血清YKL-40和P185联合检测在早期卵巢癌诊断中的应用

发布时间：2018-07-05 06:13

  本文选题：YKL-40 + P185　； 参考：《吉林大学》2014年硕士论文

【摘要】：背景及目的：卵巢癌（Ovarian canaer，OC）是常见的妇科恶性肿瘤，90％的卵巢癌均为上皮性卵巢癌（Epithelial Ovarian canaer，EOC），其死亡率居于妇科常见三大恶性肿瘤之首，卵巢癌起病较宫颈管癌及子宫内膜癌隐匿，部位较深，临床症状、体征不典型并且缺乏有效的早期诊断方法，且易发生多部位的转移和侵袭，，多数患者发现时已达晚期，晚期卵巢癌的5年生存率仅为30％左右。而早期卵巢癌的5年生存率达90％，所以，寻找卵巢癌早期诊断的血清肿瘤标记物，对卵巢癌的早期诊断及时治疗具有重大意义。P185是由癌基因HER-2/neu或e-errbB-2编码的糖蛋白，癌基因e-errbB-2的扩增和（或）过度表达可导致细胞生长失控及侵袭性肿瘤细胞的产生，阻止肿瘤细胞的凋亡并促进其生长。血清中可溶性P185的检测可用于恶性肿瘤的检测。YKL-40即人类软骨蛋白39（Human cartilage glycoprotein-39；HCgp-39），是一种哺乳动物壳质酶样蛋白物质，在人体组织中参与细胞的增殖、分化、生长，抗凋亡、侵袭和转移，血管生成、炎性反应以及肿瘤细胞外基质的构成等多种生命细胞活动。本研究采用酶联免疫法及电化学发光免疫法对正常卵巢组织、卵巢良性肿瘤、卵巢癌患者血清YKL-40、P185水平进行检测，并对二者与卵巢癌临床分期的关系进行分析，分别探讨二者在卵巢癌中的表达及与卵巢癌发生、发展、转移的关系。进一步探讨二者联合检测在卵巢癌早期临床诊断及临床分期的意义。 方法：收集吉林大学中日联谊医院、吉林省肿瘤医院2012年1月-2013年10月经临床及术后病理确诊为卵巢癌患者的术前血液标本62例，60例卵巢良性肿瘤及60例体检健康妇女血液标本作为正常对照组，所有研究对象均在清晨采集空腹静脉血3毫升，血液标本均采用非抗凝管收集。取血后,常温下血液凝固至少30分钟至1小时。当血清自然析出后，在4℃下，2000转/分，离心10分钟，吸取血清，弃去不溶物。将血清移至一干净EP管，做好标记，-20℃储藏直至使用。所有血清标本避免溶血和反复冻融。用酶联免疫法测定血清中YKL-40、P185水平。数据分析应用SPSS19.0统计软件包进行数据的统计分析。 结果： 1.血清YKL-40、P185在卵巢癌患者中阳性表达率分别75.81％、80.65％经统计学分析，卵巢癌患者血清YKL-40、P185水平高于正常卵巢组及卵巢良性肿瘤组，差异具有显著性（P0.01），而卵巢良性肿瘤和正常对照组之间无统计学意义（P0.05）。 2.血清YKL-40、P185两项联合检测较单独检测任一项阳性率升高，高达91.94%，其中对I期和II期卵巢癌患者检测的阳性率高达91.43%，对III期和IV期卵巢癌患者检测的阳性率高达92.59%。 3.联合检测卵巢癌患者血清中YKL-40和P185水平阳性率与卵巢癌临床分期、病理分型、分化程度无关。 结论： 1.血清YKL-40和P185的升高可能提示卵巢癌的发生、发展。 2.血清YKL-40、P185两项联合检测可有效提高卵巢癌早期诊断的敏感度。
[Abstract]:Background and objective: ovarian cancer (Ovarian canaeroc) is a common gynecologic malignant tumor, 90% of which are epithelial ovarian cancer (EOC). The mortality rate of ovarian cancer is the highest among the three most common malignant tumors in gynecology. Ovarian cancer is more occult than cervical canal cancer and endometrial carcinoma. The site is deep, clinical symptoms and signs are not typical, and lack of effective early diagnosis, and prone to multiple sites of metastasis and invasion, most patients have been found by the late stage, the 5-year survival rate of advanced ovarian cancer is only about 30%. The 5-year survival rate of early ovarian cancer is 90%. Therefore, looking for serum tumor markers for early diagnosis of ovarian cancer is of great significance for early diagnosis and treatment of ovarian cancer. P185 is a glycoprotein encoded by the oncogene HER-2pneu or e-errbB-2. The amplification and / or overexpression of oncogene e-errbB-2 can lead to uncontrolled cell growth and the production of invasive tumor cells, which can prevent the apoptosis of tumor cells and promote their growth. The detection of soluble P185 in serum can be used to detect malignant tumor. YKL-40 is human cartilage glycoprotein-39 (HCgp-39), which is a kind of mammalian chitin like protein-like protein, which is involved in cell proliferation, differentiation, growth and anti-apoptosis in human tissues. Invasion and metastasis, angiogenesis, inflammatory response and the formation of tumor extracellular matrix, and so on. In this study, the serum levels of YKL-40 and P185 in normal ovarian tissues, benign ovarian tumors and ovarian cancer patients were detected by enzyme linked immunosorbent assay (Elisa) and electrochemiluminescence immunoassay (ECLIA), and the relationship between the levels of YKL-40 and P185 and the clinical stages of ovarian cancer was analyzed. To investigate the relationship between the expression of Ovarian Cancer and the occurrence, Development and Metastasis of Ovarian Cancer. To explore the significance of combined detection in early clinical diagnosis and clinical staging of ovarian cancer. Methods: the Sino-Japanese Friendship Hospital of Jilin University was collected, From January 2012 to October 2013, 62 patients with ovarian cancer confirmed by clinical and postoperative pathology in Jilin Cancer Hospital, 60 patients with benign ovarian tumor and 60 healthy women as normal control group. All subjects collected 3 ml of fasting venous blood in the early morning. Blood samples were collected by non-anticoagulant tube. After blood collection, blood coagulates at room temperature for at least 30 minutes to 1 hour. When the serum naturally precipitated, it was centrifuged at 4 鈩

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