HAase、HA在卵巢肿瘤患者血清、组织中的表达及临床意义

Hyaluronidase hyaluronic acid concentrations in serum and tissue extracts from patients with ovarian tumor and their clinical significance

目的:探讨卵巢肿瘤患者血清、组织中透明质酸酶(HAase)及透明质酸(HA)在其诊断、术后监测中的临床价值。方法:采用ELISA-likeAssay方法检测卵巢恶性肿瘤术前、术后随访时,良性卵巢肿瘤和正常对照血清及组织提取液中HAase及HA含量。结果:卵巢恶性肿瘤患者治疗前血清HAase高于良性肿瘤及正常对照(P<0.01);血HAase在复发组较未复发组升高(P<0.05),以300U/L为界值,检测卵巢恶性肿瘤的灵敏度为81.5%,特异度为77.3%,而检测临床复发的灵敏度为85.7%,特异度为72.7%。卵巢恶性肿瘤患者治疗前血清HA高于良性肿瘤及正常对照(P<0.01);且血清HA含量与FIGO分期、病理类型有关:其中FIGOIII～IV期高于I～II期(P<0.05);上皮性卵巢肿瘤(EOT)高于其它类型(P<0.05)。卵巢恶性肿瘤组织提取液中HAase活性高于良性肿瘤及正常对照(P<0.05);其活性与组织学分级相关(P<0.05);转移灶提取液中HAase活性较原发灶活性升高(P<0.01)。结论:HAase与肿瘤生长、浸润及转移等生物学行为有关。

Objective:To judge the value of hyaluronidase(HAase)activity and hyaluronic acid(HA)in the serum and tissues in diagnosis and postoperational surveilance for the patients with malignant ovarian tumor (MOT)and their relationship with biological behavior of ovarian tumor .Methods:HAase activity and HA concentration in serum specimens of patients with malignant and benign ovarian tumors and extracts from malignant and benign tumors and normal ovarian tissues were determined with ELISA-like Assay.Results:The HAase activity in the serum of patients(MOT)ovarian malignant tumor patients before surgery as remarkably higher than the serum of patients with benign tumor and in the control group(P<0.01).The HAase activity in serum of patients with relapse during follow-up period as significantly higher than in the serum of those with out relapse(P<0.01).The cut-off level of HAase activity was defined as300u /l,The sensitive rate was81.5%,and the specific rate was77.3%,For postoperative monitoring,the sensitive rate was85.7%,and the specific rate was72.7%.The serum HA levels before surgery in cases of (MOT)were significantly higher than those of in with benign tumor and in the control group(P<0.01).The serum HA levels before surgery in MOT cases of were closely associated with tumor stage,histology type,and ascitic cytology(P<0.05).The serum HA levels in patients with relapse during follow-up period were significantly higher than in patients with out relapse(P<0.05).it was much lower than those in the serum of MOT patients;The HAase activity in the extracts of MOT as significantly higher than in patients with benign tumor and in the control group(P<0.05).The HAase activity in extracts of the MOT tissues increased with histological grade(P<0.05)and tumor stage(P<0.05).The HAase activity in the extracts from metastases as significantly higher than from the primary tumor (P<0.01).The HA levels in extracts from MOT were similar to those from benign tumor and the control group(P>0.05).There were no significant association between clinic-pathological factors and HA levels in extracts(P>0.05).The HA levels in extracts from the primary tumor were the same as those in the metastases(P>0.05).Conclusions:It can be easily concluded that HAase and HA were crucial for the development,invasion and metastases of malignant ovarian tumor.