hTERT与血清CA125联合检测对子宫内膜癌诊断和评估预后的价值

Combined detection of the expressions of hTERT and the serum levels of CA125 in endometrium carcinoma and their significance

目的探讨端粒酶逆转录酶(hTERT)与血清CA125联合检测对子宫内膜癌诊断和预后评估的价值。方法采用免疫组化SP法分别检测试验组的46例子宫内膜癌术后标本和选作对照的同期内膜标本,包括20例不典型增生(EIN)、40例单纯及复杂增生和20例正常子宫内膜hTERT的表达,并采用放射免疫法检测患者术前血清CA125水平。结果 (1)hTERT在内膜癌组中的表达高于正常子宫内膜组、单纯及复杂增生组和EIN组(P<0.05),hTERT对诊断子宫内膜癌的敏感度为76.1%,特异度为80.2%,准确度为71.4%;上述四组中血清CA125在内膜癌组中的阳性表达明显高于对照各组(P<0.05),血清CA125诊断子宫内膜癌的敏感度为56.5%,特异度为77.6%,准确度为74.6%;(2)病灶组织hTERT和血清CA125水平的阳性表达与子宫内膜癌患者的手术病理分期(FIGO分期,2009)及组织学分级有关联(P<0.05);(3)病灶组织hTERT和血清CA125联合检测诊断子宫内膜癌的敏感度为80.6%,特异度为88.6%,准确度为81.4%,较hTERT和CA125单项检测敏感度、特异度和准确度均增高(P<0.05)。结论病灶组织hTERT联合血清CA125对子宫内膜癌具有较好的诊断价值,同时对评估预后有重要作用。

[ Objective ] To observe the expression of human telomerase reverse transcriptase （hTERT） and the serum levels of CA125 in patients with endometrial carcinoma（EC） and to explore their clinical significance. [ Methods ] The expression of hTERT was examined with immunohistochemistry and the serum levels of CA125 were determined with radioimmunity in 46 cases of EC and 80 cases of control group（includlng 20 eases of EIN,40 cases of endometrial simple and complex hyperplasia,20 cases of normal endometrium）.All of the subjects come from Jinan Military General Hospital ~ Pathology is the final diagnostic criteria. [ Results ] （1）The expression of hTERT was stronger in cancer group than the other groups （P〈0.05）. The sensitivity and specificity and accuracy were 76.1% and 80.2% and 71.4% respectively. There was significant difference in the serum level of CA125 between EC and the other three control groups （P 〈 0.05）.The sensitivity and specificity and accuracy were respectively 56.5% and 77.6% and 74.6%;（2） The expression of hTERT and the serum levels of CA125 were significantly higher in patients with more advanced diseases （lower grade differentiation and higher FIGO stage） than those in patients with less advanced diseases （P〈0.05）. （3）The sensitivity and specificity and accuracy of combining detection of the expression of hTERT with the serum levels of CA125 were 80.6% and 88.6% and 81.4%, and it was better than detection of hTERT or the serum levels of CA125 alone （P〈0.05）. [ Conclusion ] Combined determination of hTERT with the serum levels of CA125 can not only improve the diagnostic sensitivity but also indicate prognosis of the patients with endometrlal carcinoma.