目的 分析血清耐药相关的差异表达蛋白质在诊断卵巢上皮性癌铂类耐药患者中的价值,为非手术卵巢上皮性癌患者化疗药物方案的制定提供参考.方法 选择川北医学院附属医院妇产科2015年3月至2016年3月收治的经铂类药物治疗无效的卵巢癌患者40例设为观察组,选择同期收治的经铂类药物治疗获得改善的卵巢癌患者40例作为对照组,采集两组受试者静脉血,采用酶联免疫法(ELISA)检测并比较两组患者的血清耐药相关蛋白(SERPINA1、FN1、ORM1、annexinA3、destrin、IDHl))的表达情况,所有患者均行病理穿刺,获取病理组织,采用逆转录一聚合酶链反应(RT-PCR)检测方法对病理组织中的上述耐药相关蛋白进行检测.分析血清标本检测结果和病理组织检测的SERPINA1、FN1、ORM1、destrin、annexinA3、IDHl结果之间的差异性和相关性.结果 观察组患者血清中的SERPINA1、FN1、ORM1、destrin、annexinA3、IDHl水平分别为(753.6±138.6)μg/μL、(223.5±51.5)μg/μL、(72.2±40.9)μg/μL、(331.5±21.8)μg/μL、(344.2±40.6)μg/μL、(44.5±21.3)μg/μL,病理组织中上述指标分别为(38.69±6.7)％、(32.32±6.6)％、(35.48±6.1)％、(29.44±5.4)％、(26.63±4.8)％、(11.37±1.5)％,对照组患者血清中的SERPINA1、FN1、ORM1、destrin、annexinA3、IDHl水平分别为(512.6±113.4)μg/μL、(125.5±41.4)μg/μL、(64.6±41.4)μg/μL、(215.7±21.1)μg/μL、(23.42±5.3)μg/μL、(115.5±21.3)μg/μL,病理组织中上述指标分别为(27.49±5.7)％、(21.38±5.4)％、(23.41±5.2)％、(23.41±5.2)％、(21.22±4.6)％、(29.43±2.3)％.观察组患者血清中SERPINA1、FN1、ORM1、destrin、annexinA3均明显高于对照组,但血清中IDHl水平明显低于对照组,差异均有统计学意义(P<0.05);观察组患者卵巢癌病理组织中的SERPINA1、FN1、ORM1、destrin、annexinA3水平均明显高于对照组,但IDHl水平明显低于对照组,差异均有统计学意义(P<0.05);血清中检测的SERPINA1、FN1、ORM1、destrin、annexinA3、IDHl水平与病理组织中检测的结果的spearman相关性系数分别为0.734、0.683、0.702、0.682、0.593、0.618,均呈正相关(P<0.05).结论 血清中耐药相关的差异表达蛋白质检测结果与病理组织中的检测结果密切相关,对于无法行手术探查或者治疗的患者,采用血清样本检测耐药相关差异蛋白质可为化疗药物方案的制定提供重要的参考,具有较高的临床价值.%Objective To analyze the clinical value of differential expression proteins related to drug resistance in the diagnosis of epithelial ovarian carcinoma in platinum resistant patients, and to provide a reference for the formula-tion of chemotherapy protocols for patients with non-operation epithelial ovarian cancer. Methods A total of 40 ovari-an cancer patients with no-effect for the platinum drug treatment, who admitted to our hospital from March 2015 to March 2016, were selected as the observation group. At the same time, 40 ovarian cancer patients with improved-effect for platinum drug treatment were enrolled the control group. The venous blood of the two groups were collected, and en-zyme-linked immunosorbent assay (ELISA) was used to detect and compare the serum resistance associated proteins (SERPINA1, FN1, ORM1, annexinA3, destrin, IDHl) expression. All the patients were subjected to pathological biopsy to obtain the pathological tissue. Reverse transcription polymerase chain reaction (RT-PCR) was used to detect the drug resistance related proteins in the pathological tissue. The results of serum samples and the differences and correlations between the results of SERPINA1, FN1, ORM1, destrin, annexinA3 and IDHl in pathological tissues were analyzed. Results The serum levels of SERPINA1, FN1, ORM1, destrin, annexinA3, IDHl of patients in the observation group were respectively (753.6±138.6)μg/μL, (223.5±51.5)μg/μL, (72.2±40.9)μg/μL, (331.5±21.8)μg/μL, (344.2±40.6)μg/μL, (44.5 ± 21.3)μg/μL. The above indexes in pathological tissue were respectively (38.69 ± 6.7)％, (32.32 ± 6.6)％, (35.48 ±6.1)％, (29.44±5.4)％, (26.63±4.8)％, (11.37±1.5)％;The serum levels of SERPINA1, FN1, ORM1 , destrin, annexinA3, IDHl of the control group were (512.6 ± 113.4)μg/μL, (125.5 ± 41.4)μg/μL, (64.6 ± 41.4)μg/μL, (215.7 ± 21.1)μg/μL, (23.42 ± 5.3) μg/μL, (115.5 ± 21.3) μg/μL, respectively. The above indexes in pathological tissue in the control group were (27.49±5.7)％, (21.38±5.4)％, (23.41±5.2)％, (23.41±5.2)％, (21.22±4.6)％, (29.43±2.3)％, respectively. The serum SERPINA1, FN1, ORM1, destrin, annexinA3 in the observation group were significantly higher than those in the con-trol group (P<0.05), but the IDHl level of the observation group was significantly lower than that in the control group (P<0.05);SERPINA1 FN1, destrin, ORM1, and annexinA3 levels in the pathological tissue of ovarian cancer in the ob-servation group were significantly higher than those of the control group (P<0.05), but the level of IDHl was signifi-cantly lower than that of the control group (P<0.05). Spearman correlation coefficient test results of SERPINA1, FN1, ORM1, destrin, annexinA3, IDHl level between serum and pathological tissues were respectively 0.734, 0.683, 0.702, 0.682, 0.593, 0.618. Conclusion The results of differentially expressed proteins related to drug resistance in serum were closely related to the results of pathological tissues. For patients who cannot be surgically probed or treated, the use of serum samples to detect the drug-resistant related differential proteins may provide an important reference for the for-mulation of chemotherapy regimens with high clinical value.
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