Diagnostic Value Of Determination Of Serum InhibinA,ActivinA And CA125 In Patients With Ovarian Cancer

Ovarian malignent tumor is one the three main malignent genital tumor of female. The incidence of this disease is raising year by year. Because there is no effective mathod to diagnosis the disease at it's early stage, most of patients are at the late stage when they have the sympotoms. The 5 years survial rate of malignent ovarian toumor is still very low at about 25 ~ 30%. Now the CA125 is a very common tumor marker and is popuparly used to detect the epithelial ovarian cancer in the clinic. Because CA125 is only very sensitive to the serous cys-tadenocarcinoma, but not very sensitive to mucinous cystadenocarcinoma and other types of ovarian tumors. And in the other benign diseases of female such as endometriosis, pelvic inflammation disease ( PID) , and even in the cases of other malignent genital tumor of female or other malignent disease of other organs , the level of CA125 have different higher degree than normal. So it is short of chracters in diagnosing the ovarian cancer. So for earlier diagnosis, treatment, raise up the survival rate, finding out a more sensitive ovarian tumor marker is becoming the studing hotspot. among these studies, lots of interests were payed on Inhibin and Activin. Inhibin and Activin are belong to transforming growth factor ( TGF) family. They are all glucoprotein hormone of couple - chain with multiple . At normal condition, Inhibin is secreted by granocytes and luteal cells of follicle and inhibit the composing and secreting of FSH by pituitary though the feedback machanism. Activin can be detected in many kinds of tissues but it is mainly secreted by granocytes in ovarian and by Gn cells in pituitary. Its fuction is contrary to Inhibin, it can encourage the composing and secrerting of FSH in anterior lob of pituitary by the way of self - secrete and pa-rasecrete. And it can accelerate the development of primordial follicles. Some reports proved that in the plasma of postmenupausal femal, the levels of Inhibin and Activin are stalbe despite the increase of the age. Another reports showed that these two kind of hormone have magnificant increasing in both malignant o-varian tumor tissues and blood. These results proved that these kinds of hormon probably play an important fuction during the development of ovrain cancer, and showed that they can be the tumor marker at the same time. There were some scholars finding out that the blood level of Inhibin has abnormal increasing in granulosa cell tumor and mucinous cystadenocarcinoma patients. They pointed out that Inhibin combined with CA125 can improve the successful diagnose of o-varian cancer. But until now there is no report published of those three targets combination for detecting the oarian cancer. In this study, we want to find out the value of combination of Inhibin, Activin and CA125 in diagnosing the ovarin cancer.Materials and methods1. General materialsSelect the hospitalized patients in Gynecologic department of the 2nd clicnic hospital of the Chinese Medical University during July ,2004 ~ September,2005. All the patients are postmenupause. The cancer group has 30 ovarian cancer women, mean age: 59. 4 ± 5. 0;30 benign overain tumor women as the benign tumor group, mean age: 58. 6 ±3.7;27 healthy postmenupause women as the contrast group, mean age: 57. 7 ±3.9. All these women have no hormone treatment during the last 3 months, and have not any other endocrine disease and other organic tumor history.2. Sample collectionIn the group of ovarian cancer group ( group 1) and benign ovarian tumor group (group 2) , take the elbow vein blood 3 ml 2 ~3 days before the surgery. In the contrast group, all the women were taken 3 ml elbow vein blood at the yearly exam. All the samples were put under the usual room temprature for 1 hour, then centifuge at 3000r/min. Collect the upper liquid and protect in therefrigeratory under - 20X! waiting for test.3. Detection methodsUse ELISA to test the InhibinA and ActivinA level in all groups of women' s blood plasm. The CA125 level was abtained by the ragluar lab test in our hospital.4. Statistical analysisThe date were all expressed as mean standard deviation. Statistical analysis use two independent sample t test in two groups and differences in masculine rate was analyzed by x test with SPSS software. Statistical analysis was significantly inhibited ( P < 0. 05 ).ResultsThe average blood levels of InhibinA of these groups are 8. 91 ±4. 26u/ml of malignent ovarian tumor,4.01 ±1. 13u/ml of benign ovarian tumor and 3. 98 ± 1. 15 u/ml of healthy women.The average blood levels of ActivinA of these groups are 2328. 61 ± 1047. 03pg/ml of malignent ovarian tumor, ,898. 86 ±720.24pg/ml of benign ovarian tumor and 705. 81 ±460.40 pg/ml of healthy women.The average blood levels of CA125 of these groups are 186.77 ± 178. 95u/ ml of malignent ovarian tumor, 19.44 ±18. 59u/ml of benign ovarian tumor and 13. 93 ±9.49u/ml of healthy women.Of the malignent ovarian cancer patients, those three kind of marker are all have significant differnce with binign ovarian tumor patients and healthy women (t test,p <0. 05) ,has statistic interests. But between benign ovarian tumor patients and healthy women, those three kind of marker has no statistic interests (t test,p>0.05).These three markers possitive detected rate are 66.7% of InhibinA, 70% of ActivinA and 63. 3% of CA125. The possitive detected rate of the combination of CA125 with InhibinA or with ActivinA are 90% and 86. 7% ,and 93. 3% of the combination of these three markers. By the test of x ,the to compare with the possitive detected rate of CA125, the combination of two markers and threemarkers are all have significant differences (p <0. 05) ,has statistic interests. But between the later two combination(p >0. 05) ,has no statistic interests.Conclution1. InhibinA >, ActivinA can become new ovarian tumor marker.2. This study also showed at the same time that the combination of these three markers can raise up the possitive rate of diagnose of ovarain cancer and this combinating detector may become a guilline for the early diagnosis of ovarian cancer and filtration of healthy.3. InhibinA may becoming a new particular cancer marker of mucinous cys-tadenocarcinoma and granulosa cell tumor.4. There still need further study to confirm whether or not ActivinA has high sesitivity to endomerioid carcinoma.