血清铜蓝蛋白水平在HBV携带伴妇科肿瘤患者治疗中的意义

Clinical value of serum ceruloplasmin levels in HBV carriers with gynecologic tumor

目的探究血清铜蓝蛋白水平对HBV携带伴妇科肿瘤患者治疗和预后的意义。方法选取2013年6月1日至2016年7月3日于首都医科大学附属北京地坛医院住院的HBV携带伴妇科肿瘤患者90例为肿瘤组,包括42例良性肿瘤患者和48例恶性肿瘤患者,另外选取45例女性HBV携带者为对照组。采用免疫透射比浊法测定各组患者血清铜蓝蛋白含量,追踪随访20例恶性肿瘤根治术患者及6例术后复发患者的血清铜蓝蛋白水平,检测各组患者138和397位点上铜蓝蛋白的核心岩藻糖基化比率。结果良性肿瘤及恶性肿瘤根治术后患者血清铜蓝蛋白含量与对照组相比,差异无统计学意义(t值分别为0.771、0.534,P值分别为0.586、0.711);恶性肿瘤患者血清铜蓝蛋白水平显著高于良性肿瘤组及对照组,差异有统计学意义(t值分别为3.259和1.365,P值分别为0.013和0.022);行恶性肿瘤根治术的20例患者中有6例肿瘤复发,铜蓝白水平显著升高(t=3.255,P=0.015)。恶性肿瘤患者138位点和397位点铜蓝蛋白岩藻糖基化比率显著高于对照组及良性肿瘤组,差异有统计学意义(138位点:t值分别为3.567、4.556,P值分别为0.023、0.014;397位点:t值分别为4.598、4.620,P值分别为0.013、0.011)。结论检测肝脏合成的血清铜蓝蛋白水平对HBV携带伴妇科肿瘤患者的良、恶性鉴别有参考价值,并且对恶性肿瘤患者的随访具有一定意义。

Objective To investigate the clinical value of serum ceruloplasmin in the diagnosis and prognosis of hepatitis B virus carriers with gynecologic tumor. Methods Total of 90 HBV carriers with gynecologic tumor in Beijing Ditan Hospital,Capital Medical University from June 1, 2013 to July 3, 2016 were selected as cancer group （including 42 cases with benign tumors and 48 cases with malignant tumors） and another 45 female HBV carriers were selected as control group. Immunohistochemical rate nephelometer technique was used to assess the levels of serum ceruloplasmin. The core-fucosylation ratio of 138 site and 397 site were also detected.Results The serum level of ceruloplasmin in benign group and patients underwent radical resection of malignant tumor had no statistical differences compared with that in control group （t = 0.771, 0.534; P = 0.586, 0.711）. The serum levels of ceruloplasmin in patients with malignant tumor were significantly higher than those of patients with benign tumor and controls （t = 3.259, 1.365; P = 0.013, 0.022）. After radical correction, 6 out of 20 cases were found tumor recurred, whose serum ceruloplasmin levels increased significantly （t = 3.255, P = 0.015）.The ceruloplasmin core-fucosylation ratio of 138 site and 397 site of malignant tumor group were significantly higher than those of benign group and controls （138 site： t = 3.567, 4.556, P = 0.023, 0.014; 397 site： t = 4.598,4.620, P = 0.013, 0.011）. Conclusions Serum ceruloplasmin level has a reliable clinical value on the differential diagnosis of gynecological oncological diseases and has great significance on the follow-up strategy of cancer.