卵巢癌、子宫内膜癌及宫颈癌与血清中透明质酸含量的相关性研究

发布时间：2018-04-20 18:05

本文选题：卵巢癌 + 子宫内膜癌　；参考：《西南交通大学》2017年硕士论文

【摘要】：目前妇科恶性肿瘤已经成为主要威胁女性生命的重要杀手,其中卵巢癌、子宫内膜癌和子宫颈癌的发病率最高,且发病日益趋向年轻化。由于缺乏有效的早期发现及治疗手段,妇科恶性肿瘤已成为不容忽视的严重威胁女性健康的头等大事。近年来研究发现,由多种细胞(包括肿瘤细胞)分泌到细胞外基质的主要成分透明质酸,参与细胞的定位、迁移,并涉及肿瘤细胞的运动与增殖,因此,目前普遍认为,透明质酸与肿瘤发生发展关系密切。本研究选取44份卵巢癌、39份子宫内膜癌和35份宫颈癌共计118位妇科恶性肿瘤患者的部分术后病理检查、免疫组化分析、血清肿瘤标志物(CA125、CA199、SCC和HE4)检测结果以及全部118份妇科恶性肿瘤患者血清透明质酸含量测定结果,用生物统计学方法,对卵巢癌、子宫内膜癌和宫颈癌患者的部分术后病理检查、免疫组化分析、血清肿瘤标志物与血清中透明质酸含量相关性进行分析,获得以下研究结果:20份妇科非恶性肿瘤患者血清中透明质酸平均值为189.15±48.029ng/ml;与妇科非恶性肿瘤患者血清透明质酸含量比较,卵巢癌和子宫内膜癌患者血清中透明质酸含量均值分别为293.75±173.08 ng/mL和239.57±61.70 ng/mL,达到了差异极显著(P0.01),而宫颈癌患者血清中透明质酸含量237.30±118.01 ng/mL则无显著差异。对卵巢癌、子宫内膜癌和宫颈癌妇科恶性肿瘤患者癌症淋巴转移、分化程度、临床分期与血清中透明质酸含量相关性分析结果显示:在检测所分析样本中,与妇科非恶性肿瘤患者血清中透明质酸含量比较,无癌淋巴转移患者血清中透明质酸含量存在显著差异(P0.05),而癌淋巴转移者则达到了极显著差异(P0.01),表明卵巢癌、子宫内膜癌和宫颈癌妇科恶性肿瘤患者淋巴转移与否与患者血清中透明质酸含量升高呈现出显著正相关。卵巢癌患者血清中透明质酸含量与卵巢癌分化高低没有显著差异;子宫内膜癌患者血清中透明质酸含量与子宫内膜癌分化高低有显著差异(P0.01);宫颈癌患者血清中透明质酸含量只有在中和中高分化程度才与妇科非恶性患者血清中透明质酸含量存在显著差异(P0.05)。卵巢癌和子宫内膜癌患者血清中透明质酸含量随临床分期不同存在显著差异(P0.05),但宫颈癌患者血清中透明质酸含量与临床分期无关。按血清肿瘤标志物CA125诊断指标临界值35 U/mL,CA19-9诊断指标临界值37 U/mL,HE4诊断指标临界值150 pmol/L,SCC诊断指标临界值1.5 ng/mL的判断标准,对卵巢癌、子宫内膜癌和宫颈癌三种妇科恶性肿瘤患者血清中肿瘤标志物与透明质酸含量相关性分析结果显示:卵巢癌患者血清肿瘤标志物CA125、HE4和CA19-9检测结果与实际病理诊断结果准确率分别为95.45%、50%和27.27%。进一步分析卵巢癌患者血清肿瘤标志物CA19-9和HE4检测阴性的患者血清中透明质酸含量,与妇科非恶性肿瘤患者血清中透明质酸含量比较,其差异分别到达显著(P0.05)和极显著(P0.01)水平,表明卵巢癌患者血清中透明质酸检测可能比肿瘤标志物CA19-9和HE4检测更敏感。子宫内膜癌患者血清肿瘤标志物CA125和CA19-9检测结果与实际病理诊断结果准确率分别为42.86%和32.43%,但子宫内膜癌血清肿瘤标志物CA125和CA19-9阴性患者的血清中透明质酸含量,与妇科非恶性肿瘤患者血清中透明质酸含量比较,分别到达显著(P0.05)和极显著(P0.01)差异,表明子宫内膜癌患者血清中透明质酸检测可能比肿瘤标志物CA125和CA19-9更敏感。宫颈癌患者血清肿瘤标志物SCC检测结果与实际诊断结果准确率为57.14%,只有肿瘤标志物SCC检测阳性的患者血清中透明质酸含量,与妇科非恶性肿瘤患者血清中透明质酸含量比较才有显著差异(P0.05)。我们实验结果分析表明,检测卵巢癌、子宫内膜癌妇科恶性肿瘤患者血清中透明质酸含量可能比检测目前的某些肿瘤标志物(如HE4和CA19-9)更敏感,当然本研究结果仅仅是一个初步,研究的也不够深入,收集的样品标本也有限,我们的初步结论还需要进一步的深入研究。
[Abstract]:At present, gynecological malignant tumor has become an important killer of female life, among which ovarian cancer, endometrial cancer and cervical cancer have the highest incidence, and the incidence of the disease is becoming increasingly young. Due to the lack of effective early detection and treatment, gynecologic malignant tumor has become a serious threat to women's health. In recent years, it has been found that hyaluronic acid, the main component of a variety of cells (including tumor cells), is secreted to the extracellular matrix, participates in the location and migration of cells, and involves the movement and proliferation of tumor cells. Therefore, it is generally believed that hyaluronic acid is closely related to the development of tumor. 44 ovarian cancer and 39 uterus were selected in this study. Partial postoperative pathological examination, immunohistochemical analysis, serum tumor markers (CA125, CA199, SCC and HE4) and serum hyaluronic acid content in all 118 patients with gynecologic malignant tumor, and the results of serum hyaluronic acid content in all 118 cases of gynecologic malignant tumor, and biostatistical methods for ovarian cancer, endometrial cancer and endometrium cancer. The correlation of postoperative pathological examination, immunohistochemical analysis, serum tumor markers and serum hyaluronic acid content in serum of patients with cervical cancer was analyzed. The following results were obtained: the average value of hyaluronic acid in serum of 20 non malignant gynecologic tumor patients was 189.15 48.029ng/ml, and the serum hyaluronic acid content of the patients with non malignant gynecologic tumor was compared with the serum hyaluronic acid content of the patients with non malignant gynecologic cancer. The serum levels of hyaluronic acid in the patients with ovarian cancer and endometrial carcinoma were 293.75 + 173.08 ng/mL and 239.57 + 61.70 ng/mL respectively, and the difference was very significant (P0.01). There was no significant difference between the serum hyaluronic acid content in the serum of the patients with cervical cancer and 237.30 + 118.01 ng/mL. The correlation analysis