CAJ | 학술논문

目的探讨卵巢上皮癌患者血清中人附睾蛋白4(HE4)的水平及其与患者预后的相关性.方法回顾性分析112例卵巢上皮癌患者的临床病理资料和随访信息,采用双抗体夹心酶联免疫吸附法和电化学发光免疫分析法测定患者治疗前血清中HE4和CA125的水平,分析治疗前血清HE4和CA125的水平与患者临床病理特征和预后的相关性.结果 112例卵巢上皮癌患者治疗前的血清HE4水平为26.9～ 3253.5 pmol/L,中位值为415.5 pmol/L;血清CA125水平为5～ 17 694 U/ml,中位值为699 U/ml.Spearman相关分析的结果显示,治疗前血清HE4水平与卵巢上皮癌患者的肿瘤分化程度(r=0.21,P=0.037)、术后病理分期(r=0.40,P=0.001)、腹水量(r=0.39,P=0.001)、血清CA125水平(r=0.53,P=0.001)以及术后残存肿瘤大小(r=0.22,P=0.027)相关,而与患者绝经与否无相关性(P=0.115).Logistic多因素回归分析显示,术后残存肿瘤大小与治疗前血清HE4水平无关(P =0.259).112例患者的平均生存时间为53.0个月.Log rank分析显示,低HE4组患者总生存时间比高HE4组明显延长(P=0.001).多因素Cox风险回归分析显示,治疗前血清HE4水平和术后残存肿瘤大小是影响患者总生存时间的独立因素(P =0.044和P=0.048).结论治疗前血清HE4水平是影响卵巢上皮癌患者预后的独立因素.血清HE4的测定可为卵巢上皮癌患者的预后评估提供有价值信息.
목적 탐토란소상피암환자혈청중인부고단백4(HE4)적수평급기여환자예후적상관성.방법 회고성분석112례란소상피암환자적림상병리자료화수방신식,채용쌍항체협심매련면역흡부법화전화학발광면역분석법측정환자치료전혈청중HE4화CA125적수평,분석치료전혈청HE4화CA125적수평여환자림상병리특정화예후적상관성.결과 112례란소상피암환자치료전적혈청HE4수평위26.9～ 3253.5 pmol/L,중위치위415.5 pmol/L;혈청CA125수평위5～ 17 694 U/ml,중위치위699 U/ml.Spearman상관분석적결과현시,치료전혈청HE4수평여란소상피암환자적종류분화정도(r=0.21,P=0.037)、술후병리분기(r=0.40,P=0.001)、복수량(r=0.39,P=0.001)、혈청CA125수평(r=0.53,P=0.001)이급술후잔존종류대소(r=0.22,P=0.027)상관,이여환자절경여부무상관성(P=0.115).Logistic다인소회귀분석현시,술후잔존종류대소여치료전혈청HE4수평무관(P =0.259).112례환자적평균생존시간위53.0개월.Log rank분석현시,저HE4조환자총생존시간비고HE4조명현연장(P=0.001).다인소Cox풍험회귀분석현시,치료전혈청HE4수평화술후잔존종류대소시영향환자총생존시간적독립인소(P =0.044화P=0.048).결론 치료전혈청HE4수평시영향란소상피암환자예후적독립인소.혈청HE4적측정가위란소상피암환자적예후평고제공유개치신식.
Objective To study the characteristics of HE4 expression in patients with epithelial ovarian cancer,and to evaluate whether the pre-treatment serum human epididymis protein 4 (HE4) level is an independent prognostic factor in the patients.Methods The clinicopathological characteristics and follow-up information of 112 patients with epithelial ovarian cancer were collected.The pre-treatment serum samples from these patients were measured for HE4 and CA125 expression.Serum HE4 levels were tested by a quantitative enzyme-linked immunosorbent assay (ELISA) and serum CA125 levels were tested using Elecsys kit.The correlation of HE4 and CA125 expressions with overall survival and other clinical data were analyzed.Results The median level of pre-treatment serum HE4 and CA125 in the 112 patients was 415.5 pmol/L (26.9-3253.5 pmol/L) and 699 U/ml (5-17 694 U/ml),respectively.Serum HE4 level before treatment was significantly related to grade (r =0.21,P =0.037),stage (r =0.40,P =0.001),amount of ascites (r =0.39,P =0.001),serum CA125 level (r =0.53,P =0.001) and residual disease after surgery (r=0.22,P =0.027),but was not related to menopausal stauts (P =0.115),revealed by Spearman correlation test.However,logistic multivariate regression analysis indicated that residual tumor size was not significantly correlated with pre-operative HE4 level (P =0.259).The mean survival of the 112 patients was 53 months.Log rank test indicated that the overall survival in patients with higher HE4 level was significantly shorter than those with lower HE4 level (P =0.001).Multivariate Cox proportional hazard model analysis revealed that the pre-treatment serum HE4 level and residual tumor size were independent prognostic factors for overall survival (P =0.044 and P =0.048).Conclusion Pre-treatment serum HE4 level is a valuable prognostic factor for the overall survival in patients with epithelial ovarian cancer.