检测血清肿瘤型丙酮酸激酶在子宫内膜癌中的临床意义

Preliminary investigation of the clinical significance serum level of tumor M_2–pyruvate kinase in endometrial carcinoma

目的检测正常子宫内膜、子宫内膜增生症(单纯型增生、复杂型增生、不典型增生)和子宫内膜癌患者的血清肿瘤型丙酮酸激酶(Tu M2-PK),探讨其在子宫内膜癌发生发展中的作用,并初步分析其在子宫内膜癌中的临床意义。方法选取2009年8月至2010年8月在江门市中心医院妇科行子宫切除术或诊断性子宫内膜刮除术的患者140例,其中正常子宫内膜患者30例,子宫内膜增生症55例(单纯型增生15例,复杂型增生20例,不典型增生20例),子宫内膜癌55例,采用酶联免疫吸附试验(ELISA方法)检查其血清中的Tu M2-PK的浓度水平。结果 (1)正常子宫内膜、子宫内膜增生症患者中的血清Tu M2-PK水平差异无统计学意义(P>0.05),但与子宫内膜癌患者比较有显著性差异(P<0.01);(2)子宫内膜癌患者血清Tu M2-PK水平与手术分期及病理分级有相关性,即手术分期Ⅲ与分期Ⅰ-Ⅱ、病理分级G3与G1-G2之间差异有统计学意义(P<0.05;P<0.01),但与患者年龄、术前血清CA125值、肌层浸润深度、腹水细胞学无相关性(P>0.05)。结论子宫内膜良性病变的患者与子宫内膜癌患者的血清Tu M2-PK水平比较有显著性差异(P<0.01),子宫内膜癌患者血清Tu M2-PK水平与手术分期及病理分级密切相关,提示其有望成为子宫内膜癌临床诊断的生物学标志之一,对临床诊断治疗有一定作用。

Objective The expression of serum level of tumor M 2-pyruvate kinase（Tu M2-PK）in patients of normal endometrial,endometrial hyperplasia（simple hyperplasia,complex hyperplasia,atypical hyperplasia）and endometrial carcinoma will be tested in this paper.Thereby we can analyze the effect of development of Tu M2-PK on endometrial carcinoma and discuss its clinical significance in endometrial cancer.Methods We selected 140 patients who accepted the hysterectomy or endometrial biopsy from August 2009 to August 2010 in the Gynecology at Jiangmen Central Hospital.In our sample,there are 30 cases of normal endometrial tissues,55 endometrial hyperplasia（15simple hyperplasia,20 complex hyperplasia,20 atypical hyperplasia）and 55 endometrial carcinoma.the patients＇ serum level of Tu M2-PK was examined by ELISA（Enzyme-Linked Immunosorbnent Assay）.Results（1）There was no significant difference between the patients＇ serum level of Tu M2-PK in normal endometrial group and endometrial hyperplasia group（P〈0.05）,except endometrial carcinoma group（P〈0.01）.（2）The serum level of Tu M2-PK were positive related to clinical FIGO staging and histological grade of endometrial carcinoma.That is the differences between FIGO stage III and stage I-II,histological grade 3and grade 1-2were significant（P〈0.05;P〈0.01）.But Tu M2-PK had no relationship with the patients＇ age,the serum level of CA125 before operation,the depth of invasion and peritoneal cytology（P〈0.05）.3The diagnostic cutoff value for Tu M2-PK was 7.175.The expression of Tu M2-PK in tissues and the serum level of Tu M2-PK had a moderate positive correlation that the correlation coefficient is 0.551.ConclusionThe serum level of Tu M2-PK have close relationship with clinical FIGO staging and histological grade of endometrial carcinoma.Tu M2-PK may be a useful biomarker to detect the early carcinogenesis of endometrial carcinoma,and play a certain role in the diagnosis and treatment of endometrial carcinoma.