子宫内膜样腺癌患者组织与血清中YKL-40蛋白的表达

YKL-40 protein levels both in serum and tissue of human endometrioid adenocarcinoma of uterine corpus

目的:探讨子宫内膜样腺癌患者血清及组织中人类软骨糖蛋白(YKL-40)表达的临床意义,并分析其与不同病理特征的相关性。方法:用酶联免疫吸附法(ELISA)测定41例子宫内膜样腺癌患者、27例子宫肌瘤患者及30例正常妇女外周血血清中YKL-40的表达;用免疫组化法检测子宫内膜样腺癌、子宫肌瘤患者组织中YKL-40的表达;分析其在血清及组织中的表达相关性,并分析血清YKL-40与子宫内膜样腺癌病理特征的关系。结果:(1)子宫内膜样腺癌组术前血清YKL-40浓度(157.2μg/L,76.0～301.2μg/L)明显高于子宫肌廇组(86.6μg/L,69.3～183.6μg/L)及正常组(86.2μg/L,52.1～201.1μg/L)(P均<0.05);子宫内膜样腺癌组患者组织中YKL-40表达阳性率(34.1%,14/41)显著高于子宫肌瘤组(11.1%,3/27)(P<0.05);子宫内膜样腺癌患者血清YKL-40表达阳性率显著高于组织(63.4%vs 34.1%,P<0.05)。(2)单因素分析提示,子宫内膜样腺癌患者术前血清YKL-40浓度与FIGO分期、组织分级、细胞冲洗液阳性、血清CA125浓度及YKL-40组织表达有关(P<0.05);多因素分析结果表明,其与FIGO分期(P<0.05)及组织分级(P<0.01)有关;结论:子宫内膜癌诊治中,检测YKL-40有一定临床意义,其来源可能不局限于肿瘤细胞。

Objective：To determine the expression of YKL-40 in tumor tissue and serum in patients with endometrioid adenocarcinoma of uterine corpus（EA）,and examine the association between the expression of YKL-40 and clinicopathologic features of patients with EA.Methods：Preoperative serum levels of YKL-40 were examined by enzyme linked immunosorbent assay（ELISA） from 41 patients with EA,27 patients with hysteromyoma and 30 normal individuals.YKL-40 protein expression in tissue was determined by immunohistochemistry for the corresponding 41 patients with EA and 27 patients with hysteromyoma.Statistical analysis was performed to examine the relationship of the tissue expression of YKL-40 with the corresponding serum value in EA,and to correlate serum YKL-40 with clinicopathologic features of EA patients.Results：（1）Median preoperative serum YKL-40 level of EA was 157.2μg/L（range,76.0~301.2μg/L） for EA patients,compared with 86.6 μg/L（range,69.3~183.6 μg/L） for hysteromyoma（P0.05）,86.2μg/L（range,52.1~201.1μg/L） for normal healthy subjects（P0.05）.The positive rate of YKL-40 tissue staining was higher in EA patients（34.1%,14/41）than hysteromyoma（11.1%,3/27）（P0.05）.The frequency of positive tissue staining（34.1%） tended to be lower than that of elevated serum levels（63.4%,26/41）（P0.05）.（2）In multivariate analysis,elevated serum YKL-40 level was significantly correlated with FIGO stage（P0.05） and histologic grade（P0.01） other than age,washing cytology,and serum CA125 level,which were significant in the univariate analysis.Conclusions：The elevated level of preoperative serum YKL-40 may represent a novel marker for the detection of EA.Intrauterine tumor may not be the main source of serum YKL-40 in EA.