Diagnostic Value Of Determination Of SLPI And CA125 In Patients With Ovarian Cancer

Objective: As one of the three main malignant genital tumors of female, the death rate of ovarian malignant tumor remains in top. Because there is no effective method to diagnose the disease at its early stage, most patients are at the late stage when symptoms occur. Now CA125 is a very common tumor marker and is popularly used to detect epithelial ovarian cancer in clinic, of which the value has been appreciated. However, the early diagnosis rate of CA125 is low, and the level of CA125 has higher degree than normal in other benign diseases of female such as endometriosis, pelvic inflammation disease. It is therefore becoming one of the contemporary research focuses to discover tumor markers to be used together with CA125 with the aim of increasing early diagnosis rate, sensitivity and specificity of ovarian cancer. Serum secretary leukocyte protease inhibitor is a serine protease inhibition. In recent years, SLPI has been found expressed in a variety of human carcinomas, which indicates SLPI is closely related to development of tumors. It has been proved that SLPI mRNA was over expressed in tumor cells in contrast to the lack or only weak staining in normal ovarian tissue. While there have been no reports published on correlation between SLPI and tumor, some researchers abroad have made some progresses. The objective of the study aims at improving diagnosis rate of ovarian cancer by determining level of SLPI and CA125 and assessing the value of combination of SLPI and CA125 in diagnosis , especially in early stage of the ovarian cancer.Method: Object: 31 patients with ovarian cancer who were in Dalian obstetric hospital were chosen between June, 2006 and December, 2007 as the malignant group. By FIGO stage, there were 13 cases of type I—II, 18 cases of type III-IV; by histological type, 19 cases of cystadenocarcinoma, 2 cases of mucinous cystadenocarcinoma, 6 cases of endometrioid carcinoma, 4 cases of clear-cell carcinoma; by clinical phases, 14 cases of G₁-G₂, 17 cases of G₃. While 24 patients with benign ovarian tumor were chosen as benign group, 31 healthy women were taken as control group. All the patients had no inflammatory states with their peripheral leukocyte counted below 10×10⁹/l, and had not any other endocrine disease and organic tumor history. Besides, they were not treated by radiation therapy chemotherapy, hormonotherapy. Method of experiment: use ELISA to test SLPI. The level of CA125 was obtained by regular lab test in our hospital. Statistics analysis use two independent example t test in two groups with SPSS software., Statistics Analysis was significantly inhibited.Results: 1. The determining result of CA125: (1) The CA125 level of malignant group is significantly higher than that of benign group and control group and p<0.001. When comparing benign group and control group, P>0.05. (2) The positive rate of CA125 in the benign group is 87% and CA125 is sensitive to cystadenocarcinoma,mucinous cystadenocarcinoma, and endometrioid carcinoma. (3) The level of CA125 is correlated to FIGO stages. The level of stage III-IV ovarian cancer is significantly higher than that of stage I-II. (p<0.01), which is nonrelated to clinical phases ( P>0.05). (4) The diagnosis rate of CA125 in stage I ovarian cancer shows low, only 55%. 2. The determining result of SLPI: (1) The SLPI level of malignant group is significantly higher than that of benign group and control group, and p<0.001. When comparing benign group and control group, P>0.05. (2) The level of SLPI is nonrelated to FIGO stages, the clinical phases and histological type (3) The SLPI level of stage I is significantly higher than that of benign group, and p<0.001. (4) Sensitivity and specificity of combination of SLPI and CA125 is higher than each individual measure.Conclusions: 1. CA125 is sensitive to invasive epithelial ovarian cancer, and it increases with stage, but the early diagnosis rate is low. 2. The level of SLPI in invasive epithelial ovarian cancer shows high, and is nonrelated to FIGO stages, the clinical phases and histological type. 3. The level of SLPI rises in the early stage of ovarian cancer, which could be treated as a potentially useful marker for diagnosis. 4. The combination of SLPI and CA125can improve sensitivity and specificity of diagnosis of ovarian cancer.