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目的探讨血清人附睾分泌蛋白4(HE4)在卵巢癌组织中的表达及意义。方法以2012年5月-2016年5月在青岛市妇女儿童医院切除的157个卵巢标本为研究材料,其中卵巢癌127例,卵巢交界性肿瘤18例,卵巢囊肿6例,正常卵巢6例。免疫组化法检测标本中HE4蛋白的表达,比较HE4在卵巢癌、卵巢交界性肿瘤、卵巢囊肿以及正常卵巢中表达的阳性率,分析HE4阳性率与卵巢癌临床分期,卵巢癌淋巴结转移以及卵巢癌细胞分化程度相关性。结果 HE4在卵巢癌、卵巢交界性肿瘤、卵巢囊肿中的阳性率分别为69.29%、50.00%、16.67%,在正常卵巢组织中无阳性表达;卵巢癌组织中HE4表达阳性率显著高于正常卵巢癌组织(P<0.01),卵巢交界性肿瘤组织中HE4阳性率高于正常卵巢组织(P<0.05),卵巢癌组织中HE4阳性率高于卵巢囊肿(P<0.05),其余各组间进行比较未见明显统计学差异(均P>0.05)。卵巢癌早期患者中HE4阳性率为46.43%,卵巢癌晚期为75.76%,两者比较,差异具有统计学意义(P<0.01)。无淋巴结转移的卵巢癌患者HE4阳性率为25.58%,有淋巴结转移为88.10%,两者比较,差异有统计学意义(P<0.01)。高分化的卵巢癌中HE4阳性率为46.43%,中、低分化的为75.00%,两者比较,差异有统计学意义(P<0.01)。结论 HE4的阳性率与卵巢癌临床分期,卵巢癌淋巴结转移以及卵巢癌细胞分化程度均相关,且HE4阳性率可以作为判别卵巢癌发生淋巴结转移可能性的一个可靠指标。
Objective To investigate the expression of human epididymal secretion protein 4 (HE4) in ovarian cancer and its significance. Methods A total of 157 ovarian specimens resected from Qingdao Children’s Hospital from May 2012 to May 2016 were selected as experimental materials. There were 127 cases of ovarian cancer, 18 cases of ovarian borderline tumor, 6 cases of ovarian cyst and 6 cases of normal ovary. Immunohistochemistry was used to detect the expression of HE4 protein in HEK293 cells. The positive rates of HE4 expression in ovarian cancer, borderline ovarian tumor, ovarian cyst and normal ovary were compared. The positive rate of HE4 was correlated with the clinical stage of ovarian cancer, lymph node metastasis of ovarian cancer and ovarian Differentiation of cancer cells. Results The positive rates of HE4 in ovarian cancer, borderline ovarian tumor and ovarian cyst were 69.29%, 50.00% and 16.67%, respectively. There was no positive expression in normal ovarian tissue. The positive rate of HE4 in ovarian cancer was significantly higher than that in normal ovary (P <0.01). The positive rate of HE4 in borderline ovarian tumors was higher than that in normal ovarian tissues (P <0.05). The positive rate of HE4 in ovarian cancer was higher than that in ovarian cysts (P <0.05) There was no obvious statistical difference (all P> 0.05). The positive rate of HE4 was 46.43% in early stage of ovarian cancer and 75.76% in late stage of ovarian cancer, the difference was statistically significant (P <0.01). The positive rate of HE4 was 25.58% in ovarian cancer without lymph node metastasis and 88.10% in lymph node metastasis, the difference was statistically significant (P <0.01). The positive rate of HE4 in well-differentiated ovarian cancer was 46.43%, moderate and poorly differentiated was 75.00%, the difference was statistically significant (P <0.01). Conclusion The positive rate of HE4 is correlated with the clinical stage of ovarian cancer, lymph node metastasis of ovarian cancer and the differentiation of ovarian cancer cells. The positive rate of HE4 can be used as a reliable indicator of the possibility of lymph node metastasis in ovarian cancer.