The Values Of DNA Ploidy Analysis In Ascites And The Expression Of CA₁₂₅ In Serum, Ascites And Tissue In Patients With Ovarian Cancer

Objective: To detect the expression of CA₁₂₅ in the original lesions of epithelial ovarian cancer and the metastasis in abdominopelvic cavity (peritoneal and omental metastatic lesions) by S-P immunohistochemical methods ; To compare the expression of CA₁₂₅ in tuberculose focus and acute inflammation focus in abdominopelvic cavity; and to find the source of CA₁₂₅ in serum and the significance to the ovarian cancer therapy and prognosis by combined with the detection of CA₁₂₅ in ascitic fluid by ELISA ; To discuss whether combined assay can approve the sensitivity and specificity in the diagnosis of ovarian cancer,and the significance of combined assay to the therapy and prognosis of ovarian cancer through the DNA diploid analysis of exfoliated cells from ascites by flow cytometry,compared with the results of the detection of CA₁₂₅ in serum and ascites.Stuff and methods: The serum and ascites of the in-patients before or during operation,ovarian tissue,omentum and peritoneum of the in-patients after operation were collected , the in-patients were hospitalized because of ovarian tumor or the tumor in abdominopelvic cavity(confirmed as the tuberculose focus and acute inflammation focus in abdominopelvic cavity after operation).The in-patients were in the department of gynecology and obstetrics of The Second Clinical Hospital of JiLin University and The TB Hospital of ChangChun(长春结核病院). Those samples included 76 ovarian epithelial cancer(48 serous cystadenocarcinoma, 11 mucous cystoadenocarcinoma,17endometrioid carcinoma);14 benign ovarian epithelial tumors(8 serous cystadenoma,6 mucinous cystadenoma);15 tuberculose focus in abdominopelvic cavity; 10 acute inflammation focus in abdominopelvic cavity. 10 normal ovarian tissue were collected as comparison in exploratory laparotomy because of other gynecological disease confirmed by pathology.The allocation of positive expression of CA₁₂₅ were detected in the original lesions of ovarian epithelial cancer, metastatic peritoneal and omental lesions, TB lesions, acute inflammatory lesions by S-P immunohistochemistry.To detect the expression of CA₁₂₅ in serum and ascites by ELISA double antibody sandwich method. Do DNA ploidy analysis of exfoliated cells from ascites by flow cytometry in 30 cases of patients with epithelial ovarian cancer, 15 cases of patients with tuberculose focus in abdominopelvic cavity,who were randomly selected from the in-patients above.Result:1,The expression rates of CA₁₂₅ in the original lesions of ovarian epithelial cancer,benign ovarian epithelial tumor and normal ovarian tissue were 89.5%, 36 % and 10 % ,respectively.The expression rate of CA₁₂₅ in the original lesions of ovarian epithelial cancer was significantly higher than that in normal ovarian tissue and benign ovarian epithelial tumor,there was significant difference(P<0.01).2,The level of CA₁₂₅ in serum was unrelated to the ages of patients,the result of exfoliated cells and the size of the tumors(P>0.05);it was related to the amount of ascites , lymph node metastasis, pathological types (p <0.05) (P<0.05); the level of CA₁₂₅ in serum raised with the progression of clinical period and histology grade,and there was significant difference. (P<0.01); The expression of CA₁₂₅ in the original lesion of ovarian epithelial cancer was unrelated to the ages of patients,the result of exfoliated cells and the size of the tumors(P>0.05);it was related to the amount of ascites , lymph node metastasis, pathological types (p <0.05); The expression of CA₁₂₅ in the original lesion of ovarian epithelial cancer raised with the progression of clinical period and histology grade,and there was significant difference. (P<0.01);3,The level of CA₁₂₅ in serum of the ovarian epithelial cancer was not significant different from that in abdominopelvic cavity (p>0.05). The level of CA₁₂₅ in ovarian epithelial cancer was higher than that in TB lesions in abdominopelvic cavity,and there was significant difference(p<0.01).4,The PI, DI values in ascites of Ovarian cancer were higher than those of tuberculous ascites,and there was significant difference(p<0.05).5,As the standard diagnosis of ovarian cancer ascites ,the specificity of heteroploid positive, CA₁₂₅ in serum positive and CA₁₂₅ in ascites positive were 93.33%,26.67% and 66.67% ,respectively.6,As the standard diagnosis of ovarian cancer , the sensitivity of the combined assay of the three methods above was 66.67% ,the specificity was 100%.Conclusion:1,The expression of CA₁₂₅ in the tissue of benign ovarian tumor is the main source of CA₁₂₅ in serum.2,Besides the original and metastatic lesions (greater omentum and peritoneal) of epithelial ovarian cancer can express CA₁₂₅, the second maller's canal, for example the peritoneum mesothelial cell can be stimulated to express CA₁₂₅ by ascetic fluid ,which results in the increasement of CA₁₂₅ in serum.3,As the solitary diagnosis criteria of ovarian epithelial cancer combined ascites,the sensitivity of DNA ploidy analysis by flow cytometry is the best among the DNA ploidy analysis ,the detection of CA₁₂₅ in serum and ascites.4,The combined assay of two indexes can improve not only the sensitivity and specificity in the diagnostis of ovarian epithelial cancer, but also the correct diagnostic rate of ovarian epithelial cancer.5,The expression of CA₁₂₅ in tissue , the level of CA₁₂₅ in ascites and DNA diploid analysis may become important index in the therapy and prognosis of ovarian cancer.