The Study Of The Expression Of CD34,Lymphocyte Subsets,P53 And Bcl-2 In Patients With Ovarian Cancer

[Objective] To investigate the relationship of mononuclear cells- CD34 +,lymphocyte subsets in the peripheral blood and ascites of patients with ovarian cancer and the prognosis clinicopathological factors; to explore the expression of p53, Bcl-2, mononuclear cells CD34+,microvascular density and the association of clinicopathological factors in ovarian cancer ,and provide a theoretical basis of ovarian cancer diagnosis, monitoring the efficacy and prognostic evaluation。[Method]By flow cytometry (FCM) detect 74 cases of malignant ovarian tumors (61 cases of primary tumor, 13 cases of metastatic tumors) mononuclear cells CD34+,lymphocyte subsets in peripheral blood and ascites, and compared to 30 cases of the health of women; Using immunohistochemical methods to detect 61 cases of primary ovarian cancer p53, Bcl-2 and microvessel density。[Results]1.The comparation of the Primary epithelial ovarian cancer, metastatic tumors, and healthy control group1) Comparison of peripheral blood among groups:The expression of mononuclear cells CD34+ in peripheral blood in Primary epithelial ovarian cancer and metastatic tumors were higher significantly (P<0.01) than the healthy control group。that in the primary epithelial ovarian cancer patients increased significantly (P<0.01) compared with metastatic tumors。Primary epithelial ovarian cancer patients compared with healthy control group, lymphocyte subsets CD3+, CD4+, CD4+ /CD8+ ratio, CD25+ in peripheral blood decreased significantly, but CD8+ cells increased significantly (all P <0.01); metastatic tumors compared with healthy controls ,lymphocyte subsets CD4+ cells in peripheral blood decreased, CD3+, CD4+ / CD8+ ratio, CD25+significantly decreased ,but CD8+ cells increased significantly (P <0.05; P<0.01; P<0.01; P<0.01; P<0.01). there was no significant difference between the two groups of cancer patients (P>0.05).2) Comparison of ascites between two groups of patients with tumor There was no statistically significant difference between the expression of CD34+ mononuclear cells and lymphocyte subsets CD3+, CD4+, CD8+ CD4+ / CD8+ ratio, CD25+ in the ascites in Primary epithelial ovarian cancer group and the metastatic tumors (P>0.05).2. The relationship between clinicopathological factors and CD34+ mononuclear cells and changes in lymphocyte subsets in peripheral blood and ascites in 61 cases of primary epithelial ovarian cancer patients1) AgePeripheral blood within Ovarian cancer groups: CD34+ in age>50 decreased slightl than age≤50 years ,but no statistical significance (P = 0.109); CD4+,CD4+ / CD8+ ratio in age>50 years increased than in age≤50 years (P = 0.023; P <0.001).Ascites of ovarian cancer: CD34+ in age>50 increased significantiy than age≤50 years (P = 0.011); CD3+, CD4+, CD4+/CD8+, CD25+ in age>50 years were significantly higher than in age≤50 years (P = 0.003; P<0.001; P<0.001; P = 0.005), and CD8+, although a slight decrease but no statistical significance (P=0.070).2) Tumor diameterPeripheral blood within Ovarian cancer groups: tumor diameter>5cm in diameter compared to≤5cm,CD34+ mononuclear cells increased slightly, but no statistical significance (P = 0.085); CD8+lymphocytes significantly increase and CD4+ / CD8+ ratio were significantly decreased (P = 0.011; P = 0.011).Ascites of ovarian cancer: tumor diameter > 5cm in diameter compared to≤5cm,CD34+ mononuclear cells increased slightly, but no statistical significance (P = 0.236); CD4+ / CD8+ ratio were significantly decreased and CD4+ lymphocytes significantly decreased (P = 0.001; P = 0.016).3) The volume of ascitesPeripheral blood within Ovarian cancer groups: the patients with the volume of ascites>300ml compared to≤300ml, CD34+ peripheral blood mononuclear cells increased significantly (P <0.001); CD4+ lymphocyte population , CD25+ increased and CD8+ decreased significantly (P = 0.049; P = 0.046; P = 0.013), CD3+, CD4+ / CD8+ ratio decreased significantly (P = 0.007; P<0.001).Ascites of ovarian cancer: the patients with the volume of ascites>300ml compared to≤300ml,CD34+ mononuclear cells increased significantly (P = 0.034); CD4+ / CD8 + ratio decreased significantly (P = 0.022).4) Clinical staging FIGOSeen from Table 5, peripheral blood within Ovarian cancer groups: stage III ~ IV compared to stage I ~Ⅱpatients ,CD34+ peripheral blood mononuclear cells increased significantly (P <0.001), CD3+ CD4+, CD25+, CD4+ / CD8+ ratio decreased significantly, CD8+ was significantly higher (P <0.001; P = 0.003; P = 0.005; P<0.001).Ascites of ovarian cancer: stage III ~ IV compared to stage I ~Ⅱpatients ,CD34+ mononuclear cells increased significantly (P = 0.015); CD3+ cells decreased with statistical significance (P = 0.025), CD4+, CD4 +/ CD8+ ratio decreased significantly, CD8+ cells increased significantly (P=0.001;P<0.001;P<0.001)5) The classificationperipheral blood within Ovarian cancer groups: well-differentiated compared to poorly differentiated ovarian cancer patients , CD34 + peripheral blood mononuclear cells decreased significantly (P <0.001); CD3 + increased, CD8 + decreased significantly (P = 0.021; P = 0.016), CD4 +, CD25 +, CD4 + / CD8 + ratio was significantly higher (P = 0.008; P<0.001; P = 0.005).Ascites of ovarian cancer: well-differentiated compared to poorly differentiated ovarian cancer patients ,CD34 + mononuclear cells changed slightly but no significantly (P = 0.133); CD3+, CD4+, CD4+ / CD8 + ratio was significantly increased and CD8 + decreased significantly, CD25+ cells increased