血清MIC-1和CA125在卵巢上皮癌诊断及预后中的应用研究  

Application of serum MIC-1 and CA125 in diagnosis and prognosis of ovarian epithelial cancer

作　　者：赵丹[1] 田海梅[2] 李艳芬[2] 李茉[2] 吴令英[1] 李斌[1] 赵文雅[2] 张超[2] 王腾[2] 王小兵[2] 张伟[2] 

机构地区：[1]北京协和医学院中国医学科学院肿瘤医院妇瘤科,北京100021 [2]北京协和医学院中国医学科学院肿瘤医院生物检测中心,北京100021

出　　处：《癌症进展》2015年第6期618-622,共5页Oncology Progress

基　　金：国家高技术研究发展计划(863计划)(2008AA02Z415);国家自然科学基金(81441080)

摘　　要：目的探讨巨噬细胞抑制因子-1(MIC-1)和CA125的卵巢癌诊断和预后判断价值。方法通过检测92例未经治疗的卵巢上皮癌患者(观察组)和96例健康女性(对照组)血清样本中的MIC-1和CA125水平,分析血清MIC-1和CA125水平与卵巢癌的关系;通过ROC曲线评价MIC-1和CA125单项及联合应用的卵巢癌诊断效能;通过对其中74例卵巢癌患者按术后残瘤大小和首次化疗敏感性结果分组,比较两组治疗前MIC-1和CA125水平,评价MIC-1和CA125的疗效评价价值;并通过分析68例患者的MIC-1和CA125水平与无瘤生存时间(relapse free survival,RFS)的关系评价其预后判断价值。结果观察组血清MIC-1水平显著高于对照组(P<0.001);MIC-1诊断卵巢癌的ROC(AUC=0.945)与CA125的ROC(AUC=0.966)比较差异无统计学意义,MIC-1和CA125联合应用的卵巢癌诊断效能显著提高(AUC=0.966)。术前CA125水平与术后残瘤大小显著相关(P=0.07);术前血清MIC-1水平与化疗敏感性显著相关(P=0.001),并且血清MIC-1水平与患者RFS呈负相关。结论 MIC-1和CA125联合检测可提高卵巢癌的诊断率,MIC-1高水平预示卵巢上皮癌患者存在较大的耐药风险,且MIC-1可作为预测卵巢癌患者生存期的独立指标。Objective To investigate the diagnostic and prognostic value of macrophage inhibitory cytokine-1 （MIC-1） and CA125 in patients with ovarian cancer. Method The levels and distribution of MIC-1 and CA125 in se-rum samples from 92 previously untreated patients with ovarian cancer （observation group） and 96 healthy normal subjects （control group） were analyzed. The association of the serum levels of MIC-1 and CA125 with ovarian were analyzed; and the clinical value of MIC-1 alone and its combination with CA125 were explored by ROC curve. The level of pre- and post-treatment MIC-1 and CA125 was compared in 74 cases of ovarian cancer for assessing their predictive value of therapeutic effect by postoperative residual tumor size and sensitivity to initial chemotherapy; Ad-ditionally, the relationship of MIC-1 and CA125 level with time of relapse free survival was investigated in 68 cases of ovarian cancer to evaluate the value of MIC-1 and CA125 in prognostic prediction. Result The serum levels of＆amp;nbsp;MIC-1 in observation group were significantly higher than those in control group （P〈0.001）. The ROC of MIC-1 （AUC, 0.945） was comparable to that of CA125 （AUC, 0.966）. The diagnostic ability of MIC-1 was significantly in-creased as in combination with CA125 （AUC, 0.966）. Furthermore, preoperative CA125 level was significantly corre-lated with the postoperative residual tumor size （P=0.07）; And the preoperative serum MIC-1 level was significantly correlated with the chemotherapy sensitivity （P=0.001）, and was negatively correlated with RFS. Conclusion The combined panel of MIC-1 and CA125 may significantly increase the diagnostic ability of tumor biomarker in ovarian cancer. High levels of MIC-1 indicate greater risk of drug resistance in ovarian cancer, and MIC-1 can be used as an independent indicator in predicting survival of patients with ovarian cancer.

关 键 词：卵巢癌 巨噬细胞抑制因子-1 CA125 诊断 预后 

分 类 号：R737.31[医药卫生—肿瘤]