發(fā)布時(shí)間：2018-02-02 04:42

  本文關(guān)鍵詞： 卵巢癌復(fù)發(fā) HE4 腫瘤標(biāo)記物 CA125　出處：《青島大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：研究目的:通過檢測(cè)83例卵巢癌患者血清中人附睪蛋白4(HE4)及CA125不同階段的水平,分析血清HE4水平、CA125水平與卵巢癌患者臨床病理特征(年齡、最大腫塊直徑、腹水量、殘留病灶大小、鉑類耐藥復(fù)發(fā)時(shí)間、卵巢癌FIGO分期、分化級(jí)別)之間的關(guān)系,采用CA125與HE4聯(lián)合檢測(cè)預(yù)測(cè)卵巢癌復(fù)發(fā)可能及程度,探討檢測(cè)HE4對(duì)預(yù)測(cè)卵巢癌術(shù)后復(fù)發(fā)的意義。研究方法:本研究采用酶聯(lián)免疫吸附(ELISA)方法測(cè)定83例卵巢癌患者血清標(biāo)本CA125、HE4的表達(dá)水平。分析不同時(shí)間卵巢癌患者血清CA125、HE4的表達(dá)水平與卵巢癌FIGO分期、分化級(jí)別、年齡、術(shù)后殘留病灶大小、術(shù)前腫物最大直徑、腹水、復(fù)發(fā)時(shí)間之間的關(guān)系,探討HE4對(duì)預(yù)測(cè)卵巢癌術(shù)后復(fù)發(fā)的意義。結(jié)果:患者術(shù)前血清中HE4表達(dá)水平與其臨床病理特征的統(tǒng)計(jì)分析表明,腹水量大于500ml和小于500ml的卵巢癌患者在術(shù)前HE4水平上的差異是具有統(tǒng)計(jì)學(xué)意義的,術(shù)前HE4的水平越高,提示卵巢癌患者腹水量較多。術(shù)后殘留病灶大于2cm和術(shù)后殘留病灶小于2cm的卵巢癌患者在術(shù)前HE4水平上的差異是具有統(tǒng)計(jì)學(xué)意義的,術(shù)前HE4水平越高,其手術(shù)切除干凈的難度越大,術(shù)后殘留病灶越大。卵巢癌的不同分期與術(shù)前HE4的水平之間是有差異的,且其差異具有統(tǒng)計(jì)學(xué)意義,術(shù)前HE4水平異常,多提示卵巢癌分期越晚。術(shù)后2周HE4下降幅度與臨床病理特征之間關(guān)系的統(tǒng)計(jì)分析顯示,不同的術(shù)前腫塊最大直徑在術(shù)后兩周HE4下降幅度上的差異是具有統(tǒng)計(jì)學(xué)意義的,術(shù)前腫塊最大直徑小于10cm的卵巢癌患者,術(shù)后兩周HE4下降幅度越可能超過50%,化療3療程后HE4水平與臨床病理特征之間關(guān)系的分析發(fā)現(xiàn),卵巢癌發(fā)病年齡在60歲以上及以下的在3療程后HE4水平上的差異是具有統(tǒng)計(jì)學(xué)意義的,卵巢癌的發(fā)病年齡越小,3療程后HE4值的水平越容易在正常范圍內(nèi)。不同的術(shù)前腫塊最大直徑在3療程后HE4水平上的差異是具有統(tǒng)計(jì)學(xué)意義的,術(shù)前腫塊最大直徑小于10cm的卵巢癌患者,3療程后HE4水平更趨于正常,其復(fù)發(fā)的時(shí)間可能更早。殘留病灶大小在3療程后HE4水平上的差異是具有統(tǒng)計(jì)學(xué)意義的。殘留病灶越小,3療程后HE4水平更趨于正常。其復(fù)發(fā)時(shí)間在3療程后HE4水平上的差別是具有統(tǒng)計(jì)學(xué)意義的。3療程后HE4水平異常,其復(fù)發(fā)的時(shí)間可能更早。CA125與HE4聯(lián)合檢測(cè)與單獨(dú)檢測(cè)出的結(jié)果的差別沒有統(tǒng)計(jì)學(xué)意義,其聯(lián)合檢驗(yàn)還需要進(jìn)一步研究。以上結(jié)論均通過統(tǒng)計(jì)學(xué)分析,P值均小于0.05。結(jié)論:卵巢癌患者的血清HE4水平對(duì)預(yù)測(cè)卵巢癌復(fù)發(fā)具有重要的臨床意義。
[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.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R737.31

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