卵巢肿瘤患者外周血乙酰肝素酶测定及临床意义

Detection and Clinical Significance of Serum Heparanase in Malignant Ovarian Tumor

目的:探讨卵巢肿瘤患者外周血乙酰肝素酶(Hpa)含量测定的临床价值。方法:选择经病理学检查确诊的卵巢肿瘤,采用酶联免疫吸附法(ELISA)检测51例卵巢恶性肿瘤患者血清标本,其中未接受治疗26例(恶性治疗前组)、术后16例(恶性术后组)、复发9例(复发组);17例卵巢良性肿瘤(良性组)及16例正常妇女(对照组)血清中Hpa的表达。并将其与患者临床病理关系及预后进行分析。结果:①恶性治疗前组血清中Hpa含量(39.00±7.26μg/L)显著高于良性组(32.36±6.17μg/L)及对照组(26.22±8.06μg/L),差异有高度统计学意义(P<0.01);复发组、恶性术后组血清中Hpa含量(35.89±4.48μg/L,33.85±6.96μg/L)均高于对照组,差异均有高度统计学意义(P<0.01),与良性组差异均无统计学意义(P>0.05)。卵巢恶性肿瘤患者术后血清Hpa含量明显低于术前(31.58±5.67μg/L与38.02±7.74μg/L),差异有统计学意义(P<0.05)。②卵巢恶性肿瘤患者血清Hpa含量与肿瘤的临床分期、组织学分化程度、腹水量和有无肝转移相关(P<0.05)。③ROC曲线Hpa取值31.59μg/L时,术前判断卵巢恶性肿瘤的敏感度为74.5%,特异度为75.0%。结论:Hpa的表达与卵巢恶性肿瘤的发生、发展有关。Hpa有望成为临床上判断卵巢恶性肿瘤的指标之一。

Objective：To explore the clinical significance of serum heparanase（Hpa） detection in patients with malignant ovarian tumors.Methods：The serum heparanase（Hpa） was detected by enzyme-linked immunosorbent assay in 51 cases of ovarian cancers confirmed by pathology,in which 26 cases were without any treatment（malignant preoperation） ,16 cases were after operation（malignant postoperation） ,9 cases were recurrence（recurrence group） ,17 cases were with ovarian benign tumors（begin group） and 16 cases were normal controls（control group） . The relationship between the serum heparanase（Hpa） and clinical pathology as well as prognosis was analyzed.Results：The serum levels of the Hpa in malignant preoperation group（39.00±7.26 μg/L） were significantly higher than that in the benign group（32.36±6.17 μg/L） and control group（26.22±8.06 μg/L）（P0.01） . The serum levels of the Hpa were significantly higher in recurrent group（35.89±4.48 μg/L） and malignant postoperation group（33.85±6.96 μg/L） than that in control group（P0.01） ,but no significant difference to benign group（P0.05） . The serum levels of the Hpa in malignant ovarian tumor were significantly higher in pre-operation than that in post-operation（38.02±7.74 μg/L,31.58±5.67 μg/L）（P0.05） ②The serum level of Hpa in ovarian cancer was associated with tumor clinical stage,tumor pathological grade,ascitic fluid amount and metastasis（P0.05） ,but there was no relationship between the serum contain of heparanase（Hpa） and histotypes,lymph node and omentum metastasis（P0.05） .③ The ROC curve showed when heparanase（Hpa） value was 31.59 g/L,the sensitivity and specificity to determine invasion and metastasis of malignant ovarian tumors preoperatively was 74.5% and 75.0% respectively.Conclusions：The expression of Hpa is correlated with carcinogenesis and progress of ovarian cancer and is expected to become as indicators for judging invasion and metastasis.