Clinical Research For Microsatellite Instability Of Epithelial Ovarian Cancer

Objective:Ovarian cancer is one of the three common female genital malignancies. Because lack of typical symptoms of early stage, ovarian cancer is still lack of early diagnosis means that most patients seek medical treatment when they are found already late. Conventional surgery, chemotherapy, endocrine therapy are difficult to significantly prolong survival in these patients, so the five-year survival rate of ovarian cancer is still hovering around 25%-30%. Epithelial ovarian cancer is the most common ovarian tumor, accounting for 50%-70% of primary ovarian tumors , and 50%-70% of malignant ovarian tumors. The highest mortality rate in all ovarian tumors, and therefore epithelial ovarian cancer research are highly valued, so searching the high genetic markers is significantly important to early diagnosis, the guidance of clinical treatment, to assess the prognosis of great significance.Microsatellite instability is a new mechanism of tumor after oncogene activation and tumor suppressor gene inactivation .In recent years, found that microsatellite instability is a widespread phenomenon of cancer, Microsatellite instability has become a new hot spots of the cause of cancer. Numerous studies have shown that lung cancer, gastric cancer, colorectal cancer, breast cancer, cervical cancer, endometrial cancer susceptibility related to microsatellite instability that may be associated with the occurrence of these organs tumors. This study of 71 cases of epithelial ovarian cancer patients were analyzed by using polymerase chain reaction (Polymerase Chain Reaction, PCR) and polyacrylamide gel electrophoresis (Polyacrylamide gel elelctroforesis, PAGE) technology to detect the microsatellite instability. Analysis of microsatellite instability in epithelial ovarian cancer and the frequency of occurrence of epithelial ovarian cancer with pathological stage, histological grade relationship for epithelial ovarian cancer, we respect to provide cilinical evidence for early diagnosis and the basis for assessment of prognosis. Method:From 2006 to 2008,seventy-one patients with ovarian cancer who undewent operation and specimens were finally diagnosed by pathologists as ovarian malignancies at the China-Japan Union Hospital of Jilin University. The 71 cases of ovarian cancer specimens have complete clinical data. Select the same period treated 15 cases of ovarian benign tumor patients and 15 normal blood samples as a control group.This study of epithelial ovarian cancer patients with clinical data to do a retrospective analysis of patients with ovarian cancer age of onset, clinical manifestations, pathological stage, histological grade, and the use of PCR-SSCP to detected in epithelial ovarian cancer microsatellite instability in the frequency and with epithelial ovarian cancer and epithelial ovarian cancer of pathological stage, histological grade relationship.Result:1.The median age is 53±16.5 years old of 71 patients with ovarian cancer(range from 17 to 75). Fifty-five patients who manifested as abdomenal tumeur account 78.9%; Eight patients who were detected unexpectedly account 11.3%;Five who manifested as vaginal irregular bleeding and sencondary modest,severe aneamia acccount 5.6%;Three who had dysuria and difficult defecation account 4.2%. Which epithelial ovarian cancer, including serous cystadenocarcinoma are 46 cases, mucinous cystadenocarcinoma are 12. According to FIGO staging,of these patients, stage I patients are 17 cases,accout 24.94%;stage II are 9 cases,accout12.68%;stageⅢ-Ⅳare45 cases,accout 62.38%. 23 cases of poorly-differentiated, accounting for 32.39%, 17 cases of moderately-differentiated, accounting for 23.94%, 31 cases of well-differentiated, accounting for 43.66%. 2.71 patients with epithelial ovarian cancer occurred in the frequency of microsatellite instability for 64.79% (46/71). Early (Ⅰ-Ⅱ) patients and late stage (Ⅲ-Ⅳ) patients with microsatellite instability frequency were 42.3% (11/26), 77.78% (35/45), the microsatellite instability in the early and late in comparison there was a significant difference (χ2 = 10.91, p <0.05). Epithelial ovarian malignancies in G1-G2 phase, G3 period the frequency of occurrence of MSI were 50% (20/40), 83.7% (26/31). Comparison between the two there was a significant difference (χ2 = 10.33, p <0.05).Conclusion:1. In patients with epithelial ovarian cancer exist D7S522 locus microsatellite instability.2. D7S522 locus microsatellite instability in epithelial ovarian cancer with pathological stage, histological grade were related, D7S522 microsatellite locus instability in epithelial ovarian cancer to participate in progress.3. D7S522 locus microsatellite instability in ovarian cancer only, but not occur in normal ovaries and benign tumors in patients.4. D7S522 microsatellite loci may be associated with instability in the progression of ovarian cancer, the more serious lesions, D7S522 microsatellite loci higher incidence of instability.