卵巢上皮癌患者血清中人附睾蛋白4的水平及其与预后的相关性  

Expression of serum human epididymis protein 4 in epithelial ovarian cancer and its correlation with prognosis

作　　者：郑虹[1] 高雨农[1] 高维娇[1] 高敏[1] 燕鑫[1] 

机构地区：[1]100142北京大学肿瘤医院暨北京市肿瘤防治研究所妇科恶性肿瘤发病机制及转化研究教育部重点实验室

出　　处：《中华肿瘤杂志》2013年第6期445-449,共5页Chinese Journal of Oncology

摘　　要：目的探讨卵巢上皮癌患者血清中人附睾蛋白4（HE4）的水平及其与患者预后的相关性。方法回顾性分析112例卵巢上皮癌患者的临床病理资料和随访信息，采用双抗体夹心酶联免疫吸附法和电化学发光免疫分析法测定患者治疗前血清中HE4和CA125的水平，分析治疗前血清HE4和CA125的水平与患者临床病理特征和预后的相关性。结果112例卵巢上皮癌患者治疗前的血清HE4水平为26．9～3253．5pmol／L，中位值为415．5pmol／L；血清CA125水平为5～17694U／ml，中位值为699U／ml。Spearman相关分析的结果显示，治疗前血清HE4水平与卵巢上皮癌患者的肿瘤分化程度（r=0．21，P=0．037）、术后病理分期（r=0．40，P=0．001）、腹水量（r=0．39，P=0．001）、血清CA125水平（r=0．53，P：0．001）以及术后残存肿瘤大小（r=0．22，P=0．027）相关，而与患者绝经与否无相关性（P=0．115）。Logistic多因素回归分析显示，术后残存肿瘤大小与治疗前血清HE4水平无关（P=0．259）。112例患者的平均生存时间为53．0个月。Logrank分析显示，低HE4组患者总生存时间比高HE4组明显延长（P=0．001）。多因素Cox风险回归分析显示，治疗前血清HFA水平和术后残存肿瘤大小是影响患者总生存时间的独立因素（P=0．044和P=0．048）。结论治疗前血清HFA水平是影响卵巢上皮癌患者预后的独立因素。血清HE4的测定可为卵巢上皮癌患者的预后评估提供有价值信息。Objective To study the characteristics of HEd expression in patients with epithelial ovarian cancer, and to evaluate whether the pre-treatment serum human epididymis protein 4 （HE4） level is an independent prognostic factor in the patients. Methods The clinicopathological characteristics and follow-up information of 112 patients with epithelial ovarian cancer were collected. The pre-treatment serum samples from these patients were measured for HEd and CA125 expression. Serum HE4 levels were tested by a quantitative enzyme-linked immunosorbent assay （ELISA） and serum CA125 levels were tested using Elecsys kit. The correlation of HFA and CA125 expressions with overall survival and other clinical data were analyzed. Resdts The median level of pre-treatment serum HE4 and CA125 in the 112 patients was 415. 5 pmol/L （26.9-3253.5 pmol/L） and 699 U/ml （5-17 694 U/ml）, respectively. Serum HE4 level before treatment was significantly related to grade （ r = 0.21, P = 0. 037 ）, stage （ r = 0.40,P = 0.001 ）, amount of aseites （ r = 0.39 ,P = 0.001 ）, serum CA125 level （ r = 0.53 ,P = 0. 001 ） and residual disease after surgery （r=0.22,P =0. 027）, but was not related to menopausal stauts （P =0. 115）, revealed by Spearman correlation test. However, logistic multivariate regression analysis indicated that residual tumor size was not significantly correlated with pre-operative HE4 level （P =0.259）. The mean survival of the 112 patients was 53 months. Log rank test indicated that the overall survival in patients with higher HE4 level was significantly shorter than those with lower HE4 level （ P = 0. 001 ）. Multivariate Cox proportional hazard model analysis revealed that the pre-treatment serum HFA level and residual tumor size were independent prognostic factors for overall survival （P = 0.044 and P = 0.048）. Conclusion Pre-treatment serum HE4 level is a valuable prognostic factor for the overall survival in patients with epithelial ovarian cancer.

关 键 词：人附睾蛋白4 CA125 卵巢肿瘤 预后 

分 类 号：R737[医药卫生—肿瘤]