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目的探讨血浆溶血磷脂酸(LPA)及糖类抗原125(CA125)在子宫内膜癌患者血浆中的表达及与临床病理特征之间的关系。方法选取2013年3月至2014年12月间武汉市第一医院收治的58例子宫内膜癌(EC)患者作为子宫内膜癌EC组,选取同期收治的42例子宫内膜非典型增生(EAH)患者作为EAH组,另选取42例同期健康体检的女性作为对照组。检测并比较三组人员血浆溶血磷脂酸和血浆CA125含量。结果 EC组患者血浆LPA水平为(5.47±2.41)μmol/L,明显高于EAH组(2.52±1.94)μmol/L和对照组的(2.45±0.76)μmol/L,差异均有统计学意义(均P<0.05)。EC组患者血浆中LPA和CA125诊断子宫内膜癌的阳性率分别为69.0%和63.8%。LPA诊断子宫内膜癌0~Ⅰ期的阳性率明显高于Ⅱ~Ⅳ期的阳性率,差异有统计学意义(P<0.05)。血浆LPA的阳性率随EC患者TNM分期、淋巴结转移与否及浸润深度的进展而降低,差异均有统计学意义(均P<0.05);CA125的阳性率随EC患者TNM分期、淋巴结转移与否及浸润深度的进展而升高,差异均有统计学意义(均P<0.05)。结论血浆LPA检测对子宫内膜癌的早期诊断及鉴别诊断具有一定的临床应用价值,明显优于CA125,LPA可作为判断子宫内膜癌预后的重要指标。
Objective To investigate the expression of plasma lysophosphatidic acid (LPA) and carbohydrate antigen 125 (CA125) in the plasma of patients with endometrial carcinoma and its relationship with clinicopathological features. Methods Fifty-eight patients with endometrial carcinoma (EC) admitted to Wuhan No.1 Hospital from March 2013 to December 2014 were enrolled as EC group of endometrial cancer. Forty-two patients with endometrial atypical hyperplasia EAH) patients as EAH group, another 42 cases of the same period of health examination of women as a control group. The levels of plasma lysophosphatidic acid and plasma CA125 in three groups were detected and compared. Results The level of LPA in EC group was (5.47 ± 2.41) μmol / L, which was significantly higher than that in EAH group (2.52 ± 1.94) μmol / L and control group (2.45 ± 0.76) μmol / L All P <0.05). The positive rates of LPA and CA125 in endometrial carcinoma in patients with EC were 69.0% and 63.8% respectively. The positive rate of LPA in the diagnosis of endometrial carcinoma from stage 0 to stage Ⅰ was significantly higher than that of stage Ⅱ to Ⅳ (P <0.05). The positive rate of plasma LPA decreased with the progress of TNM staging, lymph node metastasis and depth of invasion in EC patients (all P <0.05). The positive rate of CA125 was positively correlated with TNM staging, lymph node metastasis or not And the progress of invasion depth increased, the differences were statistically significant (P <0.05). Conclusion Plasma LPA test has some clinical value in the early diagnosis and differential diagnosis of endometrial cancer, which is obviously superior to CA125. LPA can be used as an important index to judge the prognosis of endometrial cancer.