【摘要】 目的用分支DNA(b DNA)技术定量检测卵巢癌患者血清游离DNA(cf-DNA)含量,探讨其与临床病理参数的关系及对卵巢癌辅助诊断的价值。方法收集67例卵巢癌患者、22例卵巢良性肿瘤患者和29例健康妇女静脉血标本。用b DNA技术检测各组血清cf-DNA浓度,化学发光法检测血清CA125和HE-4含量;用Krudkal-Wallis H检验比较各组间总体差异,MannWhitney U检验进行两两比较;绘制ROC曲线评价上述三项指标的诊断效能。结果卵巢癌组、卵巢良性肿瘤组和健康对照组血清cf-DNA含量分别为:865.41(497.62~1 311.56)、221.08(90.93~356.07)和199.94(78.73~396.21)μg/L,卵巢癌组显著高于良性肿瘤组和健康对照组(P均<0.01);按FIGO分期为Ⅲ期和Ⅳ期的卵巢癌患者显著高于Ⅰ~Ⅱ期组(P均<0.01),Ⅲ期和Ⅳ期组间差异也有统计学意义(P<0.05)。卵巢癌组血清cf-DNA的ROC曲线下面积、诊断敏感性和特异性分别为:0.886、83.9%、84.2%,均高于CA125(0.774、74.2%、63.2%)和HE-4(0.706、74.2%、78.9%),cf-DNA、CA125和HE-4联合检测的敏感性和特异性可提高到92.54%(62/67)、88.24%(45/54)。结论 b DNA技术检测血清cf-DNA对卵巢癌诊断的敏感性和特异性高于CA125和HE-4,可作为卵巢癌辅助诊断的一个重要分子生物学指标。更多还原

【Abstract】 Objective To quantify the cell-free DNA( cf-DNA) in serum of patients with ovarian cancer by branched DNA( b DNA)technology,analyze the relationship between cf-DNA and the clinical pathological parameters,and evaluate the supplementary diagnostic significance of cf-DNA for ovarian cancer. Methods The serum samples were collected from 67 patients with ovarian cancer,22 patients with benign ovarian tumor and 29 healthy female subjects. The concentration of cf-DNA was determined by b DNA,and the concentrations of carcinoembryonic antigen 125( CA125) and human epididymal protein 4( HE-4) were assayed by chemiluminescence.The Krudkal-Wallis H test was used to compare the overall difference and Mann-Whitney U test was used for paired-comparisons. The receiver operating characteristic curves( ROC) was drawn to evaluate the diagnostic significance of the above three parameters for ovarian cancer. Results The level of cf-DNA in the patients with ovarian cancer,ovarian benign tumor and healthy individuals were865. 41( 497. 62 to 1311. 56),221. 08( 90. 93 to 356. 07) and 199. 94( 78. 73 to 396. 21) μg / L respectively. The level of cf-DNA in ovarian cancer patients was significantly higher than that of the patients with ovarian benign tumor and healthy individuals( all P <0. 01). The levels of cf-DNA in the patients with ovarian cancer in FIGO stage Ⅲ of Ⅳ were significantly higher than that of the patients in FIGO stage Ⅰ and Ⅱ( all P < 0. 01). There was significant difference of the levels of cf-DNA between the patients in FIGO stage Ⅲand Ⅳ( P < 0. 05). The area under the ROC curves,sensitivity and specificity of cf-DNA level( 0. 886,83. 9%,84. 2%)were higher than those of CA125( 0. 774,74. 2%,63. 6%),HE-4( 0. 706,74. 2%,78. 9%) in ovarian cancer patients. The combined detection of cf-DNA,CA125 and HE-4 raised up the sensitivity and specificity for diagnosis of ovarian cancer to 92. 54%( 62 /67),88. 24%( 45 /51) respectively. Conclusion Compared with the traditional tumor markers CA125 and HE-4,serum cf-DNA level detection showed high sensitivity and specificity for diagnosis of ovarian cancer,and may be used as an important molecular biological indicator for the supplementary diagnosis of ovarian cancer.更多还原