Epithelial Ovarian Cancer Patients With Epithelial Cell Adhesion Molecule Level And The Assessment Of Prognosis

Back ground: Ovarian carcinoma is the third common gynecologic malignancy, and epithelial ovarian cancer accounts for 85 percent of ovarian cancer to 90 percent. Because lacked effective early diagnostic methods, ovarian cancer mortality was the highest. The patients with early-stage ovarian cancer have little symptom. The biomarker used widely for the defection and management of ovarian cancer was CA125 at present, but it was not very sensitive and lack specificity. So more than 70% of patients with ovarian cancer were diagnosed at the late stage (stageâ…¢+â…£). The five-year survival rate of patients with ovarian cancer was less than 30 percent. If patients of ovarian cancer were able to be diagnosed at an early stage (stageâ… +â…¡) that, the survival rate could be improved greatly. The statistical data showed, the 5-year survival rates of stageâ… andâ…¡were 90% and 70% respectively . Therefore, it was extremely pressing to look for new cancer tumor markers that can improve the rate of early diagnosis of ovarian. As a tumor marker, epithelial cell adhesion molecule (EpCAM) was identified in colon cancer. In its most malignant tumor cell surface expression of limitations, a large number of clinical trials to target EpCAM as immune therapy research. But as a tumor marker, EpCAM in the diagnosis of the study is a handful. According to reports, the EpCAM serum levels of patients with malignant tumors were significantly higher than normal. 2003, Jae-Hoon Kim's studies show that the patients with ovarian cancer whose EpCAM autoantibody serum level were significantly higher than normal. A report in 2004 pointed out: EpCAM expression in patients with ovarian cancer, which was an early event for epithelial ovarian cancer and has the potential to be used in the early diagnosis of ovarian cancer. Moreover, 2006, Gilbert SpizzoWill proposed EpCAM can be as a tumor marker to predict the prognosis of patients with ovarian cancer and guide treatment. There was no research at home and abroad about it that EpCAM as a serum marker for the diagnosis and prognosis of ovarian cancer.Objective: Testing EpCAM serum levels of patients with epithelial ovarian cancer, benign epithelial ovarian tumor patients and healthy women. The collection of ovarian cancer cases were followed up.The correlation between the level of serum EpCAM and the survival rate of patients who sufferd from ovarian cancer was assessed. Then evaluated the power of EpCAM in diagnosis and prognosis of ovarian cancer.Mathods: Enrolled 20 healthy women as control group, 48 patients with epithelial ovarian cancer,11 patients with benign epithelial ovarian tumor from Second Hospital of Hebei Medical University during Jan 2002 to June 2006 to get their serum. The final diagnoses were confirmed by histopathology for all patients. The EpCAM kit was provided by Shanghai Xitang Biological Technology Co., Ltd. Extracted, separated and colored the EpCAM. And the intensity of the color is measured at 492nm. Calculate the absorbance value (A492) for each set of samples. Followed-up patients with ovarian cancer and recorded their survival time, calculated the three years survival rate of them. Make use of SAS6.0 to carry out statistical treatmentResult:1 The values of EpCAM in serum ranged between 103.52U/ml and 205.56U/ml, and the mean was 121.64 (47.58,146.52) U/ml, in the group of epithelial ovarian cancer.But the scope of EpCAM covered 72.29~82.21U/ml, the mean was 81.57(73.56,85.44) U/ml in the group of benign epithelial ovarian tumor.The scope of EpCAM covered 23.21~87.58U/ml, and the mean was 31.99 (28.66,36.63) U/ml in healthy women control. Serum EpCAM levels of patients with ovarian cancer were significantly higher than those of benign epithelial ovarian tumor and healthy controls (P<0.001).2 There were no significant difference among EpCAM values of different histopathologic types, but there were significant in statistics between EpCAM values and clinic stage(P<0.001). There was no significant relation between the serum EpCAM levels ofâ… andâ…¡stages, nore betweenâ…¢andâ…£stages. The serum EpCAM levels ofâ…¢andâ…£stages were significantly higher than those of benign epithelial ovarian tumor and healthy controls also(P<0.001). 3 Within 48 patients of epithelial ovarian cancer, 23 patients were dead, 25 patients survived . Their three years survival rate was 55.6%.The decreasing of EpCAM level was significantly correlated with decreased overall survival (P = 0.000). Overall survival decreased with decreasing EpCAM scores.Conclusion: Testing EpCAM serum level of patients with epithelial ovarian cancer was a convenient effective and non-invasive method. Serum EpCAM levels of patients with ovarian cancer were significantly high. So EpCAM could be used as an ovarian cancer marker. In this study, all of the serum EpCAM levels of early stage ovarian cancer cases were greatly high. The serum EpCAM levels of early stage ovarian cancer cases were significantly higher than the late stage's. Meanwhile, there were no significant difference among EpCAM values of different histopathologic types. EpCAM overcomed the disadvantage of CA125 (the level of CA125 increased only in half of ovarian cancer patients and it's clinic value in discrimination of mucinous cancer was limited ). Moreover, with the serum EpCAM levels decreasing, the overall survival of patients with ovarian cancer significantly decreased. So serum EpCAM was a very valuable marker in diagnosing and prognosis epithelial ovarian cancer especially in early diagnosis.