血清HE4、FS、SMRP及CA125在卵巢癌患者中的表达及临床意义
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摘要
目的:探讨血清人附睾蛋白4(HE4)、卵泡抑素(FS)、可溶性间皮素相关蛋白(SMRP)、糖类抗原125(CA125)在卵巢癌患者中的表达水平及临床意义。方法:选取2014年6月-2017年9月我院收治的卵巢癌患者60例作为卵巢癌组,另选取同期收治的卵巢良性肿瘤患者32例作为良性组,选取同期健康体检妇女40例作为对照组,检测三组受试者血清HE4、FS、SMRP、CA125水平,对比三组HE4、FS、SMRP、CA125阳性表达率,并分析血清HE4、FS、SMRP、CA125对卵巢癌的诊断价值。结果:三组受试者的HE4、FS、SMRP、CA125水平整体对比有统计学意义(P<0.05),其中卵巢癌组与良性组HE4、FS、SMRP、CA125水平高于对照组,且卵巢癌组高于良性组,差异有统计学意义(P<0.05)。三组受试者的HE4、FS、SMRP、CA125阳性表达率整体对比有统计学意义(P<0.05),卵巢癌组与良性组HE4、FS、SMRP、CA125阳性表达率高于对照组,且卵巢癌组高于良性组,差异有统计学意义(P<0.05)。联合检测的灵敏度高于FS、SMRP单项检测,差异有统计学意义(P<0.05),联合检测的特异度高于HE4、FS、SMRP、CA125单项检测,但差异无统计学意义(P>0.05)。结论:卵巢癌患者血清HE4、FS、SMRP、CA125水平及阳性表达率均较高,四项指标联合检测可提高诊断卵巢癌的灵敏度及特异度。
Objective:To investigate the expression level and clinical significance of serum epididymal protein-4(HE4),follistatin(FS),soluble mesothelin associated protein(SMRP) and carbohydrate antigen 125(CA125) in patients with ovarian cancer.Methods:60 cases of ovarian cancer who were treated in our hospital from June 2014 to September 2017 were selected as ovarian cancer group,32 cases of benign ovarian tumor in the same period were selected as benign group,40 women in healthy physical examination at the same time as a control group.The serum levels of HE4,FS,SMRP and CA125 were detected in the three groups,the positive rates of HE4,FS,SMRP and CA125 in three groups were compared,the value of serum HE4,FS,SMRP and CA125 in the diagnosis of ovarian cancer were analysed.Results:The levels of HE4,FS,SMRP and CA125 in the three groups were statistically significant(P<0.05),among them,the levels of HE4,FS,SMRP and CA125 in the ovarian cancer group and the benign group were higher than those in the control group,the ovarian cancer group was higher than that of the benign group,and the differences were statistically significant(P<0.05).The overall comparison of the positive rates of HE4,FS,SMRP and CA125 in the three groups were statistically significant(P<0.05),the positive expression rate of HE4,FS,SMRP and CA125 in the ovarian cancer group and the benign group were higher than that in the control group,and the ovarian cancer group was higher than the benign group,and the differences were statistically significant(P<0.05).The sensitivity of the combined test was higher than that of FS and SMRP,and the difference was statistically significant(P<0.05),the specificity of the combined test was higher than that of HE4,FS,SMRP and CA125,but the difference was not statistically significant(P>0.05).Conclusion:The serum levels of HE4,FS,SMRP,CA125 and positive expression are higher in the patients with ovarian cancer,the combined detection of four indexes could improve the sensitivity and specificity of the diagnosis of ovarian cancer.
Objective:To investigate the expression level and clinical significance of serum epididymal protein-4(HE4),follistatin(FS),soluble mesothelin associated protein(SMRP) and carbohydrate antigen 125(CA125) in patients with ovarian cancer.Methods:60 cases of ovarian cancer who were treated in our hospital from June 2014 to September 2017 were selected as ovarian cancer group,32 cases of benign ovarian tumor in the same period were selected as benign group,40 women in healthy physical examination at the same time as a control group.The serum levels of HE4,FS,SMRP and CA125 were detected in the three groups,the positive rates of HE4,FS,SMRP and CA125 in three groups were compared,the value of serum HE4,FS,SMRP and CA125 in the diagnosis of ovarian cancer were analysed.Results:The levels of HE4,FS,SMRP and CA125 in the three groups were statistically significant(P<0.05),among them,the levels of HE4,FS,SMRP and CA125 in the ovarian cancer group and the benign group were higher than those in the control group,the ovarian cancer group was higher than that of the benign group,and the differences were statistically significant(P<0.05).The overall comparison of the positive rates of HE4,FS,SMRP and CA125 in the three groups were statistically significant(P<0.05),the positive expression rate of HE4,FS,SMRP and CA125 in the ovarian cancer group and the benign group were higher than that in the control group,and the ovarian cancer group was higher than the benign group,and the differences were statistically significant(P<0.05).The sensitivity of the combined test was higher than that of FS and SMRP,and the difference was statistically significant(P<0.05),the specificity of the combined test was higher than that of HE4,FS,SMRP and CA125,but the difference was not statistically significant(P>0.05).Conclusion:The serum levels of HE4,FS,SMRP,CA125 and positive expression are higher in the patients with ovarian cancer,the combined detection of four indexes could improve the sensitivity and specificity of the diagnosis of ovarian cancer.
