XIAP、survivin、LPA及CA125在上皮性卵巢癌中的表达

Expression of XIAP,Survivin,LPA and CA125 in human epithelial ovarian carcinoma

目的:探讨上皮性卵巢癌患者的组织标本中survivin mRNA和XIAP mRNA及血浆LPA和血清CA125表达与卵巢癌患者临床病理学指标的关系。方法:采用逆转录-聚合酶链反应(RT-PCR)法分别检测50例上皮性卵巢癌及12例正常卵巢组织标本中survivin mRNA和XIAP mRNA的表达,检测50例卵巢癌、44例卵巢良性疾病患者及20例健康女性血浆LPA和血清CA125的表达情况。结果:在正常卵巢标本与卵巢癌标本中,XIAP mRNA的阳性表达率分别为2/12(16.7%)、37/50(74%),差异有统计学意义(P<0.05);sur-vivin mRNA的阳性表达率分别为0、42/50(84%),差异有统计学意义(P<0.05)。survivin mRNA与XIAP mR-NA在卵巢癌组织中的表达呈正相关rs=0.03(P<0.05)。XIAPs、urvivin表达与肿瘤的病理分期、病理类型、淋巴结转移和腹水形成有关(P<0.05)。卵巢癌组血浆LPA均值为(7.67±3.02)μmol/L,阳性率为78.0%;卵巢良性疾病组LPA均值为(2.734±1.471)μmol/L,阳性率为27.3%,健康对照组LPA均值为(1.557±1.294)μmol/L,阳性率为5.0%,三者间的差异有统计学意义(P<0.05)。卵巢癌的诊断中LPA的特异度为75.0%,高于CA125;早期卵巢癌的诊断中二者联合检测的灵敏度最高,为85.7%;LPA的灵敏度为71.4%,高于CA125的28.6%,差异有统计学意义(P<0.05)。Ⅱ-Ⅳ期患者血浆LPA水平较Ⅰ期显著升高(P<0.01);Ⅱ-Ⅳ期各期之间无显著性差异(P>0.05)。3种病理类型中LPA阳性率的差异无显著性(P>0.05)。结论:survivin和XIAP基因系重要的肿瘤相关基因,与卵巢癌的发生发展有关;血浆LPA诊断早期卵巢癌的特异性和敏感性均高于CA125,联合检测有较高的临床价值。

Objective： To explore the expression of Survivin mRNA and XIAP mRNA in ovarian tissues and LPA and serum CA125 in plasma of patients with epithelial ovarian carcinoma and evaluate their correlation with the clinicopathological and other molecular parameters. Methods： The expression of Survivin mRNA and XIAP mRNA was determined by RT-PCR in 50 epithelial ovarian carcinoma tissues and 12 normal ovarian tissues, and the level of plasma LPA was determined by a reagent in 50 patients with epithelial ovarian carcinoma, 44 with ovarian benign diseases and 20 healthy women. Results： Expression of Survivin mRNA and XIAP mRNA had significant differences between epithelial ovarian carcinoma and normal ovarian tissues （ P 〈 0.05）. Expression of Survivin mRNA and XIAP mRNA increased in the 50 epithelial ovarian carcinoma tissues, which were related to the clinicopathological stage, degree, and lymph node metastasis （ P 〈 0.05）. Expression of survivin mRNA correlated with that of XIAP mRNA in 50 epithelial ovarian carcinoma tissues rs = 0.03 （ P 〈 0.05）. In the group of ovarian carcinoma, the mean LPA in plasma was （7.67 ± 3.02）μmol/L and the positive rate was 78.0%, while in the group of ovarian benign diseases, they were（2.734 ± 1.471） μmol/L and 27.3%, respectively, in the group of healthy women, they were（1.557 μ 1.294）μmol/L and 5%, respectively. The LPA specificity was 75.0% ,which was higher than CA125＇s. The sensitivity of LPA was 71.4% ,which was higher than that of CA125 （28.6%）（ P 〈 0.05）. The level of LPA in stage Ⅱ～Ⅳ was significantly higher than that in stage Ⅰ （ P 〈 0.05）. There were no statistical significance among stages Ⅱ～Ⅳ （ P 〉 0.05）, and no significant relations between the LPA value and the pathologic types（ P 〉 0.05）. Conclusions： Survivin and XIAP are candidate tumor genes related to the development of ovarian carcinoma. In early diagnosis of ovarian carcinoma, the specificity and sensitivity of LPA are beth higher than those of CA125.