Abstract
Objectives:To study the value of serum miR21, human epididymal secretory protein 4 (HE4) and carbohydrate antigen 125 (CA125) in the surveillance for postoperative recurrent or metastatic ovarian cancer.Methods:A total of 169 patients diagnosed with ovarian conditions in Luanzhou Hospital of Traditional Chinese Medicine during January 2016 and March 2019 were divided into a benign lesion (BL) group and an ovarian cancer (OC) group by pathological findings and assigned to a good prognosis (GP) group and a poor prognosis (PP) group according to the follow-up results. A real-time fluorescence quantitative PCR (RT-fqPCR) system was utilized to detect the serum level of miR-21; an enzyme-linked immunosorbent assay (ELISA) was conducted to determine the serum level of HE4; electrochemiluminescence (ECL)-based imaging analysis was performed to measure serum CA125. A receiver operating characteristic (ROC) curve was depicted to analyze the predictive value of serum miR-21, HE4, and CA125 for poor postoperative prognosis in patients with ovarian cancer.Results:Compared with the control group, the BL and OC groups had substantially elevated expression of miR-21, HE4, and CA125 in serum, and the serum levels of miR-21, HE4, and CA125 in the OC group were significantly higher than in the BL group. In the OC group, the serum levels of miR-21, HE4, and CA125 were independent of age and pathological patterns and associated with the clinical staging, degree of transformation and lymphatic metastasis of ovarian cancer; after laparoscopic ovarian tumorectomy, the serum levels of miR-21, HE4, and CA125 were markedly reduced in comparison with the preoperative levels. Compared with the GP group, the PP group experienced a dramatic increase in serum miR-21, HE4, and CA125 expression. The ROC curve showed that the detection of miR-21, HE4, and CA125 was a highly sensitive and specific method to predict the poor prognosis in ovarian cancer; a patient with ovarian cancer was at high risk of a poor prognosis when the serum levels of miR-21, HE4, and CA125 exceeded 1.536, 157.004 pmol/L and 175.243 kU/L, respectively, in which case early intervention should be made to prevent recurrent or metastatic ovarian cancer.Conclusion:Elevated expression of miR-21, HE4, and CA125 in serum is closely associated with the disease status of ovarian cancer. Therefore, the simultaneous detection of these tumor markers has some diagnostic value for postoperative recurrence and metastasis of ovarian cancer.
Highlights
Ovarian cancer is a common malignancy of the female reproductive system, which has an incidence rate lower than corpus cancer and endometrial cancer and is usually seen in womenPak J Med Sci March - April 2022 (Part-II) Vol 38 No 4 www.pjms.org.pk 939 at the age of about 50 years old
Compared with the control group, the benign lesion (BL) and ovarian cancer (OC) groups experienced a marked increase in serum miR-21, human epididymal secretory protein 4 (HE4), and Carbohydrate antigen 125 (CA125) expression (p< 0.05, respectively), with the serum levels of miR21, HE4, and CA125 in the OC group significantly higher than in the BL group (p< 0.05, respectively)
In the ovarian cancer patients, serum miR-21, HE4, and CA125 expression levels were independent of pathological patterns (p> 0.05) and associated with the clinical staging, degree of transformation and lymphatic metastasis of ovarian cancer
Summary
Ovarian cancer is a common malignancy of the female reproductive system, which has an incidence rate lower than corpus cancer and endometrial cancer and is usually seen in womenPak J Med Sci March - April 2022 (Part-II) Vol 38 No 4 www.pjms.org.pk 939 at the age of about 50 years old. Ovarian cancer causes no detectable symptoms during the early stage. It can progress quickly and metastasize rapidly. Ovarian cancer has already progressed to an advanced stage at the time of onset, with the patients presenting such symptoms as bloating, abdominal pain and weight loss.[1,2]. Tumorectomy is currently the standard treatment for ovarian cancer, which entails a relatively high risk of postoperative recurrence and metastasis that undermines the quality of life for patients with ovarian cancer.[3]. It is important to evaluate the risk of postoperative recurrence and metastasis of ovarian cancer through detection of related markers. As an acknowledged cancer-promoting gene, miR21 is highly expressed in liver and lung cancer tissues.[5] but rarely studied in patients with ovarian cancer. Carbohydrate antigen 125 (CA125) derived from coelomic epithelium is a member of the mucin family of glycoproteins
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