with statistical significance (P <0.001; P <0.001; P <0.001; P = 0.001; P = 0.016).6) Tissue type CD3+, CD4+, CD8 +, CD25+, CD34+, CD4+ / CD8+ ratio between Groups had no differences either in the peripheral blood or ascites (all P>0.05)7)The relationship with serum CA125 valuesPeripheral blood within Ovarian cancer groups: CA125> 500U/ml compared to CA125≤500U/ml , CD34+ peripheral blood mononuclear cells were statistically significant differences (P = 0.015); lymphocyte subsets CD3+ decline in statistical significance (P = 0.033), CD4+, CD25+, CD4+ / CD8+ ratio decreased significantly (P = 0.001; P <0.001; P = 0.002).Ascites of ovarian cancer: CA125> 500U/ml compared to CA125≤500U/ml, CD34+ mononuclear cells increased significantly (P = 0.005); CD3+, CD4+, CD25+, CD4+ / CD8+ ratio decreased significantly and CD8+ was significantly higher (P <0.001; P <0.001; P = 0.005; P = 0.003; P = 0.003).3. Changes of CD34+ peripheral blood mononuclear cells and lymphocyte subsets in 30 patients with advanced ovarian cancer before and after operation.After-operation compared to before operation,the peripheral blood CD34+ mononuclear cells was no significant difference (P = 0.077); CD4+ / CD8+ ratio increased with statistical significance (P = 0.018).4. The expression of p53, Bcl-2 and MVD in ovarian cancer, ovarian tumors and normal ovarian tissueCompared three groups, the positive rate of P53, Bcl-2 expression and MVD were significantly differences. The ovarian cancer group compared with benign ovarian tumors and normal ovaries, the positive rate of MVD and P53, Bcl-2 expression was significantly higher; MVD of benign ovarian tumors is significantly higher than normal ovarian group, but Bcl-2 positive expression rate was no significant difference. Ovarian cancer group P53, Bcl-2 positive group was higher than the negative of the MVD group, P53 increased significantly.5. The relationship between clinicopathological factors and P53, Bcl-2 expression and MVDAge>50 compared with age≤50 tissue MVD significantly increased (P = 0.009), CD34+ mononuclear cells in ascitese were statistically significant differences (P = 0.011); in poorly differentiated compared with well-differentiated ,the positive rates of p53 expression was significantly higher (P = 0.037), MVD increased significantly (P = 0.004), peripheral blood CD34+ mononuclear cells increased significantly (P<0.001); p53 and Bcl-2 expression and MVD in all types of organizations, the difference was not statistically significant (all P>0.05);Ⅲ~Ⅳcompared with I ~Ⅱperiod ,the positive rate of p53 expression, the CD34+ mononuclear cells in ascites were statistically significant differences (P = 0.023; P = 0.015), MVD and CD34+ peripheral blood mononuclear cells increased significantly (P = 0.007; P <0.001 ); lymph node metastasis compared with no-lymph node metastasis, Bcl-2 positive rate of expression, MVD and ascites CD34+ mononuclear cells were significantly increased (P = 0.033; P = 0.036; P = 0.044), peripheral blood CD34+ mononuclear cells increased significantly (P = 0.004).6. The relevant studies of CD34+ cells in the peripheral blood and ascites in 40 patients with advanced ovarian cancer and MVDBy correlation analysis, peripheral blood CD34+ mononuclear cells and MVD ratio in patients with ovarian cancer was a positive linear correlation, correlation coefficient r = 0.888 (P <0.001); ascites CD34+ mononuclear cells and the ratio of the level of MVD in patients with ovarian cancer was positively linear correlation, correlation coefficient r = 0.853 (P <0.001); peripheral blood CD34+ mononuclear cells and ascites CD34+ mononuclear cells in patients with ovarian cancer was positively linear correlation, correlation coefficient r = 0.902 (P <0.001).[Conclusion]1. Primary epithelial ovarian cancer, metastatic cancer patients compared with healthy control group, peripheral blood CD34+ mononuclear cells significantly increased, there is a significant imbalance in the proportion of lymphocytes; compared with metastatic tumors, CD34+ mononuclear cells significantly increased in primary epithelial ovarian cancer, but there is no significant difference in the proportion of lymphocytes .2.In peripheral blood of patients with ovarian cancer, the change of CD34+ mononuclear cells and lymphocyte subsets have relationship with ascites volume, clinical stage, grade, CA125 values; in ascites of patients with ovarian cancer, the change of CD34+ mononuclear cells and lymphocyte subsets have relationship with age, ascites volume, clinical stage, CA125 values;but they has nothing to do with the type of tumor tissue.3. Surgery can eased. the imbalance of peripheral blood lymphocytes.4.The increasing of CD34+ cells may be associated with ovarian cancer-related angiogenesis in patients with ovarian cancer.5.MVD have relationship with age, clinical stage, pathological grade, lymph node metastasis, which were related with the expression of Bcl-2 or P53. There is a certain relationship P53, Bcl-2 may have a more important role. in promoting angiogenesis in ovarian cancer6. Peripheral blood CD34+ mononuclear cells ratio and MVD in patients with ovarian cancer was a positive linear correlation, ascites CD34+ mononuclear cells ratio and MVD in patients with ovarian cancer was a positive linear correlation, and peripheral blood and ascites CD34+ mononuclear cells ratio in patients with ovarian cancer was a positive linear correlation, suggesting that CD34+ cells in the ascites may come from CD34+ cells in peripheral blood, it may be involved in intra-abdominal tumor angiogenesis and metastasis.