mucinous ovarian tumors had hormonal activity most often, and malignancy had no effect on hormonal activity.     

Ovarian neoplasms and the risk of adnexal torsion

Previous reports examining adnexal torsion suggested that benign ovarian neoplasms are more likely to undergo torsion than malignant ovarian neoplasms. To our knowledge, this clinical observation has not been quantified. To examine this hypothesis, we reviewed our experience with ovarian neoplasms found at the time of surgery over a 10-year period. Benign ovarian neoplasms had a 12.9-fold increased risk of undergoing adnexal torsion when compared with malignant ovarian neoplasms (95% confidence interval, 10.2 to 15.9). The histologic type of ovarian neoplasm does not appear to affect the rate of adnexal torsion. Adnexal torsion rarely involves cancer.     

C-erbB_2、p16基因在卵巢肿瘤中的表达及其临床意义的研究

目的：探讨卵巢肿瘤中癌基因Ｃ－ｅｒｂＢ２及抑癌基因ｐ１６的表达及其与临床病理特征及患者预后的关系。方法：用免疫组化ＡＢＣ法，分析４９份卵巢恶性肿瘤、１２份交界性肿瘤、１５份良性肿瘤石蜡包埋组织中Ｃ－ｅｒｂＢ２、ｐ１６的表达情况。结果：①在卵巢恶性肿瘤、交界性肿瘤、良性肿瘤之间Ｃ－ｅｒｂＢ２的表达差异有显著性（Ｐ＜０．０１）。Ｃ－ｅｒｂＢ２的表达率及表达强度与组织分化程度患者及生存期有显著相关性（Ｐ＜０．０５），Ｃ－ｅｒｂＢ２的过度表达见于恶性程度高、组织分化差、患者预后不良的肿瘤中。②在卵巢恶性肿瘤、交界性肿瘤、良性肿瘤之间ｐ１６的表达差异有显著性（Ｐ＜０．０１）。其表达强度与组织分化程度及临床分期有显著相关性，在恶性程度较高、组织分化差、较晚期的肿瘤中ｐ１６的表达较弱。结论：癌基因Ｃ－ｅｒｂＢ２及抑癌基因ｐ１６在卵巢癌组织中广泛存在，并与其临床病理指标之间有一定的相关性，提示这些基因在卵巢癌的发生、发展中起一定作用，并对患者预后的判断及治疗有一定的指导意义。对各基因之间复杂的相互作用、协同作用有待进一步研究。     

Relative frequency of primary ovarian neoplasms: a 10-year review

The relative frequency of ovarian neoplasms varies according to information in different texts. In an attempt to clarify the distribution of primary ovarian neoplasms by decades of life, a 10-year retrospective review of 861 women with a postoperative diagnosis of an ovarian neoplasm was undertaken. Benign cystic teratoma was the single most common ovarian neoplasm, accounting for 44% of all neoplasms, and was 57% more frequent than benign serous tumors. Germ cell neoplasms were the most common group of benign ovarian neoplasms; epithelial neoplasms were the most common malignant neoplasm. Stromal neoplasms and neoplasms of low malignant potential were uncommon at all ages. The risk that an ovarian neoplasm was malignant increased 12-fold from ages 20-29 to 60-69. The overall risk that an ovarian neoplasm was malignant was 13% in premenopausal women and 45% in postmenopausal women.     

Update on the surgical management of ovarian neoplasms in children and adolescents: analysis on 32 cases

This study analyzes updated clinical, diagnostic, and surgical directions for the treatment of ovarian neoplasms in children and adolescents, comparing them with a retrospective analysis of 32 cases treated in two Pediatric Surgery University Institutions. From January 2005 to December 2015, 32 pediatric patients were surgically treated for 32 ovarian tumors: 28 (87.5%) benign and 4 (12.5%) malignant neoplastic lesions. Median age at surgery was 11.2 years (12.8 years in patients with benign neoplasms, 7.25 years in patients with malignant ones). All patients with malignant and 25% of patients with benign ovarian lesions had elevated serum level of tumors markers. The surgical approach was laparotomic in 62.5% and laparoscopic in 37.5%; 81.2% surgeries were performed in elective surgery and 18.8% in emergency. Intraoperative frozen section analysis was performed in 18.75% of patients. The most frequent surgery (96.8%) was unilateral oophorectomy. After a median follow-up of 76 months (range 6–132 months), 31/32 patients are alive and disease-free. In case of malignant tumors, fertility-sparing surgery with accurate staging must be performed. Laparoscopic multiport is the gold standard approach for benign pediatric ovarian neoplasms, but the use of laparoscopy in full respect of oncological principles also for early stage malignant tumors is currently increased.     

Adenosine deaminase activity in patients with ovarian neoplasms

Purpose

The aim of this study was to investigate the serum and peritoneal fluid adenosine deaminase (ADA) activity in patients with benign and malignant ovarian neoplasms.

Methods

This is a prospective cross-sectional study performed in Cukurova University, Department of Gynecologic Oncology. Eighty-four patients with ovarian mass were included in this study within 13?months. The levels of serum and peritoneal fluid ADA levels were measured and compared in patients with benign and malignant ovarian neoplasms and also low- and high-grade malignant tumors.

Results

Serum and peritoneal fluid ADA levels were found to be significantly higher in patients with ovarian cancers as compared with benign ovarian tumors (p?=?0.001). Additionally, ADA levels were found to be significantly different according to the histopathological subtypes and grade of ovarian cancers. However, there was no significant difference for ADA levels between the benign and low-grade malignant tumors. There was an important correlation between the peritoneal fluid and serum ADA levels.

Conclusions

Serum and peritoneal fluid ADA levels were found to be higher in malignant ovarian neoplasms. This finding may be useful to understand the biochemically characteristics of malignant ovarian tumors and ADA may be a useful biomarker in diagnosis and management of ovarian tumors.