引文
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[20]Smits S,Boivin J,Menon U,et al.Influences on anticipated time to ovarian cancer symptom presentation in women at increased risk compared to population risk of ovarian cancer[J].BMC Cancer,2017,17(1):814
[21]Zeng J,Huang H,Shan Y,et al.The Effect of CA125 Nadir Level on Survival of Advanced-Stage Epithelial Ovarian Carcinoma after Interval Debulking Surgery[J].J Cancer,2017,8(17):3410-3415
[22]Prapa M,Solomons J,Tischkowitz M.The use of panel testing in familial breast and ovarian cancer[J].Clin Med(Lond),2017,17(6):568-572
[23]Nowak EM,Pocz誰ta M,Bieg D,et al.DNA methyltransferase inhibitors influence on the DIRAS3 and STAT3 expression and in vitro migration of ovarian and breast cancer cells[J].Ginekol Pol,2017,88(10):543-551
[24]Capriglione S,Luvero D,Plotti F,et al.Ovarian cancer recurrence and early detection:may HE4 play a key role in this open challenge A systematic review of literature[J].Med Oncol,2017,34(9):164
[25]文晓荣.血清FS、HE4与CA125诊断卵巢癌的临床价值比较[J].中国妇幼保健,2015,30(34):6002-6004Wen Xiao-rong.Comparison of the clinical value of serum FS,HE4and CA125 in the diagnosis of ovarian cancer[J].Maternal&Child Health Care of China,2015,30(34):6002-6004
[26]Fritz-Rdzanek A,Grzybowski W,Beta J,et al.HE4 protein and SMRP:Potential novel biomarkers in ovarian cancer detection[J].Oncol Lett,2012,4(3):385-389
[27]Hacker NF.Neoadjuvant chemotherapy for advanced epithelial ovarian cancer.Who really benefits?[J].Aust N Z J Obstet Gynaecol,2017,57(6):585-587
[28]Chen S,Dai X,Gao Y,et al.The positivity of estrogen receptor and progesterone receptor may not be associated with metastasis and recurrence in epithelial ovarian cancer[J].Sci Rep,2017,7(1):16922
[29]Sittadjody S,Saul JM,Mc Quilling JP,et al.In vivo transplantation of3D encapsulated ovarian constructs in rats corrects abnormalities ofovarian failure[J].Nat Commun,2017,8(1):1858
[30]K G S,Mirza AA,Swamy S,et al.Metachronous Synchronous Sternal and Colonic Metastasis with Asymptomatic Colo-colic Fistula from Carcinoma Ovary Rare Presentation of?Ovarian Cancer[J].Indian JSurg Oncol,2017,8(4):615-618
[2]Uma Devi K,Purushotham N,Jayashree N.Management of O varian Cancer In Younger Women[J].Rev Recent Clin Trials,2015,10(4):263-269
[3]Li X,Liu Y,Lu J,et al.Integrative analysis to identify oncogenic gene expression changes associated with copy number variations of enhancer in ovarian cancer[J].Oncotarget,2017,8(53):91558-91567
[4]Deniz M,Romashova T,Kostezka S,et al.Increased single-strand annealing rather than non-homologous end-joining predicts hereditaryovarian carcinoma[J].Oncotarget,2017,8(58):98660-98676
[5]Ducoulombier S,Golfier F,Colomban O,et al.Modeling CA-125During Neoadjuvant Chemotherapy for Predicting Optimal Cytoreduction and Relapse Risk in Ovarian Cancer[J].Anticancer Res,2017,37(12):6879-6886
[6]Tongsong T,Wanapirak C,Tantipalakorn C,et al.Sonographic Diagnosis of Tubal Cancer with IOTA Simple Rules Plus Pattern Recognition[J].Asian Pac J Cancer Prev,2017,18(11):3011-3015
[7]Xu C,Li H,Yin M,et al.Osteopontin is involved in TLR4 pathway contributing to ovarian cancer cell proliferation and metastasis[J].Oncotarget,2017,8(58):98394-98404
[8]Xi QP,Pu DH,Lu WN.Research on application value of combined detection of serum CA125,HE4 and TK1 in the diagnosis of ovarian cancer[J].Eur Rev Med Pharmacol Sci,2017,21(20):4536-4541
[9]Goff BA,Agnew K,Neradilek MB,et al.Combining a symptom index,CA125 and HE4(triple screen)to detect ovarian cancer in women with a pelvic mass[J].Gynecol Oncol,2017,147(2):291-295
[10]Chen F,Ren P,Feng Y,et al.Follistatin is a novel biomarker for lung adenocarcinoma in humans[J].PLoS One,2014,9(10):e111398
[11]陈桂莲,张秀平,王春香,等.心理干预对卵巢癌术后化疗患者的作用[J].神经损伤与功能重建,2011,06(2):156-156Chen Gui-lian,Zhang Xiu-ping,Wang Chun-xiang,et al.Effect of psychological intervention on patients with postoperative chemotherapy of ovarian cancer[J].Neural Injury and Functional Reconstruction,2011,06(2):156-156
