| Aims:1. To study the serum levels of soluble E-cadherin (sE-cad) in patients with epithelial ovarian carcinoma, as well as the combining application of sE-cad, CA125, CA19-9andCEA.2. To study the expression of E-cad and sE-cad in three human epithelial ocarian carcinoma cell lines (SKOV3, SAO and ES-2).Methods:1. Using enzymelinked immunoassay (ELISA), we detected the serum levels of sE-cad in 35 patients with epithelial ovarian carcinoma and in 35 patients with benign ovarian tumor, 35 health subjects as control. The serum levels of CA125, CA19-9 and CEA were measured by chemiluminescent immunoassay (CLIA). The correlations between four serum tumor markers and clinicopathololgical characteristics were analyzed. The prognostic significance of tumor markers for survival was assessed in a multivariate analysis with the Cox's proportional hazards model.2. Using ELISA, reverse transcriptase polymerase chain reaction (RT-PCR) and Western Blot Assay, the expression of E-cad and sE-cad in three human epithelial ovarian carcinoma cell lines (SKOV3, 3AO and ES-2) were measured.Results:1. The serum concentrations of sE-cad in epithelial ovarian carcinoma group were significantly higher, as compared to the benign ovarian tumor group and health group (F=630.315, P < 0.001). Regarding the distribution of tumor marker levels according to the FIGO stage, sE-cad level was significantly higher in III-IV stage than I-II stage (F=5.696, P =0.003). However, among patients with epithelial ovarian carcinoma, preoperative serum sE-cad correlated neither with the pathological type nor with the histological grade. Postoperative serum sE-cad concentration decreased in one month, reaching the normal levels (t=0.093, P > 0.05). Serum sE-cad levels were increased again when tumors recur.2. The sensibility, specificity, positive prediction value and negative prediction value of sE-cad in diagnosis of epithelial ovarian carcinoma were 88.57%, 85.71%, 86.11% and 88.24%.3. From analyses of tumor marker levels according to pathologic types, the level of CA19-9 was significantly higher in patients with mucinous cystadenocarcinoma, which of CA125 was significantly higher in patients with serous cystadenocarcinoma.4. When the Cox's proportional hazard model was used, sE-cad and CA125 had been identified as independent prognostic factors.5. The correlation between sE-cad and CA125 was significantly related in epithelial ovarian carcinomas (r=0.483, P <0.05) .6. sE-cad was found as 80 kDa peptides released from three human epithelial ovarian carcinoma cell lines (SKOV3, 3AO and ES-2) into the serum-free culture medium.7. The expression of sE-cad mRNA in three human epithelial ovarian carcinoma cell lines (SKOV3, 3AO and ES-2) were detected. The quantity of sE-cad mRNA in ES-2 was the lowest, while that in SKOV3 was the highest.8. Full-length E-cadherin (120kDa) was expressed. In in vitro studies, it was demonstrated that treatment with trypsin and Ca2+ generated sE-cad fragments of 80kDa.Conclusion:The serum concentrations of sE-cad in epithelial ovarian carcinoma group were significantly higher. The sensibility, specificity, positive prediction value and negative prediction value of sE-cad in diagnosis of epithelial ovarian carcinoma were all above 85%. In a word, serum sE-cad could be used as tumor marker for epithelial ovarian carcinoma. The combining application of sE-cad, CA125 and CA19-9 could improve the diagnosis of epithelial ovarian cancer and early detection of recurrence.In in vitro studies, it was demonstrated that treatment with trypsin and Ca2+ generated sE-cad fragments of 80kDa in three human epithelial ovarian carcinoma cell lines (SKOV3, 3AO and ES-2). The functional role of the sE-cad in fluids has been known to disrupt cell-cell adhesion in carcinoma cell and lead to a more invasive phenotype.
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