Expressions And Significances Of Serum CA125 And CA724 Levels In Patients With Carcinoma Of Endometrial

Endometrial cancer (endometral carcinoma, EC) refers to the original hair in a group of endometrial epithelial malignant tumors, and the most common aden -ocarcinoma from endometrial glands.It is common for female genital mutilati -on-one of three malignant tumors, which account for 7 percent of female malignan -t tumors, account for 20%-30% of female genital tract malignant tumors, which is more common in older women, accounted for 70% -75% of postmenopausal women , 15%-20% of perimenopausal women, accounted for only 5% -10% of 40 years of age. It is reported that it have a high incidence of domestic aged 50-60 years old,and average age around 55 years of age. Most of Endometrial cancer patients often present with signs or symptoms that result in the diagnosis of their disease in the early stages and therefore most women have an excellent prognosis.However, because of the apparent extension of life expectancy in recent decades,it increases the high incidence of endometrial cancer of the volume of the age groups.In the same time with widely useing foreign estrogen- especially without a pure progesterone antagonist therapy to replace the use of estrogen which results endometrial hyperplasia,atypical hyperplasia,cancer,so that the incidence rate is an upward trend worldwide in recent years. In some western countries, endometrial cancer has become the first in gynecological malignancies.Approximately 40,880 new cases of uterine cancer are diagnosed in the United States annually, resulting in 7470 deaths. The incidence of endometrial cancer has been rising nationally,which has been near or over the incidence of cervical cancer. For women that are at increased risk for the development of endometrial cancer there may be related to patients with the extension of average life expectancy, severe obesity and exogenous estrogen and other factors. Endometrial cancer is generally believed that the prognosis is better than other genital malignancies, but in endometrial cancer survival rate is not satisfactory-endometrial cancer 5-year survival rate about 90% with stage I disease, about 50% with stage II - III ,about 60% -70% wih the overall 5-year survival. Therefore,it become urgent with endometrial cancer diagnosis and treatment - the effective assessment for patients with endometrial cancer before and after treatment, the determination with prognosis associated with a variety of factors, the selection of appropriate individualized treatment.In recent years, with the rapid development of molecular biology, genetics, immunology, microbiology and other disciplines, new tumor markers have been found. The tumor markers of endometrial cancer may not only benefit for early diagnosis and treatment, but also contribute in clinical diagnosis for the prognosis of endometrial cancer, thus they has provided many new way for the pathogenesis, diagnosis and treatment of endometrial cancer.There is a wide range of cancer genes and associated factors involvement with the development of endometrial cancer. CA125 is a high degree of epithelial ovarian cancer cell tumor markers. CA125 exist in mesothelial cells and tissues (including the peritoneum, pleura and pericardium) and the mullerian duct epithelium and its derivatives occurred in the tumor. CA125 is a high molecular weight glycoprotein, with no or weak reactivity to normal adult tissues ,but it is substantial secreted and released into the blood in a very small number of cancer patients such as in some ovarian cancer patients ,which is the clinical diagnosis of ovarian cancer on the most commonly used tumor markers. In 1981, The monoclonal antibody used in the assay was raised against the antigen OVCA 433, prepared from a cell line of a papillary serous cystadenocarcinoma of the ovary .In recent years it was also found and elevated in patients with endometrial cancer and endometriosis serum .It is in same with my study and results.In 1981,CA724 has been found from liver lesions in patients with breast cancer,which is tumor-associated protein different with CEA and CA 199. It is a high molecular-weight of the viscous 1000ku protein (TAG-72), with dual-epitope, which have relevant with the level of tumor size, staging and metastasis. CA724 exist in normal Mullerian derivatives mucosa, the uterus and fallopian tubes which have the CA724 antigen. The majority of human adenocarcinomas can express (TAG-72) TAG72 (tumor-associated glycoprotein) antigen. CA72-4 is a high molecular weight which has been identified and characterized, using two different monoclonal antibodies: B72.3 and CC49.It is reported that CA 724 were higher expression at the mucinous carcinoma and endometrial carcinoma with71.4%, lower in the mucinous carcinoma and poorly differentiated adenocarcinoma, respectively, 66.7% and 54.5%. At present, there is have shown that CA724 is closely related to human ovarian adenocarcinoma from lot of studies. Foreign countries it have not yet reached consensus that CA724 has on the expression of in endometrial cancer . It is not yet up to study of CA724 whether it is expression in endometrial cancer in our country.The CA72-4 antigen has demonstrated reactivity to the majority of human adenocarcinomas including colorectal, gastric, pancreatic, ovarian, endometria -l。