of lymph node metastasis, differentiation, clinical stage and serum hyaluronic acid content showed that there was a significant difference in serum hyaluronic acid content in the serum of patients with non malignant tumor of Gynecology, and there was significant difference in serum hyaluronic acid content in the patients with non cancer lymphatic metastasis (P0.05). There was a very significant difference (P0.01), indicating that the lymphatic metastasis of ovarian cancer, endometrial cancer and cervical cancer patients with gynecologic malignancies had a significant positive correlation with the increase of serum hyaluronic acid content in patients with ovarian cancer. The content of hyaluronic acid was significantly different from that of endometrial carcinoma (P0.01). The serum hyaluronic acid content in the sera of the patients with cervical cancer was significantly different from that of the non malignant gynecologic patients (P0.05). The serum hyaluronic acid content in the serum of the patients with ovarian cancer and endometrium carcinoma was associated with the clinical value. There were significant differences in different stages (P0.05), but the serum hyaluronic acid content in the sera of the patients with cervical cancer was not related to the clinical stage. The critical value of the serum tumor marker CA125 diagnostic index was 35 U/mL, the critical value of the CA19-9 diagnostic index, the critical value of the HE4 diagnostic index 150 pmol/L, the critical value of the SCC diagnostic index, 1.5 ng/mL, for the ovarian cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer The correlation analysis between the serum tumor markers and hyaluronic acid content in three patients with endometriosis and cervical cancer showed that the accuracy rate of the serum tumor markers CA125, HE4 and CA19-9 and the actual pathological diagnosis of ovarian cancer patients were 95.45%, 50% and 27.27%. were further analyzed for the serum swelling of ovarian cancer patients. The serum hyaluronic acid content of the tumor markers CA19-9 and HE4 negative patients was compared with the serum hyaluronic acid content in the serum of non malignant gynecologic cancer patients. The difference of serum hyaluronic acid reached significant (P0.05) and extremely significant (P0.01) levels, indicating that the serum hyaluronic acid detection in the serum of ovarian cancer patients may be more sensitive than the CA19-9 and HE4 detection of tumor markers. The results of serum tumor markers CA125 and CA19-9 in patients with endometrial cancer were 42.86% and 32.43%, respectively, but the serum hyaluronic acid content in serum of endometrial carcinoma serum tumor markers CA125 and CA19-9 negative patients was compared with the serum hyaluronic acid content in the serum of non malignant gynecologic cancer patients, respectively. The significant (P0.05) and extremely significant (P0.01) differences showed that the serum hyaluronic acid detection in patients with endometrial cancer might be more sensitive than the tumor markers CA125 and CA19-9. The accuracy rate of the serum tumor marker SCC in the patients with cervical cancer and the actual diagnosis was 57.14%, only the serum hyaluronic substance in the patients with positive tumor markers SCC detection was hyaluronic. There is a significant difference between the content of acid and the serum hyaluronic acid content in the serum of non malignant gynecologic cancer patients (P0.05). Our results show that the serum hyaluronic acid content in the serum of patients with ovarian cancer and endometrium cancer may be more sensitive than the detection of some of the present markers of swelling (such as HE4 and CA19-9), of course this study The result is only a preliminary study, and the research is not thorough enough. The samples collected are also limited. Our preliminary conclusions need further in-depth study.

【学位授予单位】：西南交通大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.31;R737.33

【参考文献】