CA<sub>125</sub>，CA<sub>19-9</sub>在子宫内膜癌组织学和血清学中表达水平的差异性及相关性研究

doi:10.3877/cma.j.issn.1673-5250.2013.02.013

目的

探讨CA₁₂₅，CA_19-9在子宫内膜癌组织学和血清学中表达水平的差异性及相关性。

方法

选择2008年4月至2012年4月于广东医学院附属廉江医院就诊并诊断为子宫内膜癌患者65例为研究对象，同时选取正常子宫内膜者30例纳入对照组及子宫内膜异位症(EMs)患者40例纳入EMs组。采用ELISA法检测3组患者血清CA₁₂₅和CA_19-9水平，并采用免疫组化和Western blot法检查3组患者组织CA₁₂₅和CA_19-9表达水平，分析CA₁₂₅和CA_19-9在子宫内膜癌血清学和组织学中表达水平的相关性(本研究遵循的程序符合广东医学院附属廉江医院人体试验委员会制定的伦理学标准，得到该委员会批准，分组征得受试对象的知情同意，并与之签署临床研究知情同意书)。

结果

Western blot、免疫组化及ELISA法检测结果均显示，CA₁₂₅，CA_19-9水平在子宫内膜癌组中表达最高，显著高于对照组和EMs组，组间比较，差异有统计学意义(P<0.05)，此外，CA₁₂₅，CA_19-9在EMs组水平亦高于正常组，两组比较，差异有统计学意义(P<0.05)。子宫内膜癌组患者血清CA₁₂₅和CA_19-9与其组织学表达水平具有相关性(r＝1.12，P<0.05；r＝2.04，P<0.05)。

结论

CA₁₂₅和CA_19-9在子宫内膜癌中高表达，且血清学水平与组织学水平具有正相关性，具有重要的诊断价值。

关键词: 子宫内膜癌, CA₁₂₅, CA_19-9, 相关性

Objective

To discuss the expression and relationship of the tissue and serum level of CA₁₂₅ and CA_19-9 in endometrial cancer.

Methods

From April 2008 to April 2012, sixty-five cases of endometrial cancer were selected into this study (endometrial cancer group). Meanwhile, thirty cases of normal endometria were included into control group and 40 cases of endometriosis (EMs) were selected as EMs group. The serum levels of CA₁₂₅ and CA_19-9 were detected by ELISA, and the histological expression level of CA₁₂₅ and CA_19-9 were detected by immunohistochemistry and Western blot. The correlation of CA₁₂₅ and CA_19-9 were analyzed. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Affiliated Lianjiang Hospital of Guangdong Medical College. Informed consent was obtained from all participates.

Results

The expression of CA₁₂₅ and CA_19-9 in endometrial cancer group were significantly higher than those in EMs group and control group (P<0.05). The level of CA₁₂₅ and CA_19-9 in EMs group were significantly higher than those of control group (P<0.05). The serum level of CA₁₂₅ and CA_19-9 were significantly related with histological expression (r=1.12, P<0.05; r=2.04, P<0.05).

Conclusions

CA₁₂₅ and CA_19-9 have high expression in endometrial cancer, and they have positive correlation between serum level and histology level, which have important diagnostic value.

Key words: endometrial cancer, CA₁₂₅, CA_19-9, correlation

表1 3组患者血清CA₁₂₅和CA_19-9水平及其阳性率比较(±s)

Table 1 Comparison of serum CA₁₂₅ and CA_19-9 levels and positive rates among three groups (±s)

组别	n	CA₁₂₅		CA_19-9
组别	n	水平(U/mL)	阳性率[n(%)]	水平(U/mL)	阳性率[n(%)]
子宫内膜癌组	65	98.40±7.71^{a b}	62(95.38)^{a b}	112.34±10.71^{a b}	63(96.92)^{a b}
EMs组	40	48.36±5.56^a	18(45.00)^a	51.91±6.62^a	21(52.50)^a
对照组	30	28.27±4.21	1 (3.33)	30.32±3.65	2 (6.67)
χ²/t		21.54	19.64	11.62	24.87

表1 3组患者血清CA₁₂₅和CA_19-9水平及其阳性率比较(±s)

Table 1 Comparison of serum CA₁₂₅ and CA_19-9 levels and positive rates among three groups (±s)

组别	n	CA₁₂₅		CA_19-9
组别	n	水平(U/mL)	阳性率[n(%)]	水平(U/mL)	阳性率[n(%)]
子宫内膜癌组	65	98.40±7.71^{a b}	62(95.38)^{a b}	112.34±10.71^{a b}	63(96.92)^{a b}
EMs组	40	48.36±5.56^a	18(45.00)^a	51.91±6.62^a	21(52.50)^a
对照组	30	28.27±4.21	1 (3.33)	30.32±3.65	2 (6.67)
χ²/t		21.54	19.64	11.62	24.87

图1 3组HE形态及CA₁₂₅和CA_19-9免疫组化染色(HE×100，免疫组化×100，A：正常子宫内膜，B：EMs，C：子宫内膜癌)

Figure 1 The observation of HE morphological and immunohistochemical staining of CA₁₂₅ and CA_19-9 in three groups (A: Normal endometrial, B: Endometriosis, C: Endometrial cancer)

表2 3组标本的免疫组化结果的CA₁₂₅和CA_19-9阳性率比较[n(%)]

Table 2 Comparison of positive rates of immunohistochemistry of CA₁₂₅ and CA_19-9 among three groups[n(%)]

组别	n	CA₁₂₅		CA_19-9
组别	n	阳性率	阴性率	阳性率	阴性率
子宫内膜癌组	65	60(92.31)^ab	5 (7.69)^{a b}	61(93.85)^ab	4 (6.15)^ab
EMs组	40	25(62.50)^a	15(37.50)^a	28(70.00)^a	12(30.00)^a
对照组	30	2 (6.67)	28(93.33)	1 (3.33)	29(96.67)
χ²		7.92	10.32	8.87	7.21

表2 3组标本的免疫组化结果的CA₁₂₅和CA_19-9阳性率比较[n(%)]

Table 2 Comparison of positive rates of immunohistochemistry of CA₁₂₅ and CA_19-9 among three groups[n(%)]

组别	n	CA₁₂₅		CA_19-9
组别	n	阳性率	阴性率	阳性率	阴性率
子宫内膜癌组	65	60(92.31)^ab	5 (7.69)^{a b}	61(93.85)^ab	4 (6.15)^ab
EMs组	40	25(62.50)^a	15(37.50)^a	28(70.00)^a	12(30.00)^a
对照组	30	2 (6.67)	28(93.33)	1 (3.33)	29(96.67)
χ²		7.92	10.32	8.87	7.21

图2 Western blot检测CA₁₂₅和CA_19-9的表达(1：子宫内膜癌组，2：EMs组，3：正常组)

Figure 2 The expression of CA₁₂₅ and CA_19-9 in the three groups detected by Western blot (A: Endometrial cancer, B: Endometriosis, C: Normal endometrial)

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Correlation and Differences Between Tissues and Serum Level of CA125 and CA19-9 in Endometrial Cancer

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Correlation and Differences Between Tissues and Serum Level of CA125 and CA19-9 in Endometrial Cancer