[12]Lippitt MH,Fairbairn MG,Matsuno R,et al.Outcomes Associated With a Five-Point Surgical Site Infection Prevention Bundle in Women Undergoing Surgery for Ovarian Cancer[J].Obstet Gynecol,2017,130(4):756-764
[13]张恒,王宇平,谷杨,等.不同给药途径的新辅助化疗在晚期上皮性卵巢癌的疗效观察[J].现代生物医学进展,2015,15(1):96-99,149Zhang Heng,Wang Yu-ping,Gu Yang,et al.Curative Effects of Neoadjuvant Chemotherapy in Advanced Epithelial Ovarian Cancer Using Different Methods[J].Progress in Modern Biomedicine,2015,15(1):96-99,149
[14]Doherty JA,Peres LC,Wang C,et al.Challenges and Opportunities in Studying the Epidemiology of Ovarian Cancer Subtypes[J].Curr Epidemiol Rep,2017,4(3):211-220
[15]Chung YS,Kim YJ,Lee I,et al.Impact of neoadjuvant chemotherapy and postoperative adjuvant chemotherapy cycles on survival of patients with advanced-stage ovarian cancer[J].PLoS One,2017,12(9):e0183754
[16]Milani A,Kristeleit R,Mc Cormack M,et al.Switching from standard to dose-dense chemotherapy in front-line treatment of advanced ovarian cancer:a retrospective study of feasibility and efficacy[J].ESMOOpen,2017,1(6):e000117
[17]Scaletta G,Plotti F,Luvero D,et al.The role of novel biomarker HE4in the diagnosis,prognosis and follow-up of ovarian cancer:a systematic review[J].Expert Rev Anticancer Ther,2017,17(9):827-839
[18]胡向丹,肖静,翟秋丽,等.卵巢癌患者血清HE4、CA125水平变化及临床意义[J].山东医药,2017,57(12):58-60Hu Xiang-dan,Xiao Jing,Zhai Qiu-li,et al.Changes of serum HE4and CA125 levels in patients with ovarian cancer and its clinical significance[J].Shandong Medical Journal,2017,57(12):58-60
[19]Wu X,Li D,Liu L,et al.Serum soluble mesothelin-related peptide(SMRP):a potential diagnostic and monitoring marker for epithelial ovarian cancer[J].Arch Gynecol Obstet,2014,289(6):1309-1314
[20]Smits S,Boivin J,Menon U,et al.Influences on anticipated time to ovarian cancer symptom presentation in women at increased risk compared to population risk of ovarian cancer[J].BMC Cancer,2017,17(1):814
[21]Zeng J,Huang H,Shan Y,et al.The Effect of CA125 Nadir Level on Survival of Advanced-Stage Epithelial Ovarian Carcinoma after Interval Debulking Surgery[J].J Cancer,2017,8(17):3410-3415
[22]Prapa M,Solomons J,Tischkowitz M.The use of panel testing in familial breast and ovarian cancer[J].Clin Med(Lond),2017,17(6):568-572
[23]Nowak EM,Pocz誰ta M,Bieg D,et al.DNA methyltransferase inhibitors influence on the DIRAS3 and STAT3 expression and in vitro migration of ovarian and breast cancer cells[J].Ginekol Pol,2017,88(10):543-551
[24]Capriglione S,Luvero D,Plotti F,et al.Ovarian cancer recurrence and early detection:may HE4 play a key role in this open challenge A systematic review of literature[J].Med Oncol,2017,34(9):164
[25]文晓荣.血清FS、HE4与CA125诊断卵巢癌的临床价值比较[J].中国妇幼保健,2015,30(34):6002-6004Wen Xiao-rong.Comparison of the clinical value of serum FS,HE4and CA125 in the diagnosis of ovarian cancer[J].Maternal&Child Health Care of China,2015,30(34):6002-6004
[26]Fritz-Rdzanek A,Grzybowski W,Beta J,et al.HE4 protein and SMRP:Potential novel biomarkers in ovarian cancer detection[J].Oncol Lett,2012,4(3):385-389
[27]Hacker NF.Neoadjuvant chemotherapy for advanced epithelial ovarian cancer.Who really benefits?[J].Aust N Z J Obstet Gynaecol,2017,57(6):585-587
[28]Chen S,Dai X,Gao Y,et al.The positivity of estrogen receptor and progesterone receptor may not be associated with metastasis and recurrence in epithelial ovarian cancer[J].Sci Rep,2017,7(1):16922
[29]Sittadjody S,Saul JM,Mc Quilling JP,et al.In vivo transplantation of3D encapsulated ovarian constructs in rats corrects abnormalities ofovarian failure[J].Nat Commun,2017,8(1):1858
[30]K G S,Mirza AA,Swamy S,et al.Metachronous Synchronous Sternal and Colonic Metastasis with Asymptomatic Colo-colic Fistula from Carcinoma Ovary Rare Presentation of?Ovarian Cancer[J].Indian JSurg Oncol,2017,8(4):615-618