血清MIC-1和CA125在卵巢上皮癌诊断及预后中的应用研究

摘要

目的：探讨巨噬细胞抑制因子-1（MIC-1）和CA125的卵巢癌诊断和预后判断价值。方法通过检测92例未经治疗的卵巢上皮癌患者（观察组）和96例健康女性（对照组）血清样本中的MIC-1和CA125水平，分析血清MIC-1和CA125水平与卵巢癌的关系；通过ROC曲线评价MIC-1和CA125单项及联合应用的卵巢癌诊断效能；通过对其中74例卵巢癌患者按术后残瘤大小和首次化疗敏感性结果分组，比较两组治疗前MIC-1和CA125水平，评价MIC-1和CA125的疗效评价价值；并通过分析68例患者的MIC-1和CA125水平与无瘤生存时间（relapse free survival，RFS）的关系评价其预后判断价值。结果观察组血清MIC-1水平显著高于对照组（P＜0.001）；MIC-1诊断卵巢癌的ROC（AUC=0.945）与CA125的ROC（AUC=0.966）比较差异无统计学意义，MIC-1和CA125联合应用的卵巢癌诊断效能显著提高（AUC=0.966）。术前CA125水平与术后残瘤大小显著相关（P=0.07）；术前血清MIC-1水平与化疗敏感性显著相关（P=0.001），并且血清MIC-1水平与患者RFS呈负相关。结论 MIC-1和CA125联合检测可提高卵巢癌的诊断率，MIC-1高水平预示卵巢上皮癌患者存在较大的耐药风险，且MIC-1可作为预测卵巢癌患者生存期的独立指标。%Objective To investigate the diagnostic and prognostic value of macrophage inhibitory cytokine-1 (MIC-1) and CA125 in patients with ovarian cancer. Method The levels and distribution of MIC-1 and CA125 in se-rum samples from 92 previously untreated patients with ovarian cancer (observation group) and 96 healthy normal subjects (control group) were analyzed. The association of the serum levels of MIC-1 and CA125 with ovarian were analyzed; and the clinical value of MIC-1 alone and its combination with CA125 were explored by ROC curve. The level of pre- and post-treatment MIC-1 and CA125 was compared in 74 cases of ovarian cancer for assessing their predictive value of therapeutic effect by postoperative residual tumor size and sensitivity to initial chemotherapy; Ad-ditionally, the relationship of MIC-1 and CA125 level with time of relapse free survival was investigated in 68 cases of ovarian cancer to evaluate the value of MIC-1 and CA125 in prognostic prediction. Result The serum levels of MIC-1 in observation group were significantly higher than those in control group (P<0.001). The ROC of MIC-1 (AUC, 0.945) was comparable to that of CA125 (AUC, 0.966). The diagnostic ability of MIC-1 was significantly in-creased as in combination with CA125 (AUC, 0.966). Furthermore, preoperative CA125 level was significantly corre-lated with the postoperative residual tumor size (P=0.07); And the preoperative serum MIC-1 level was significantly correlated with the chemotherapy sensitivity (P=0.001), and was negatively correlated with RFS. Conclusion The combined panel of MIC-1 and CA125 may significantly increase the diagnostic ability of tumor biomarker in ovarian cancer. High levels of MIC-1 indicate greater risk of drug resistance in ovarian cancer, and MIC-1 can be used as an independent indicator in predicting survival of patients with ovarian cancer.