卵巢癌患者血清胸苷激酶1水平及其临床意义

Clinical significance of serum Thymidine Kinase 1 in ovarian cancer

目的 探讨卵巢癌患者血清胸苷激酶1（TK-1）水平及其临床意义。方法 研究2010年3月~2014年6月重庆市北部新区第一人民医院及重庆市西南医院就诊的初治卵巢癌患者116例（卵巢癌组）,选择同期卵巢良性肿瘤患者54例（卵巢良性肿瘤组）及健康体检者56例（健康对照组）。记录三组一般情况、临床特征等资料,采集血清检测TK-1及CA125水平。对接受治疗患者定期随访,观察无进展生存情况。对影响无进展生存时间的危险因素进行多因素Logistic回归分析。采用Pearson和Spearman系数进行各指标间的相关性分析。结果 卵巢癌组患者TK-1[（4.89±1.85）pmol/L]及CA125[（647.08±208.83）pmol/L]水平显著高于卵巢良性肿瘤组[（0.59±0.23）、（22.71±9.62）pmol/L]及健康对照组[（0.61±0.20）、（22.11±9.94）pmol/L],且临床分期越高TK-1水平越高,有远处转移患者TK-1较无转移更高（均P〈0.01）。血清TK-1与CA125水平及临床分期呈正相关（r=0.657、0.567,均P〈0.01）。初始高TK-1水平（≥4.00 pmol/L）患者远期（30个月）无进展生存比率较低TK-1水平（〈4.00 pmol/L）患者更低,差异有统计学意义（P=0.011）。临床分期、初始CA125及TK-1水平是无进展生存时间的负性影响因素。结论 卵巢癌患者血清TK-1显著升高,与临床分期及CA125水平相关。初始高TK-1水平预示预后较差,高临床分期、初始高CA125及TK-1水平影响治疗后无进展生存时间。

Objective To investigate the serum thymidine kinase 1 （TK-1） level and its clinical significance of patients with primaryovarian cancer. Methods The research included 116 patients with ovarian cancer （ovarian cancer group） from March 2010 to June 2014 in the First People＇s Hospital of Chong Qing New North Zone and Southwest Hospital of Chongqing, while the 54 patients with ovarian benign tumor （ovarian benign tumor group） and 56 cases of healthy con- trol （healthy controls group）were selected. The general situation, clinical manifestations of three groups were recorded and levels of serum TK-1 and CA125 were detected. Patients with treatment were followed up regularly, and the risk factors of progression-free survival time were analyzed with Logistic regression. The correlation between the indexes were analyzed by Pearson and Spearman coefficient. Results The levels of TK-1 [（4.89±1.85） pmol/L] and CA125 [（647.08±208.83） pmol/L] of patients in the ovarian cancer group were significantly higher than those in the ovarian be- nign tumor group [（0.59±0.23）, （22.71±9.62） pmol/L] and healthy control group [（0.61±0.20）, （22.11±9.94） pmol/L]. The TK-1 levels were higher in patients with advanced clinical stageor and distant metastasis than others （all P 〈 0.01）. The level of TK-1 was significant positive correlation with CA125 level and clinical stage （r = 0.657, 0.567, all P 〈 0.001）. The long-term （about 30 months）progression-free survival rate of patients with initial high level of TK-1 （≥4.00 pmol/L） was lower than that of the low level （〈4.00 pmol/L）, the difference was statistically significant （P = 0.011）. Clinical stage, initial levels of CA125 and TK-1 were negative risk factors of progression-free survival time. Conclusion There is significant increase of serum TK-1 level in ovarian cancer patients, and it is related to the CA125 level and clinical stage. Initial high TK-1 level predicts poor prognosis. Advanced clinical stage, the initial high level of CA125 and TK-1 affect progression-free survival time after treatment.