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目的:探讨子宫内膜样腺癌患者血清及组织中人类软骨糖蛋白(YKL-40)表达的临床意义,并分析其与不同病理特征的相关性。方法:用酶联免疫吸附法(ELISA)测定41例子宫内膜样腺癌患者、27例子宫肌瘤患者及30例正常妇女外周血血清中YKL-40的表达;用免疫组化法检测子宫内膜样腺癌、子宫肌瘤患者组织中YKL-40的表达;分析其在血清及组织中的表达相关性,并分析血清YKL-40与子宫内膜样腺癌病理特征的关系。结果:(1)子宫内膜样腺癌组术前血清YKL-40浓度(157.2μg/L,76.0～301.2μg/L)明显高于子宫肌廇组(86.6μg/L,69.3～183.6μg/L)及正常组(86.2μg/L,52.1～201.1μg/L)(P均<0.05);子宫内膜样腺癌组患者组织中YKL-40表达阳性率(34.1%,14/41)显著高于子宫肌瘤组(11.1%,3/27)(P<0.05);子宫内膜样腺癌患者血清YKL-40表达阳性率显著高于组织(63.4%vs 34.1%,P<0.05)。(2)单因素分析提示,子宫内膜样腺癌患者术前血清YKL-40浓度与FIGO分期、组织分级、细胞冲洗液阳性、血清CA125浓度及YKL-40组织表达有关(P<0.05);多因素分析结果表明,其与FIGO分期(P<0.05)及组织分级(P<0.01)有关;结论:子宫内膜癌诊治中,检测YKL-40有一定临床意义,其来源可能不局限于肿瘤细胞。
Objective: To investigate the clinical significance of human cartilage glycoprotein (YKL-40) expression in serum and tissues of patients with endometrioid adenocarcinoma and to analyze its correlation with different pathological features. Methods: The expression of YKL-40 in peripheral blood of 41 cases of endometrial adenocarcinoma, 27 cases of uterine fibroids and 30 normal women was detected by enzyme-linked immunosorbent assay (ELISA) Endometrioid adenocarcinoma and uterine fibroids. The relationship between the expression of YKL-40 and the expression of YKL-40 in serum and tissues was analyzed. The relationship between serum YKL-40 and pathological features of endometrial adenocarcinoma was analyzed. Results: (1) The concentration of serum YKL-40 in the endometrioid adenocarcinoma group (157.2μg / L, 76.0 ~ 301.2μg / L) was significantly higher than that in the uterus muscle group (86.6μg / L, 69.3 ~ 183.6μg / (34.1%, 14/41) in endometrioid adenocarcinoma group were significantly higher than that in normal group (86.2μg / L, 52.1 ~ 201.1μg / L) (11.1%, 3/27) (P <0.05). The positive rate of serum YKL-40 in endometrioid adenocarcinoma was significantly higher than that in the tissue (63.4% vs 34.1%, P <0.05). (2) Univariate analysis showed that preoperative serum YKL-40 levels in patients with endometrioid adenocarcinoma were correlated with FIGO stage, histological grade, positive cell irrigating fluid, serum CA125 concentration and YKL-40 expression (P <0.05). Multivariate analysis showed that it was associated with FIGO staging (P <0.05) and histological grade (P <0.01). Conclusion: The detection of YKL-40 in the diagnosis and treatment of endometrial cancer has some clinical significance, the origin may not be limited to the tumor cell.