血浆溶血磷脂酸及CA125水平与子宫内膜癌临床病理特征的关系

Relationship between plasma lysophosphatidic acid and CA125 level with the clinical and pathological characteristics of endometrial carcinoma

目的：探讨血浆溶血磷脂酸（LPA）及CA125在子宫内膜癌的表达及与临床病理特征之间的关系。方法：利用化学比色法检测65例子宫内膜癌患者和40例子宫内膜非典型增生患者及40例健康献血员（对照组）血浆溶血磷脂酸含量,同时采用电化学发光法检测血浆CA125含量并作对比分析。结果：子宫内膜癌组患者血浆LPA水平为（5.87±2.02）μmol/L,明显高于对照组（2.31±0.45）μmol/L（P〈0.01）,子宫内膜非典型增生组与对照组比较,差异无统计学意义（P〉0.05）。LPA和CA125对子宫内膜癌诊断的灵敏度分别为69.2%、63.1%,特异度为60.0%、53.8%;LPA对子宫内膜癌早期（0＋Ⅰ期）诊断的阳性率明显高于晚期（Ⅱ~Ⅳ期）（P〈0.05）。与肿瘤大小无明显的相关性（P〉0.05）。其阳性率随病理分级逐渐降低并有显著性差异（P均〈0.05）,且随肿瘤浸润肌层深度及淋巴结转移程度增加亦逐渐降低（P均〈0.05）。而CA125阳性率随着病理分级逐渐升高,并有显著性差异（P均〈0.01）,在深肌层浸润及子宫外转移病例中明显升高（P均〈0.01）。结论：血浆LPA检测对子宫内膜癌的早期诊断及鉴别诊断具有一定的临床应用价值,明显优于CA125,LPA可作为判断子宫内膜癌预后的重要指标。

Objective：To study plasma lysophosphatidic acid （LPA） and the CA125 expression in endometrial carcinoma and the relationship with clinical pathological characteristics. Methods：Using chemical colorimetric assay for detection of endometrial carcinoma in 65 cancer and 40 cases of endometrial atypical hyperplasia and 40 healthy blood donors （the control group） of plasma lysophosphatidic acid concentrations using electrochemiluminescence immunoassay for detection of serum CA125 concentration. Results：Plasma LPA level in patients with endometrial cancer group （5.87±2.02 ）μmol/L was significantly higher than the control group （ 2.31± 0.45 ）μmol/L （P 〈 0.01 ）. Endometrial atypical hyperplasia group compared with the control group, the difference was not statistically sigificant （P 〉0.05）. The sensitivity and specificity of plasma LPA for endometrial carcinoma were 69.2% and 60.0% ,with 63.1% and 53.8% for CA125. LPA expression in endometrial carcinoma was related with pathological type, surgical staging, histological grade, depth of tumor invasion muscle and lymph node metastases （ P 〈 0.05 ）. For early endometrial cancer （ stage 0 ＋ I ） diagnostic - positive rate was significantly higher than the advanced （ phase Ⅱ-Ⅳ） （ P 〈 0.05 ）. No significant correlation with tumor size （ P 〉 0.05 ） and its positive rate with pathological stage in patients was decreased and there was a significant difference （ both P 〈 0.05 ） , and will gradually decrease with the degree of lymph node metastasis and depth of tumor invasion muscle growth （ both P 〈 0.05 ）. Rising CA125 and positive rate of pathological stage in patients with progressive,and there was a significant difference （both P 〈0.01 ）. Conclusion： Plasma LPA on early diagnosis and differential diagnosis of endometrial cancer has some clinical value, and significantly better than CA125. LPA is an important indicator of prognosis of endometrial carcino-