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目的探讨B7-H4蛋白、CA125蛋白在卵巢癌患者组织及血清中的表达及其临床意义。方法用免疫组织化学染色法、酶联免疫吸附试验(ELISA)方法分别检测26例患者组织和23例卵巢正常患者、35例卵巢良性病变和32例卵巢癌患者血清中B7-H4蛋白的表达,用化学发光法检测相应血清中CA125蛋白的表达,并结合临床资料对32例卵巢癌患者血清中表达的B7-H4、CA125蛋白进行分析。结果 B7-H4蛋白在卵巢浆液性癌、子宫内膜样癌、透明细胞癌、浆液性囊腺瘤、正常组织中呈阳性表达,在卵巢黏液性癌中阴性表达。血清B7-H4、CA125蛋白在卵巢正常组和良性病变组中普遍低表达,在卵巢恶性病变组中相对高表达,差异有统计学意义(P<0.05)。血清B7-H4蛋白的表达与病理类型、分级、分期、淋巴结转移等有关,差异有统计学意义(P<0.05),与年龄、腹腔积液无明显相关性。卵巢癌患者血清中2种蛋白的表达无明显相关性(r=0.321,P>0.05),2种蛋白能分别检测出不同的患者,B7-H4、CA125蛋白单独应用时,曲线下面积(AUC)分别为0.798和0.884,两者联合时AUC为0.922。结论 B-H4蛋白是卵巢癌诊断的潜在血清学标记物之一,联合CA125蛋白检测能提高卵巢癌的诊断率。
Objective To investigate the expression and clinical significance of B7-H4 protein and CA125 protein in tissues and serum of patients with ovarian cancer. Methods Immunohistochemical staining and enzyme-linked immunosorbent assay (ELISA) were used to detect the expression of B7-H4 protein in the serum of 26 patients and 23 normal ovarian patients, 35 benign ovarian lesions and 32 ovarian cancer patients. The expression of CA125 protein in the corresponding serum was detected by chemiluminescence method. Combined with clinical data, the expression of B7-H4 and CA125 proteins in serum of 32 patients with ovarian cancer was analyzed. Results The expression of B7-H4 protein was positive in ovarian serous carcinoma, endometrioid carcinoma, clear cell carcinoma, serous cystadenoma and normal tissues, and negative in ovarian mucinous carcinoma. The serum levels of B7-H4 and CA125 proteins were generally low in ovarian normal and benign lesions, and relatively high in ovarian malignancies. The difference was statistically significant (P<0.05). The expression of serum B7-H4 protein was related to histological type, grade, staging, lymph node metastasis, and the difference was statistically significant (P<0.05). There was no significant correlation between serum B7-H4 protein and age and peritoneal effusion. There was no significant correlation between the expression of two proteins in serum of patients with ovarian cancer (r=0.321, P>0.05). The two proteins could detect different patients, and the area under the curve (AUC) when B7-H4 and CA125 proteins were applied alone. ) were 0.798 and 0.884, respectively, and the combined AUC was 0.922. Conclusion B-H4 protein is one of the potential serological markers for the diagnosis of ovarian cancer. The combination of CA125 protein detection can improve the diagnostic rate of ovarian cancer.