Study On Serum InhibinA,ActivinA And FSH Levels In Postmenopausal Women With Ovarian Tumors

ObjectiveOvarian tumor is a common women disease and the incidence of malignant ovarian tumor is 10% ,which was more and more high in recent years. Ovarian cancer can result in death,which had heavily puzzled the health of women. At the present time, though the diagnosis of ovarian tumor is based on clinical signs, it is too late to treat the patients until the clinical symptoms and signs become obvious. Some studies showed either detecting the levels of glucose or many cytokines in serum or abdominal is sensitive and specific. In addition,the pathological test in the ovary tissue is a retrospective diagnosis which can not guide clinical treatments. Therefore, it is important to diagnose the ovarian cancer and treat the patients in early time,which can reduce the mortality rate of them.Inhibin is an ovarian hormone that inhibits the secretion of follicle - stimulating hormone (FSH) by the anterior pituitary gland. In contrast to that of inhibin , activin is an inducer of FSH which also belongs to the transforming growth factor beta ( TGFβ ) . Nowadays, people pay more attention to the acts in early diagnosis of ovarian tumor. Many scholars have evaluated serum inhibin levels in ovarian epithelial tumor or granulose cell tumor, but whether the concentrations are increased in women with other ovarian tumors is unknown. And few scholars have evaluated serum FSH and inhibin , activin levels at the same time in one patient of ovarian tumor.The aim of this research is to investigate the changes of serum FSH , ac-tivin A and inhibin A concentrations and the value of diagnosis in postmenopaus-al women with ovarian tumors, so as to further discuss the cause of ovarian tumor.Material and method60 menopausal inpatients of ovarian tumor at term were collected from July 2004 to September 2005 in the Department of gynecologic, Second Affiliated Hospital of China Medical University. The sera were selected before operation. And serum samples of 27 controls were collected from the general population participating in a physical examination. All the cases did not coexist with any clinical infectious signs and complications. Furthermore they didnt use hormone replacement therapy in recent 3 months.The design of this test is case — control study, so all subjects were divided into two groups;1 . The normal group (n =27);2. The ovarian tumor group (n = 60). This group assigned to two sub - groups;benign tumor group ( n = 30) and malignant tumor group. The diagnostic standard of ovarian tumor was accorded to OBSTETRICS AND GYNECOLOGY (edited by Lejie,the sixth edition) and OBSTETRICS AND GYNECOLOGY PATHOLOGY ( edited by Chenzhong-nian,the first edition) ,respectively.By use of a sensitive enzyme - linked immunosorbent assay (ELISA) , serum FSHNactivin A and inhibin A concentrations were measured in all 87 samples.The results were analyzed using t - test or Chi - square test or Nonparamet-ric test and processed by SPSS11. 5. There was a statistical significance when P <0.05.ResultsThere was no significant difference between the test group and the normalgroup in FSH ( P >0. 05). The serum levels of activin A and inhibin A in malignant tumor were significantly higher than those in patients with benign tumor and normal controls (P < 0. 05 ) . Seven of the 9 women (77.8 percent) with mucinous carcinomas of the ovary had elevated serum inhibin A concentrations, whereas only 4 of the 10 women (40 percent) with serous cystadenocarcinomas had elevated levels. Serum inhibin A concentrations were also elevated in 4 of 4 women (100 percent) with granulose - cell tumors, and 3 of 3 women (100 percent ) with ovarian endometrioid tumor. The serum concentrations of inhibin A were increased in none of 27 women with benign ovarian diseases. None of 2 women with clear - cell carcinomas had increased serum concentrations of inhibin A.Using the 95th centile in the control group as the cut off, activin A levels were elevated in 70% of women with ovarian cancer, while inhibin A was elevated in 66. 7%. FSH levels were no significantly lower in women with ovarian cancer.There was negative correlation between serum levels of FSH and inhibin A in women with ovarian cancer ( Pearson r = -0. 11, P < 0. 05), especially in women with granulose - cell tumors (Pearson r = -0.46,P<0.05). Although, inbibin A can modulate FSH levels, there was positive correlation between activin A and FSH in women with granulose - cell tumors ( Pearson r =0. 85 ,P < 0.05).Conclusions1. These data demonstrate that FSH is unlikely to be a useful tumor marker.2. These data demonstrate that inhibin A is more commonly elevated than FSH in postmenopausal women with ovarian cancer and its role as a tumor marker in the diagnosis and screening of ovarian cancer warrants further evaluation.3. Detection of the activin A concentrations in the sera of postmenopausal women may enable doctors to diagnosis sub - clinical ovarian tumor in patients.4. There was negative correlation between serum levels of FSH and inhibin A in women with granulose - cell tumors, and positive correlation between activin A and FSH. The results showed that although in ovarian tumor inhibin and activin still regulate the secretion of FSH.