The Expression Of Tumor Necrosis Factor-α And Its Receptors In Ovarian Carcinoma Ascites And Tissue And Its Meaning

Objective The development of ovarian malignacy is a procedure which multiplefactors participate, while cytokines accommodating the immunity is correlated withovarian tumor closely. To determine whether there is a relationship between theovarian cancer and the ascites levels of TNF-αand sTNFR-Ⅰ, and to evaluatewhether an elevated TNF-αor sTNFR-Ⅰascites level has a value of discriminatingthe nature of ascites. At the same time, the genic expression of TNF-αandTNFR-ⅠmRNA were detected in ovarian tumor tissue, and to analyze therelationship between TNF-α, TNFR-Ⅰand clinicpathologic features in order to makeclear of mechanism of ovarian cancer, search for a new tumor-marker and exploreclinical new treatment.Methods Ascites levels of TNF-αand sTNFR-Ⅰin 59 specimens of ovarian epithelialtumor, 9 specimens of PPSPC and 6 specimens of endometriosis were detected byELISA. The mRNA expression levels of TNF-αand TNFR-Ⅰin 59 specimens ofovarian epithelial tumor, 9 specimens of PPSPC were examined by ISH. All the datawere analyzed by statistical package SPPSS 13.0.Results 1. Ascites levels of TNF-αand sTNFR-Ⅰin patients with EOC, BOT, PPSPCwere significantly higher than those with BET and EM. There were no significantdifferences among EOC, BOT and PPSPC, or between BET and EM.2. In malignant ascites, the levels of TNF-αand sTNFR-Ⅰin patients atadvanced stage, low differentiation, with lymph node metastasis and big volume ofascites were apparently higher than those at early stage, high differentiation, withoutlymph node metastasis and small volume of ascites. There were no significantdifferences among pathology types, size of tumor. Differently, ascites levels of TNF-αin patients with positive ascites cytology were higher than negative ones, butsTNFR-Ⅰdid not.3. There is a positive correlation between ascites levels of TNF-αand sTNFR-Ⅰ. The coefficient correlation is 0.829.4. TNF-αand sTNFR-Ⅰhave a high value of discriminating the nature ofascites showing by ROC curve, for their sensitivity are 79.6%,87.8%, specificity are84.2%,78.9% respectively.5. Positive expressions of TNF-αmRNA in patients with EOC, PPSPCwere apparently higher than those with BET and BOT, while TNFR-ⅠmRNA inpatients with EOC, BOT, PPSPC were higher than those with BET.6. There is no significant correlation between tissue expressions of TNF-αmRNA, TNFR-ⅠmRNA and clinicpathologic features, except that TNFR-ⅠmRNApositive expressions step up as the tumors scale up.7. There is a positive correlation between the expressions of TNF-αmRNAand sTNFR-ⅠmRNA in tissue. The coefficient correlation is 0.652.8. There is a direct correlation between ascites levels of TNF-αand tissueexpressions of TNF-αmRNA. The coefficient correlation is 0.434. But there is nocorrelation between ascites levels of sTNFR-Ⅰand tissue expressions ofTNFR-ⅠmRNA.Conelusion 1. Ascites TNF-αlevels in patients with EOC, BOT, PPSPC weresignificantly higher than those with BET and EM. Positive expressions of TNF-αmRNA in patients with EOC, PPSPC were apparently higher than those with BET andBOT.2. The high ascites TNF-αlevels and high tissue expressions of TNF-αmRNA in patients with EOC and PPSPC were related with tumor malignant biologybehavior, including clinical stage, differentiation, lymphatic metastasis, volume ofascites and ascites cytology.3. Ascites sTNFR-Ⅰlevels in patients with EOC, BOT, PPSPC weresignificantly higher than those with BET and EM, which were linked with tumormalignant biology behavior, including clinical stage, differentiation, lymphaticmetastasis and volume of ascites. 4. By influencing each other, TNF-αand sTNFR-Ⅰcould not onlypromote tumor cells growth and metastasis, but also participate the immune escape.5. Ascites levels of TNF-αand sTNFR-Ⅰhave the high sensitivity andspecificity for diagnosis of ovarian cancer.6. TNF-αand sTNFR-Ⅰcould be the new tumor markers for thediagnosis of ovarian cancer.7. Positive expressions of TNFR-ⅠmRNA in patients with EOC, BOT,PPSPC were higher than those with BET. This reflects the aggressiveness of thespread of ovarian malignancy and has a predictive value for identifying thepoor-prognosis patients.