Department of Obstetrics and Gynecology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.
Gynecologic Cancer Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC.
J Chin Med Assoc. 2021 Nov 1;84(11):1048-1053. doi: 10.1097/JCMA.0000000000000604.
Ovarian clear cell carcinoma (OCCC) is frequently associated with endometriosis. Since serum levels of cancer antigen 125 (CA125) have limited diagnostic and prognostic value in this malignancy, there is an unmet need for reliable and specific biomarkers. Previous findings indicated that alpha 1-antitrypsin isoforms (isoAAT) are significantly increased in the peritoneal fluid of patients with endometriosis. This study was undertaken to examine whether serum isoAAT levels in patients with OCCC differ from those measured in women with endometriosis or benign ovarian tumors. We also investigated whether this biomarker may be useful for predicting survival in OCCC.
Paired serum samples before and after debulking surgery were collected from 27 patients with OCCC. All sera from patients with endometriosis (n = 44) and benign ovarian tumors (n = 32) were obtained in the pretreatment phase. Serum isoAAT levels were assayed using a proprietary ELISA kit.
The highest levels of serum isoAAT (median, range) were identified in patients with OCCC (preoperative values: 160.9 ng/mL, range, 101.4-1098.8 ng/mL), followed by patients with endometriosis (125.0 and 83.4-473.2 ng/mL), and those with benign tumors (125.2 and 60.5-191.3 ng/mL). The differences in serum isoAAT levels between patients with OCCC and benign tumors were significant (p = 0.041). Debulking surgery of OCCC resulted in a significant decrease in serum isoAAT levels compared with the preoperative period (median, 160.9 versus 113.0 ng/mL, respectively, p = 0.012). As for prognostic prediction, we found that none of the nine patients with OCCC and serum isoAAT levels ≤130 ng/mL died of disease.
Serum isoAAT levels may be diagnostically useful to distinguish OCCC from benign ovarian tumors and could also serve as a potential prognostic marker.
卵巢透明细胞癌（OCCC）常与子宫内膜异位症相关。由于在这种恶性肿瘤中，癌抗原 125（CA125）的血清水平诊断和预后价值有限，因此需要可靠和特异的生物标志物。先前的研究结果表明，α1-抗胰蛋白酶同工酶（isoAAT）在子宫内膜异位症患者的腹腔液中显著增加。本研究旨在探讨 OCCC 患者的血清 isoAAT 水平是否与子宫内膜异位症或良性卵巢肿瘤患者的测量值不同。我们还研究了该生物标志物是否可用于预测 OCCC 的生存。
从 27 例 OCCC 患者中采集手术去瘤前后的配对血清样本。所有子宫内膜异位症（n=44）和良性卵巢肿瘤（n=32）患者的术前血清均获得。使用专利 ELISA 试剂盒测定血清 isoAAT 水平。
OCCC 患者血清 isoAAT 水平最高（中位数，范围），为 160.9ng/mL（范围为 101.4-1098.8ng/mL），其次是子宫内膜异位症患者（125.0 和 83.4-473.2ng/mL）和良性肿瘤患者（125.2 和 60.5-191.3ng/mL）。OCCC 患者与良性肿瘤患者的血清 isoAAT 水平差异有统计学意义（p=0.041）。与术前相比，OCCC 的去瘤手术导致血清 isoAAT 水平显著下降（中位数，分别为 160.9 与 113.0ng/mL，p=0.012）。就预后预测而言，我们发现，血清 isoAAT 水平≤130ng/mL 的 9 例 OCCC 患者均未死于疾病。
血清 isoAAT 水平可能有助于诊断 OCCC 与良性卵巢肿瘤，并可能作为一种潜在的预后标志物。
