卵巢肿瘤患者血清尿激酶型纤溶酶原激活物及其抑制物1含量检测的临床意义

Clinical Significance of Serum uPA,PAI-1 in Detection of Ovarian Cancer Metastasis

目的：探讨血清尿激酶型纤溶酶原激活物（uPA）及其抑制物1（PAI-1）含量的检测对卵巢恶性肿瘤浸润转移诊断的临床意义。方法：采用酶联免疫吸附反应（ELISA）检测49例卵巢恶’性肿瘤，49例卵巢良性肿瘤和49例正常健康妇女血清中uPA和PAI—1含量。并对其中22例卵巢上皮性癌患者手术治疗前后外周血uPA和PAI—1含量进行动态观察，分析其与临床病理因素及预后关系和作为卵巢恶性肿瘤浸润转移诊断标志物的可能性。结果：①卵巢恶性肿瘤患者血清中uPA和PAI．1含量明显高于正常对照和良性肿瘤（P〈0．01）。②卵巢恶性肿瘤患者术后血清uPA和PAI-1含量较术前有明显下降（P〈0．01）。③低分化恶性肿瘤、Ⅲ～Ⅳ期、有淋巴结转移患者术前血清uPA和PAI-1含量均明显高于高中分化者（P〈0．05，P〈0．01）、Ⅰ～Ⅱ期患者（P〈0．05，P〈0．01）、无淋巴结转移者（P〈0．05，P〈0．01），大网膜转移者术前血清uPA含量高于无大网膜转移者（P〈0．05）。④uPA或PAI-1阳性者和阴性者的中位生存时间相比较差异均无统计学意义（P〉0．05）。结论：卵巢恶性肿瘤患者血清uPA和PAI-1含量高低与其疾病进展相关，血清uPA和PAI．1含量测定有助于判断卵巢恶性肿瘤浸润转移。

Objective：To explore the clinical significance of serum uPA, PAl-1 in detecting ovarian cancer metastasis. Methods：Serum uPA and PAl-1 were checked by immune response adsorption （ELISA） in 49 patients with ovarian cancer, 49 patients with ovarian benign tumors and 49 health women. Dynamic obser- vation of uPA and PAl-1 were done in 22 ovarian cancer patients before and after operation, the correlation of these two parameters with clinicopathological factors and prognosis were explored. Results.①The serum uPA and PAl-1 in patients with malignant ovarian tumor were significantly higher than those in healthy women and benign tumors （P 〈0.01 ）. ②The serum uPA and PAl-1 dropped markedly in ovarian malignant patients after operation than before （ P 〈0.01 ）. ③The serum uPA and PAl-1 levels in patients with poor differentiation or Ⅲ - Ⅳstage or with lymph node or omental metastasis were significantly higher than those in high to mod- erate differentiation（ P 〈0.05,P〈0.01 ）, or Ⅰ - Ⅱ stages（ P〈0.05,P〈0.01 ）, or without lymph nodes（ P 〈0.05,P〈0.01 ） and without omental metastasis （P 〈0.05,P〈0.01 ）. ④There was no significant differ- ence in median survival time between patients with positive uPA or PAl-1 and with negative results （ P 〉0.05 ）. Conclusions ：The serum uPA and PAl-1 levels in ovarian cancer patients have connection with the dis- ease progression, and checking serum uPA and PAl-1 could be helpful for diagnosing invasive and metastatic disease in ovarian cancer.