人附睾蛋白4对卵巢癌术后复发意义的研究

发布时间：2018-02-02 04:42

本文关键词： 卵巢癌复发 HE4 肿瘤标记物 CA125　出处：《青岛大学》2017年硕士论文　论文类型：学位论文

【摘要】：研究目的:通过检测83例卵巢癌患者血清中人附睾蛋白4(HE4)及CA125不同阶段的水平,分析血清HE4水平、CA125水平与卵巢癌患者临床病理特征(年龄、最大肿块直径、腹水量、残留病灶大小、铂类耐药复发时间、卵巢癌FIGO分期、分化级别)之间的关系,采用CA125与HE4联合检测预测卵巢癌复发可能及程度,探讨检测HE4对预测卵巢癌术后复发的意义。研究方法:本研究采用酶联免疫吸附(ELISA)方法测定83例卵巢癌患者血清标本CA125、HE4的表达水平。分析不同时间卵巢癌患者血清CA125、HE4的表达水平与卵巢癌FIGO分期、分化级别、年龄、术后残留病灶大小、术前肿物最大直径、腹水、复发时间之间的关系,探讨HE4对预测卵巢癌术后复发的意义。结果:患者术前血清中HE4表达水平与其临床病理特征的统计分析表明,腹水量大于500ml和小于500ml的卵巢癌患者在术前HE4水平上的差异是具有统计学意义的,术前HE4的水平越高,提示卵巢癌患者腹水量较多。术后残留病灶大于2cm和术后残留病灶小于2cm的卵巢癌患者在术前HE4水平上的差异是具有统计学意义的,术前HE4水平越高,其手术切除干净的难度越大,术后残留病灶越大。卵巢癌的不同分期与术前HE4的水平之间是有差异的,且其差异具有统计学意义,术前HE4水平异常,多提示卵巢癌分期越晚。术后2周HE4下降幅度与临床病理特征之间关系的统计分析显示,不同的术前肿块最大直径在术后两周HE4下降幅度上的差异是具有统计学意义的,术前肿块最大直径小于10cm的卵巢癌患者,术后两周HE4下降幅度越可能超过50%,化疗3疗程后HE4水平与临床病理特征之间关系的分析发现,卵巢癌发病年龄在60岁以上及以下的在3疗程后HE4水平上的差异是具有统计学意义的,卵巢癌的发病年龄越小,3疗程后HE4值的水平越容易在正常范围内。不同的术前肿块最大直径在3疗程后HE4水平上的差异是具有统计学意义的,术前肿块最大直径小于10cm的卵巢癌患者,3疗程后HE4水平更趋于正常,其复发的时间可能更早。残留病灶大小在3疗程后HE4水平上的差异是具有统计学意义的。残留病灶越小,3疗程后HE4水平更趋于正常。其复发时间在3疗程后HE4水平上的差别是具有统计学意义的。3疗程后HE4水平异常,其复发的时间可能更早。CA125与HE4联合检测与单独检测出的结果的差别没有统计学意义,其联合检验还需要进一步研究。以上结论均通过统计学分析,P值均小于0.05。结论:卵巢癌患者的血清HE4水平对预测卵巢癌复发具有重要的临床意义。
[Abstract]:Objective: to analyze the serum HE4 levels in 83 patients with ovarian cancer by detecting the levels of human epididymal protein (Hepididymal protein 4) and CA125 at different stages. CA125 levels were associated with clinicopathological features (age, maximum tumor diameter, ascites volume, residual focus size, time of platinum-resistant recurrence, and FIGO staging of ovarian cancer) in patients with ovarian cancer. CA125 and HE4 were used to predict the recurrence of ovarian cancer. To explore the significance of detecting HE4 in predicting the recurrence of ovarian cancer after operation. Methods: the serum CA125 of 83 patients with ovarian cancer was determined by enzyme linked immunosorbent assay (Elisa). Expression level of HE4. The expression level of CA125 and HE4 in serum of patients with ovarian cancer at different time was analyzed and compared with the FIGO stage, differentiation grade, age and residual lesion size of ovarian cancer. The relationship between the maximum diameter of tumor, ascites and recurrence time before operation. To explore the significance of HE4 in predicting postoperative recurrence of ovarian cancer. Results: the expression of HE4 in serum and clinicopathological features of patients before operation were statistically analyzed. The difference of preoperative HE4 level between ovarian cancer patients with ascites greater than 500ml and less than 500ml was statistically significant. The higher the preoperative HE4 level was. The results indicated that the quantity of ascites in patients with ovarian cancer was higher than that in patients with ovarian cancer with residual lesions larger than 2 cm and those with residual lesions less than 2 cm before operation. There was significant difference in preoperative HE4 levels between patients with ovarian cancer and those with residual lesions less than 2 cm. The higher the preoperative HE4 level, the greater the difficulty of surgical removal and the greater the residual focus. There is a difference between the different stages of ovarian cancer and the preoperative HE4 level, and the difference is statistically significant. The abnormal HE4 level before operation indicates that the stage of ovarian cancer is later. The statistical analysis of the relationship between the decrease of HE4 and the clinicopathological features 2 weeks after operation. There were statistically significant differences in the decrease of HE4 between the two weeks after the operation with different preoperative maximum diameter of the tumor. The preoperative tumor with the largest diameter less than 10 cm in ovarian cancer patients. The decrease of HE4 was more than 50% two weeks after chemotherapy. The relationship between HE4 level and clinicopathological characteristics was found after 3 courses of chemotherapy. The difference of HE4 level in ovarian cancer over 60 years old and below is statistically significant after 3 courses of treatment. The younger the onset age of ovarian cancer is. After 3 courses of treatment, the level of HE4 value was more easily within the normal range. The difference of the maximum diameter of different preoperative masses in the level of HE4 after 3 courses of treatment was statistically significant. After 3 courses of treatment, the HE4 level of ovarian cancer patients with the largest tumor diameter less than 10 cm was more normal. After 3 courses of treatment, the difference in the HE4 level was statistically significant. The smaller the residual focus was, the smaller the residual lesion was. After 3 courses of treatment, the level of HE4 tended to be normal, and the difference of recurrence time in the level of HE4 after 3 courses of treatment was statistically significant after 3 courses of treatment, the level of HE4 was abnormal. There was no significant difference between the combined detection of CA125 and HE4 and the results of single detection. The joint test needs further study. All the above conclusions are statistically analyzed. P < 0.05. Conclusion: the serum HE4 level in patients with ovarian cancer has important clinical significance in predicting the recurrence of ovarian cancer.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.31

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