It have a higher sensitivity and specificity of gastric cancer, the diagnosis of gastric cancer sensitivity with 59% -94% and specificity with 95% -100%, and is increased with the recurrence patients of gastric cancer before the two-egiht months, and has conducive to the early diagnosis of gastric cancer recurrence, which can help the CEA, CA242 as a marker of gastrointestinal cancer. CA72-4 was 44% -81% positive rate in ovarian cancer, and particularly have higher expression in mucinous carcinoma and endometrial carcinoma, even in borderline ovarian tumors Bo liquid, but have lower expressi in mucinous carcinoma and poorly differentiated adenocarcinoma.In patients with colorectal cancer CEA-positive rate is highest, followed by CA19-9, CA724, which is the same in Holubec's report. CA724 have higher expression in ovarian endometrioid carcinoma, whether or notin endometrial cancer, has not been reached a consensus abroad and studied less.In addition to endometrial cancer in gynecological tumors are related with the tumor markers. currently it also refer CA125 in the diagnosis of endometrial cancer. But in recent years CA125 may be elevated in the abdominal surgery or some non-malignant diseases, for exmple ,menstrual period, early pregnancy, endometriosis, pelvic inflammatory disease and other diseases. Therefore it can not be a specific tumor markers in endometrial cancer.It proves whether there is some expression in endometrial cancer from the study .Pre-operative serum samples from surgically staged patients with endometrioid adenocarcinoma of the uterus were analyzed for levels of CA72-4. Control samples were obtained from healthy postmenopausal women and dysfunctional uterine bleeding(DUB).This experiment is using enzyme-linked immunosorbent assay ELISA method to detect serum CA125 and CA724 levels for the healthy postmenopausal women, dysfunctional uterine bleeding, preoperative and postoperative endometrial cancer. The experime -ntal results show that CA125, CA724 levels with preoperative endometrial cancer patients were significantly higher than that in patients with dysfunctional uterine bleeding and the healthy group (P <0.05, P <0.01). CA125, CA724 levels with preoperative endometrial cancer patients were significantly higher than in patients with postoperative endometrial cancer(P <0.01).With other higher clinical stage, CA125, CA724 levels increased the concentration levels (P <0.01).CA125 levels with dysfunctional uterine bleeding patients were significant difference with the healthy group (P <0.05). CA724 levels with dysfunctional uterine bleeding patients were not significant difference with the healthy group (P > 0.05). It can be concluded that:①CA125, CA724 levels showed high expression of serum of endometrial cancer patients.②CA125, CA724 levels was positively correlated of surgery between pathological stage endometr -ial cancer.③CA125 levels showed moderate expression in dysfunctional uterine bleeding patients, while CA724 levels was low expression in patients with dysfunctional uterine bleeding, in contrast they were significant differences with preoperative endometrial cancer.④CA125, CA724 levels showed high expression of preoperative endometrial cancer in contrast to postoperative endometrial cancer.⑤CA125, CA724 are expected to be a valuable specific antigen marker of endometrial cancer to promote the clinical application.⑥CA125, CA724 can be used to determine the early diagnosis of endometrial cancer, detect indicators of prognosis, and prognosis of the recurrence oto be one of the warning signal .In this study, CA125, CA72-4 as the detection of tumor markers have a certain application value in differential diagnosis with its research and in-depth consultation to be at the basis of clinical symptoms and in conjunction with other test items related to endometrial cancer. Ca724 can be one of the methods for the preliminary screening especially for out-patient or a large number of patients with irregular bleeding long-term . It may be further prompted diagnosis the need for curettage or hysteroscopy with color Doppler ultrasound ,and may be high-risk warning signals for endometrial cancer. In this study, CA724 and CA125 levels was significantly higher than in patients with endometrial carcinomaⅢ-Ⅳin contrast toⅠ-Ⅱperiod (P <0.01). It can progress to diagnose preoperative evaluation of the course and monitor the recurrence signs of postoperative endometrial cancer by testing serum of preoperative and postoperative patients with endometrial cancer , so it can to be a one valuable reference by predicting the outcome after the scope of the guidance of the operation. Therefore, it not only can guide and assist in clinical pathology, but also is important to determine the individual treatment and prognosis at the same time ,by the understanding of endometrial cancer tumor marker expression pattern. However, the cases of this study was less coverage and less study at home and abroad, so the study of CA724 for endometrial cancer remains to be go on. In summary,tumor markers plays an important role for early diagnosis and treatment, detection of disease progression and guide individual treatment, prognosis, etc in endometrial carcinoma.With the continuous progress of biomedical and molecular biology,tumor marker research will be more in-depth, so as to open up new areas and provide new ideas for tumor diagnosis and therapy .