2015 年第 6 期 第 13 卷

血清MIC-1和CA125在卵巢上皮癌诊断及预后中的应用研究

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关键词：卵巢癌巨噬细胞抑制因子-1CA125诊断预后

• 摘要：
• 【摘要】目的 研究巨噬细胞抑制因子-1 (MIC-1)在卵巢癌诊断和预后判断中的价值，评价其与CA125联合应用管理卵巢癌的临床价值。方法 通过检测92例未经治疗卵巢癌患者和96 例正常人群血清样本中的MIC-1和CA125水平，分析患者血清MIC-1 水平与卵巢癌的关系，评价MIC-1单独及联合CA125检测卵巢癌的价值，通过比较治疗前后肿瘤标志物的水平改变以及与临床治疗效果之间的关系，研究MIC-1在监测卵巢癌手术残瘤、化疗耐药和预后判断中价值。结果 卵巢癌患者血清MIC-1水平显著高于正常人群 (P＜0.001)；MIC-1 诊断卵巢癌的ROC（AUC, 0.945）与CA125（AUC, 0.966）无显著差异，MIC-1诊断卵巢癌的特异性和灵敏度分别为89.1%和91.7%，MIC-1和CA125联合应用可显著提高卵巢癌的诊断能力（AUC, 0.966）。术前血清MIC-1水平与卵巢癌术后残瘤无显著相关性，但是与化疗耐药显著相关，并与患者PFS时间呈显著负相关。结论 MIC-1是卵巢癌有价值的血清肿瘤标志物，MIC-1 和CA125联合检测可显著提高卵巢癌的诊断能力，MIC-1高水平预示卵巢上皮癌存在较大的耐药风险，在预测化疗敏感性方面具有显著意义，为临床医生选择合适的化疗方案，定制个体化的治疗策略提供参考。
• Objective To investigate the diagnostic and prognosis value of macrophage inhibitory cytokine-1 (MIC-1) in patients with ovarian cancer, and estimate the clinical value of MIC-1 in combination with CA125 in the management of ovarian cancer. Method The levels and distribution of MIC-1 and CA125 in serum samples from 92 previously untreated patients with ovarian cancer and 96 healthy normal subjects were analyzed. The association of the serum levels of MIC-1 with ovarian were analyzed, and the clinical value of MIC-1 alone and its combination were explored. Additionally, the level of pre- and post-treatment tumor marker, and the relationship with the therapeutic effect was compared for assessing the value of MIC-1 in residual tumor, chemotherapy resistance and prognostic prediction. Result The serum levels of MIC-1 in patients with ovarian cancer were significantly higher than those in healthy control (P<0.001). The ROC of MIC-1 (AUC, 0.945) was comparable to CA125 (AUC, 0.966), the sensitivity and specificity of MIC-1 in diagnosis of ovarian cancer was 89.1% and 91.7%, respectively. Furthermore, the diagnostic ability of MIC-1 combined with CA125 was significantly increased (AUC, 0.966). Conclusion MIC-1 is a valuable biomarker of ovarian cancer. The panel of MIC-1 and CA125 may significantly increase the diagnostic ability of tumor biomarker in ovarian cancer. High levels of MIC-1 indicate presence greater risk of drug resistance in ovarian cancer, imply that MIC-1 have important clinical value in predicting chemosensitivity. The level of serum MIC-1 may help clinicians to select the appropriate chemotherapy program and individualized treatment strategies.