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The Levels in Serum and Expressions in Endometria of EpCAM and CA125 in Patients with Endometrial Adenocarcinoma and Endometrial Intraepithelial Neoplasia

Author: LuoLiLi
Tutor: MaXiaoYan
School: Jilin University
Course: Clinical
Keywords: Endometrial adenocarcinoma Epithelial cell adhesion molecule Cancer antigen 125 Enzyme - linked immunosorbent assay ( ELISA ) Immunohistochemistry
CLC: R737.33
Type: Master's thesis
Year: 2011
Downloads: 53
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Abstract

Objective: To study the EpCAM and CA125 protein differentially expressed in different endometrial tissue and its serum levels and endometrial adenocarcinoma and precancerous lesions, the development of the relationship and in the diagnosis, monitoring, and determine the prognosis of the disease clinical value. Materials and Methods: collect 74 cases of endometrial adenocarcinoma in patients with endometrial tissue samples, selected among 26 serum samples; collected 19 cases of endometrial atypical hyperplasia endometrial tissue specimens and serum samples collected six cases ; 54 control patients endometrial tissue samples were collected and selected among 17 serum samples (the sub control group: proliferative endometrial tissue samples of 17 cases, extracted from serum samples; secretory endometrial tissue samples 18 For example, to extract serum samples; 19 cases of atrophic endometrial tissue samples, extracted from serum samples). The immunohistochemistry (Immunohistochemtistry IHC) detected in the various pathological and physiological endometrial tissue EpCAM and CA125 protein by ELISA (Enzyme-Linked Immunosorbnent Assay, ELISA) for detecting the serum samples EpCAM and CA125 levels, and to analyze its relationship with clinicopathological parameters. Results: EpCAM and CA125 protein expression in endometrial adenocarcinoma, atypical endometrial hyperplasia and sub-control group was significant (P lt; 0.05), especially atrophic endometrial positive expression and reduce the level of overexpression was significant (P lt; 0.05). EpCAM and CA125 protein expression of cell number and cell proliferation level in the control group, the differences in atypical endometrial hyperplasia and endometrial adenocarcinoma group was significantly (P lt; 0.05); and two positive cells a correlation between the number and the degree of cell proliferation (P lt; 0.05) EpCAM protein expression in patients with surgery - pathological stage and tumor diameters (P lt; 0.05); the EpCAM protein in the positive overexpression and cytology grade, depth of invasion, the patient surgery - pathological stage and whether The risk factors associated with endometrial adenocarcinoma (P lt; 0.05). 4, CA125 protein expression in patients with surgery - pathological stage and cytological grade (P lt; 0.05); positive CA125 protein overexpression and cytological grading, depth of invasion, and patient surgery - pathological stage (P lt ; 0.05). 5, endometrial cancer, endometrial atypical hyperplasia and the control group in patients with EpCAM levels and clinical parameters of the relationship: (1) control group, atypical endometrial hyperplasia and endometrial adenocarcinoma preoperative serum EpCAM levels were 3.12 ± 2.66ng/ml, 5.85 ± 1.68ng/ml and 11.31 ± 4.92ng/ml significant difference (P lt; 0.05). (2) endometrial adenocarcinoma group and the control group had no history of postmenopausal (8.31 ± 2.88ng/ml, 1.23 ± 1.70ng/ml) with a history of menopause by surgery (12.69 ± 5.18ng/ml, 4.67 ± 2.31ng/ml) The serum level of EpCAM there is a significant difference (P lt; 0.05). (3) postoperative serum level of EpCAM endometrial cancer group (7.41 ± 3.81ng/ml) dysplasia group (1.23 ± 0.18ng/ml) of the control group as a whole (2.34 ± 1.85ng/ml) and the sub-control group ( 1.52 ± 0.89ng/ml, 0.41 ± 0.19ng/ml, 4.07 ± 1.05ng/ml), dysplasia group (1.23 ± 0.18ng/ml) of atrophic endometrial group (4.07 ± 1.05ng/ml) secretory the endometrial group (0.41 ± 0.19ng/ml) and Palace of the atrophic endometrium (4.07 ± 1.05ng/ml) significant difference (P lt; 0.05). ④ endometrial adenocarcinoma and atypical endometrial hyperplasia group and the control group, postoperative serum level of EpCAM surgery before were decreased, endometrial adenocarcinoma and atypical endometrial hyperplasia preoperative, intraoperative after the serum level of EpCAM (11.31 ± 4.92ng/ml, 7.41 ± 3.81ng/ml; 5.85 ± 1.68ng/ml, 1.23 ± 0.18ng/ml) significant difference (P lt; 0.01). 6, endometrial cancer, endometrial atypical hyperplasia and control group, serum CA125 in patients with clinical indicators of relationship: (1) control group, atypical endometrial hyperplasia and endometrial adenocarcinoma preoperative serum CA125 levels were 37.27 ± 20.56U/ml, 28.18 ± 15.89U/ml and 22.59 ± 9.23U/ml, the difference was significant (P lt; 0.05) ② no history of postmenopausal endometrial adenocarcinoma group and the control group (49.77 ± 27.40U/ml, 25.40 ± 8.01U/ml) with a history of post-menopausal (29.41 ± 14.86U/ml, 18.47 ± 3.77U/ml) in preoperative serum CA125 level there is a significant difference (P lt; 0.05). The ③ postoperative endometrial adenocarcinoma group (25.90 ± 12.40U/ml) with the control group (16.99 ± 9.38U/ml) and sub-control group the proliferative (11.73 2.26U/ml) and secretory endometrial group ( 15.25 ± 3.11U/ml) serum CA125 level there is a significant difference (P lt; 0.05). (4) endometrial adenocarcinoma, endometrial atypical hyperplasia group and normal control group, postoperative serum CA125 levels Preoperative have lower preoperative endometrial adenocarcinoma and proliferative endometrial sub-control group differences in postoperative serum CA125 level (37.27 ± 20.56U/ml, 25.90 ± 12.40U/ml; 18.89 ± 4.05U/ml, 11.73 ± 2.26U/ml) significantly (P lt; 0.05). 