Value Of Survivin In Diagnosis And Monitoring Of Epithelial Ovarian Cancer

Objective: To investigate the expression of apoptosis related factors--survivin,HE4(human epididymis Protein)and CA125 in serum of patients with epithelial ovarian tumor and its significance in the diagnosis and monitoring of the disease.Methods: People including 60 cases of epithelial ovarian cancer and 40 patients with benign ovarian tumor and 40 healthy volunteers from the Tianjin Central Obstetrics and Gynecology Hospital were tested to analyze the levels of survivin 、CA125 and HE4 in serum by Enzyme linked Immunosorbent Assay(ELISA)and electrogenerated chemiluminescence.The test results are expressed in the median.To compare the expression in different teams of three markers,statistical analysis method is used.In the ovarian cancer group,the level of survivin in serum were analyzed in different ages,pathological types,molecular types,pathological changes and clinicopathologic factors including surgery before and after chemotherapy serum survivin.The ROC curve was plotted and the diagnostic efficiency of the three markers were compared,alone and in combination.Result:1 The levels of survivin,CA125 and HE4 in patients with ovarian cancer in serum expressed significantly higher than those in the benign tumors and the healthy control group.The differences between the two were statistically significant(P<0.05);expression of survivin in the ovarian benign tumor patients were higher than that in the healthy group,but there is no significant difference.(P>0.05).2 The median level of survivin in serum was significantly higher in the elderly group(elder than 50 years old)than in the younger group(less than 50 years old),but there are not any significant difference between the two groups(P>0.05).3 In the ovarian cancer patients with FIGO III+IV(Advanced),the level of survivin in serum was significantly higher than the group with FIGO I+II(early period),the difference between the two periods was statistically significant;the expression of serum survivin change with different pathological types of epithelial ovarian cancer was statistically significant differernt,and serous carcinoma was higher than that of non-serous carcinoma,.For the molecular type of ovarian cancer,type II has the higher level of Survivin than type I(P<0.05);the level of Survivin in patients with peritoneal effusion and peritoneal lavage fluid positive is higher than that of negative ovarian cancer patients.In the patients who suffered ovarian cancer with positive lymph node,the levels of survivin in serum were significantly higher than those with negative lymph node(P<0.05).4 In the ovarian cancer group,the level of serum survivin was significantly higher than that after surgery and chemotherapy(P<0.05);the level of survivin in people after surgery is higher than that of patients receiving chemotherapy after surgery(P<0.05).5 Contrasted with the healthy group and the group with the benign ovarian tumors,the optimal determination of the critical value survivin ROC curve(ROC curve of the top left point of sensitivity and specificity and the largest point),obtained the best critical value is 98.19 pg/ml.The area under the curve was 0.848.the sensitivity and specificity were 71.66% and 86.3% 。 The sensitivity and specificity of combined detection of survivin,CA125 and HE4 were 96.67 and 71.25%,respectively.6 The expression of Survivin in the early stage of ovarian cancer is increased,the positive expression of Survivin,CA125 and HE4 alone in the early diagnosis rate(FIGOI+II)were 68.75%,56.25%,81.25%,when combined diagnosis of the three the positive rate was 87.5%,achieved the best effect of early screeningConclusion:1 The levels of survivin,CA125 and HE4 in serum of patients with ovarian cancer were higher than people in the benign ovarian tumor group and healthy control group.2The level of serum survivin was not related to age.3 The level of serum survivin in different stages of ovarian cancer was different,and the later stage(FIGO III +IV)had the higher level than the earlier stage(FIGO I+II).The serum survivin level of serous carcinoma was higher than that of non-serous carcinoma.Molecular type II has the higher level of Survivin than type I The serum survivin level in patients with ascites or peritoneal lavage positive ovarian cancer was higher than that of ascites / peritoneal lavage fluid.The level of survivin in serum in patients with lymph node metastasis was higher than that with negative lymph node.Therefore,the level of survivin in serum is thought to be related to the occurrence of ovarian cancer,so did the development,invasion and metastasis,and may be helpful to predict the prognosis of patients with ovarian cancer.4 The expression of survivin in patients with ovarian cancer before or after surgery and chemotherapy was different,and gradually decreased with the remission of the disease.It may be used as an indicator for the monitoring of ovarian cancer.5 Survivin is elevated in the early stage of ovarian cancer,and the combination of the three is useful for the detection of ovarian cancer in the early period.6 For the diagnosis of ovarian cancer,the sensitivity of CA125 was the highest,and the specificity of HE4 was the highest.The negative predictive value of the three joint detection was the highest(96.67%).It is the ideal combination of ovarian cancer screening.