Li T C, Okon M A, Dalton C F, Heatley M, Laird S M
Biomedical Research Unit, Jessop Hospital for Women, Sheffield, UK.
Hum Reprod. 1998 Oct;13(1O):2895-901. doi: 10.1093/humrep/13.10.2895.
In this prospective study, we examined the possible diagnostic value of the measurement of two endometrial proteins, placental protein-14 (PP14) and CA-125, in the evaluation of pre- and post-menopausal bleeding. Concentrations of these two proteins were measured in plasma and uterine flushings obtained from 139 pre- and post-menopausal women with bleeding problems, and 26 normal post-menopausal control women without bleeding. Endometrial biopsy samples were also obtained for histological study. Concentrations of PP14 in both the plasma and uterine flushings in post-menopausal women were significantly lower (P < 0.001) than those of control pre-menopausal women. In post-menopausal women, the concentrations of PP14 (mean +/- SEM) in both plasma and flushing were significantly higher (P < 0.001) in women with endometrial adenocarcinoma (46.9+/-7.5 ng/ml plasma; 3350+/-1711 ng/ml flushing) than in the controls (7.6+/-1.3 ng/ml plasma; 125+/-27 ng/ml flushing) or in women with post-menopausal bleeding and atrophic endometrium (20.4+/-2.1 ng/ml plasma; 453+/-167 ng/ml flushing). In contrast CA-125 concentrations in plasma and flushings were similar in post-menopausal and pre-menopausal women. Plasma concentrations of CA-125 were higher in post-menopausal women with adenocarcinoma (29.1+/-7.4 IU/ml) than in those with post-menopausal bleeding and atrophic endometrium (21.8+/-2 IU/ml) (P < 0.05) or control post-menopausal subjects (16.1+/-2.1 IU/ml) (P < 0.01). CA-125 concentrations in uterine flushings were not significantly different in any group of post-menopausal women. The results show that concentrations of PP14 are correlated more strongly to endometrial histopathology than those of CA-125 in pre- and post-menopausal women. Elevated PP14 concentrations are also associated with the presence of endometrial adenocarcinoma and may have a potential to be used as a marker for this disease.
在这项前瞻性研究中，我们检测了两种子宫内膜蛋白——胎盘蛋白14（PP14）和CA - 125的测量值在评估绝经前后出血情况时的可能诊断价值。对139例有出血问题的绝经前后妇女以及26例无出血问题的绝经后正常对照妇女的血浆和子宫冲洗液进行了这两种蛋白浓度的检测。同时获取了子宫内膜活检样本用于组织学研究。绝经后妇女血浆和子宫冲洗液中PP14的浓度显著低于绝经前对照妇女（P < 0.001）。在绝经后妇女中，患有子宫内膜腺癌的妇女血浆和冲洗液中PP14的浓度（均值±标准误）显著高于对照组（血浆7.6±1.3 ng/ml；冲洗液125±27 ng/ml）或患有绝经后出血且子宫内膜萎缩的妇女（血浆20.4±2.1 ng/ml；冲洗液453±167 ng/ml）（分别为血浆46.9±7.5 ng/ml；冲洗液3350±1711 ng/ml）（P < 0.001）。相比之下，绝经后和绝经前妇女血浆和冲洗液中CA - 125的浓度相似。患有腺癌的绝经后妇女血浆中CA - 125的浓度（29.1±7.4 IU/ml）高于患有绝经后出血且子宫内膜萎缩的妇女（21.8±2 IU/ml）（P < 0.05）或绝经后对照受试者（16.1±2.1 IU/ml）（P < 0.01）。子宫冲洗液中CA - 125的浓度在任何一组绝经后妇女中均无显著差异。结果表明，在绝经前后妇女中，PP14浓度与子宫内膜组织病理学的相关性比CA - 125更强。PP14浓度升高也与子宫内膜腺癌的存在相关，并且可能有潜力用作该疾病的标志物。