7, endometrial adenocarcinoma patients with preoperative serum EpCAM and CA125 was no significant correlation (P gt; 0.05) 8, respectively, and combined detection of serum EpCAM and CA125 level on the significance of the diagnosis of endometrial adenocarcinoma and precancerous lesions: 1 serum the EpCAM diagnosis of endometrial adenocarcinoma and precancerous lesions sensitivity, specificity, accuracy and The positive predictive degrees higher than the serum CA125, Combined detection of increased sensitivity and accuracy. (2) in the diagnosis of menopause history of endometrial adenocarcinoma and precancerous lesions, the serum the EpCAM the sensitivity, specificity, accuracy, and positive predictive degrees higher than the serum CA125 Combined detection of increased sensitivity. (3) in the diagnosis of menopause history of endometrial adenocarcinoma and precancerous lesions, the sensitivity of serum CA125 higher than the serum-EpCAM, specificity, accuracy, and positive predictive is lower, the combined detection, improved sensitivity and accuracy. 9, respectively, and combined detection of serum EpCAM and CA125 levels for the clinical significance of prognosis of endometrial adenocarcinoma: the endometrial adenocarcinoma preoperative serum CA125 level and the patient's age, cytology grade, depth of myometrial invasion, surgical - pathological staging and intrauterine tumor size; preoperative serum level of EpCAM with patient age and surgical - pathological stage; endometrial adenocarcinoma patients before EpCAM/CA125 P Day co-expression rate of myometrial invasion and clinical - pathological stage, the endometrial cancer preoperative EpCAM/CA125 negative co-expression of the rate and depth of myometrial invasion. Conclusion: 1, the EpCAM and CA125 protein in the control group, the expression in atypical endometrial hyperplasia and endometrial adenocarcinoma tended to increase with the degree of cell proliferation, suggesting that EpCAM and CA125 protein in endometrial The increase in the amount of local expression may be related to the occurrence of endometrial adenocarcinoma development related. Serum EpCAM in the control group, atypical endometrial hyperplasia and endometrial adenocarcinoma preoperative CA125 levels showed an increasing change, consistent with the trend of expression in endometrial tissue, and postoperative atypical endometrial hyperplasia groups and endometrial adenocarcinoma was significantly decreased, suggesting that to the EpCAM and CA125 protein expression in endometrial tissue may be used as the main source of endometrial adenocarcinoma and its precancerous lesions in patients with. 3, EpCAM and CA125 protein in the secretory endometrium high expression and secretion in patients with low serum levels are not consistent, probably due to the decay period of endometrial local expression of the EpCAM and CA125 With the shedding of the endometrium away from the blood circulation caused. 4, the secretory endometrium serum level of EpCAM was significantly lower than the atrophic endometrium of endometrial adenocarcinoma and precancerous lesions and the control group, this was significantly decreased for progesterone inhibition of endometrial epithelial cells proliferation and endometrial adenocarcinoma mechanism to provide experimental basis for the determination of endometrial adenocarcinoma and precancerous lesions of the state and the monitoring of progesterone treatment effect of guiding significance. 5, history of postmenopausal endometrial adenocarcinoma of the endometrium, endometrial atypical hyperplasia and the control group, serum level of EpCAM were higher than no history of menopause, suggesting that the ovaries to produce and secrete hormones function dysfunction or failure may result in this section serum of patients with EpCAM levels in postmenopausal reasons. Serum EpCAM is very likely as a diagnosis of endometrial adenocarcinoma and precancerous lesions in particular is one of the independent biological indicators of menopause. Higher than the serum-EpCAM serum CA125 in the diagnosis of postmenopausal endometrial adenocarcinoma and precancerous lesions of the sensitivity of the combined detection can improve the sensitivity and accuracy of diagnosis of endometrial adenocarcinoma and precancerous lesions, meaning significant. 7, protein expression of EpCAM and CA125 in endometrial carcinoma in helping to determine the prognosis of patients with a certain significance. 8, serum-EpCAM, CA125 and both joint detection can be used as a method of determining the prognosis of endometrial cancer.

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