The Clinical Significance Of Inhibin A In Ovarian Tumor's Diagnosis

IntroductionThe malignent ovarian tumor is one of the three maligment tumor of women's genitalia system. It's malignancy degree is high and development is secretive. It likely spreadsand metastasis at ealy stage. So about 60-70% patients were in late stage when they were diagnosed. Because the 5-years survival rate of the patient inⅠ-Ⅱstage of ovarian cancer is about 80-90%, but the patient inⅢ-Ⅳstage is only 20-30%, so ealier discover, diagnose and effectivly treatment are especially important.Now Ca125 is used very porpularly to detect the epithelial ovarian cancer(EOC),and it's value is recognized. But a lot of studise showed that Ca125 is mainly sensetive to serous cystadenocarcinoma, but not sensetive to mucinous cystadenocarcinoma. So that we are working on discovering another ovarian cancer symbol to reinfore the shortstage of Ca125. Now the always used symbols in clinic include CEA, AFP,HCG ect. All of these detected with Ca125 can improve the active rate of malignent ovarian tumor in some extent. But all of these still have some limitations in use. Some tumor such as ovarian sex cord stromal tumor and mucinous cystadenocarcinoma still don't have suitable symbol to satisfy the require of diagnosis and following up. Recently, with the studing of inhibin A(INHa), peoples find out that INHA has some expression in both epithelial ovarian cancer and ovarian sex cord stromal tumor, especially has singularly high expression in granulosa cell tumor and mucinous cystadenocarcinoma.And some research showed that serum level of INHA would be stable with the gowing of age in postmensrual women. All of these evidence are helping the INHA to be a new ovarian symbol. Foreign workers has already preparated the singal-clone antigen of INHA, and propose that detect INHA combine with Ca125 can significantly rise up the ratio of early diagnosis of maligment ovarian tumor, and it can also be used to view the effect of treatment and evaluate prognosis. But there still no report of using these two symbols at the same time to detect the ovarian cancer befor the surgery and determine the treatment effect in China. Our study is aiming at combining the INHA with Ca125 to detect malignent ovarian tumor, so that to discover if this method has any value in diagnosis and following up of malignent ovarian tumor.Purpose: Study the combination of Ca125 with INHA in detetcting the malignent ovarian tumor of postmenstrual women and find out if it has any value in diagnosis, monitoring the treatment effect and following up. Hoping that the combination of these two symbols can rise up the early diagnose rate of malignent ovarian tumor, accuratly evaluate the treatment effect and prognosis, insrtruct clinical work.Method: Select 30 postmenstrual malignent ovarian tumor patients during Dec.2005 to Dec.2006 in our hospital. Average age of these women is 54.3±6.2years; 28 postmentrual optimum ovarian tumor paitents with average age 54.1±6.3years. And randomly select 30 healthy postmentrual women as the contrast in the same stage in out-patient department with average age 55.1±7.19years. All women had no other orgen's tumor and endocrenial disease history, and had no hormone treatment during post 3months. Using ELISA to detect the serum level of INHA of all these women and the serum level of INHA of maligment women post 7days of operation. Using lepton chemical radiation to detect the serum level of Ca125 of all these women and the serum level of Ca125 of malignent women post 7days of operation. All the results are denoted as x±s. Statistics use t test and X2, P<0.05 has significate value.Result: 30 malignent ovarian tumor patients'INHA level is 7.84±4.28U/ml before operation, and 3.93±1.44U/ml 7days post-operaiton; Ca125 level is 174.29±166.49U/ml before operation and 42.22±32.83U/ml 7days post-operation. 28 optimum ovarian tumor patients'INHA level is 379±2.06U/ml and Ca125 is 19.76±9.76U/ml before operation; 30 healthy women's INHA level is 3.19±1.12U/ml and Ca125 is 19.76±7.83U/ml. To compare with optimum ovarian tumor gtoup and contrast group, the serum level of INHA and Ca125 of the malignent ovarian tumor group before operation has significate value(P<0.05), and the serum level of INHA and Ca125 of the malignent ovarian tumor group before operation compare with post-operation has significate value(P<0.05), optimum ovarian tumor gtoup has no statistical value to compare with normao contrast group(P>0.05). Active detective rate of malignent ovarian tumor of INHA is 60%, Ca125 is 63.3%, of INH combine with Ca125 is 90%. The combination of two symbols compare with singal symbol detection, the active detective rate has statistical value(P<0.05).Conclusion:1. INHA can be used as a new symbol of ovarian tumor in clinic, especially in diagnosing and monitoring devloping of mucinous cystadenocarcinoma and granulosa cell tumor, it is better than Ca125.2. INHA combine with Ca125 can rise up the active rate of diagnosis of maligment ovarian tumor of women.3. INHA can be used as an symbol for early diagnose malignent ovarian tumor.4 . We still need to further study INHA in prognosticing of ovarian cancer ,it will provide a new way in future therapy for ovarian cancer offer theory .