Finkler超声评分联合LMTK2基因在诊断上皮性卵巢癌中的应用

doi:10.7517/issn.1674-0475.220605

摘要/Abstract

摘要： 本文考察Finkler超声评分联合狐猴酪氨酸激酶2（LMTK2）基因在上皮性卵巢癌（EOC）诊断中的价值。本研究对112例EOC患者（EOC组）和76例卵巢良性上皮性肿瘤患者（良性组）进行超声检查及Finkler超声评分，并采用RT-PCR法检测血清LMTK2水平。结果显示，EOC组的Finkler超声评分和血清LMTK2 mRNA相对表达量显著高于良性组（P<0.001）。Finkler超声评分和血清LMTK2 mRNA相对表达量显著正相关（r=0.563，P<0.001）。当Finkler超声评分>5时，诊断EOC的曲线下面积（AUC）为0.964。当血清LMTK2 mRNA相对表达量>0.415时，诊断EOC的AUC为0.907。Finkler超声评分联合血清LMTK2诊断EOC的AUC （0.986）和敏感性（94.64%）高于单独诊断。Ⅲ～Ⅳ期组的Finkler超声评分和血清LMTK2 mRNA相对表达量显著高于Ⅰ～Ⅱ期组（P<0.05）。Finkler超声评分、血清LMTK2及二者联合诊断Ⅲ～Ⅳ期的AUC分别为0.643、0.850、0.851。本研究表明，在EOC的早期诊断中，与单独诊断相比，Finkler超声评分联合血清LMTK2可有效提高诊断灵敏度，并且血清LMTK2对病理分期的诊断价值可能高于Finkler超声评分。

关键词: 上皮性卵巢癌, Finkler超声评分, 狐猴酪氨酸激酶2, 早期诊断, 病理分期

Abstract: This paper investigated the value of Finkler ultrasound score combined with lemur tyrosine kinase 2 (LMTK2) gene in the diagnosis of epithelial ovarian cancer (EOC). In this study, 112 patients with EOC (EOC group) and 76 patients with benign epithelial tumor of ovary (benign group) underwent ultrasonography and Finkler ultrasound score, and detected the serum LMTK2 levels by RT-PCR. The results showed that the Finkler ultrasound score and the relative expression of serum LMTK2 mRNA in the EOC group were significantly higher than those in the benign group (P<0.001). There was a significant positive correlation between the Finkler ultrasound score and the relative expression of serum LMTK2 mRNA (r=0.563, P<0.001). When the Finkler ultrasound score was >5, the area under curve (AUC) of the diagnosis of EOC was 0.964. When the relative expression of serum LMTK2 mRNA was >0.415, the AUC of diagnosing EOC was 0.907. The AUC (0.986) and sensitivity (94.64%) of Finkler ultrasound score combined with serum LMTK2 in the diagnosis of EOC were higher than those of single diagnosis. The Finkler ultrasound score and the relative expression of serum LMTK2 mRNA in stage Ⅲ-Ⅳ group were significantly higher than those in stage Ⅰ-Ⅱ group (P<0.05). The AUCs of Finkler ultrasound score, serum LMTK2 and their combined diagnosis of stage Ⅲ-Ⅳ were 0.643, 0.850, and 0.851, respectively. This study showed that in the early diagnosis of EOC, compared with the single diagnosis, the Finkler ultrasound score combined with serum LMTK2 could effectively improve the diagnostic sensitivity, and the diagnostic value of serum LMTK2 for pathological staging could be higher than the Finkler ultrasound score.

Key words: epithelial ovarian cancer, Finkler ultrasound score, lemur tyrosine kinase 2, early diagnosis, pathological staging

范方裕, 蒲英梅, 周柱玉, 辛艳芬, 夏纪筑. Finkler超声评分联合LMTK2基因在诊断上皮性卵巢癌中的应用[J]. 影像科学与光化学, 2022, 40(5): 1062-1066.

FAN Fangyu, PU Yingmei, ZHOU Zhuyu, XIN Yanfen, XIA Jizhu. Application of Finkler Ultrasound Score Combined with LMTK2 Gene in the Diagnosis of Epithelial Ovarian Cancer[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(5): 1062-1066.

参考文献

[1] Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide:sources, methods and major patterns in GLOBOCAN 2012[J]. International Journal of Cancer, 2015, 136(5):E359-E386.
[2] Doherty J A, Peres L C, Wang C, et al. Challenges and opportunities in studying the epidemiology of ovarian cancer subtypes[J]. Current Epidemiology Reports, 2017, 4(3):211-220.
[3] Reid B M, Permuth J B, Sellers T A. Epidemiology of ovarian cancer:A review[J]. Cancer Biology & Medicine, 2017, 14(1):9-32.
[4] Goff B A, Mandel L S, Melancon C H, et al. Frequency of symptoms of ovarian cancer in women presenting to primary care clinics[J]. JAMA, 2004, 291(22):2705-2712.
[5] Lheureux S, Gourley C, Vergote I, et al. Epithelial ovarian cancer[J]. Lancet, 2019, 393(10177):1240-1253.
[6] 李洁, 王晨静, 李涵, 等. 彩色多普勒超声Finkler评分联合血清糖类抗原125诊断卵巢肿瘤的临床价值[J]. 实用癌症杂志, 2021, 36(4):672-675.
[7] 马彩叶, 刘夏天, 李星云, 等. 彩色多普勒超声评分和血流阻力指数结合糖类抗原125在卵巢肿瘤中的诊断价值[J]. 中国临床保健杂志, 2018, 21(2):179-181.
[8] 李海鹏, 陈鲜霞. Finkler超声评分联合HE4、miR-21在上皮性卵巢癌诊断中的价值[J]. 广东医学, 2019, 40(12):1754-1758.
[9] Cruz D F, Farinha C M, Swiatecka-Urban A. Unraveling the function of lemur tyrosine kinase 2 network[J]. Frontiers in Pharmacology, 2019, 10:24.
[10] Lalremmawia H, Tiwary B K. Identification of molecular biomarkers for ovarian cancer using computational approaches[J]. Carcinogenesis, 2019, 40(6):742-748.
[11] Finkler N J, Benacerraf B, Lavin P T, et al. Comparison of serum CA 125, clinical impression, and ultrasound in the preoperative evaluation of ovarian masses[J]. Obstetrics and Gynecology, 1988, 72(4):659-664.
[12] Siegel R L, Miller K D, Fuchs H E, et al. Cancer statistics, 2021[J]. CA:A Cancer Journal for Clinicians, 2021, 71(1):7-33.
[13] Lheureux S, Braunstein M, Oza A M. Epithelial ovarian cancer:Evolution of management in the era of precision medicine[J].CA:A Cancer Journal for Clinicians, 2019, 69(4):280-304.
[14] Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA:A Cancer Journal for Clinicians, 2018, 68(6):394-424.
[15] Peres L C, Cushing-Haugen K L, Köbel M, et al. Invasive epithelial ovarian cancer survival by histotype and disease stage[J]. Journal of the National Cancer Institute, 2018, 111(1):60-68.
[16] Rosendahl M, Høgdall C K, Mosgaard B J. Restaging and survival analysis of 4036 ovarian cancer patients according to the 2013 FIGO classification for ovarian, fallopian tube, and primary peritoneal cancer[J]. International Journal of Gynecological Cancer, 2016, 26(4):680-687.
[17] 钱林华, 高燕, 李惠东, 等. 超声联合CA125、CA199诊断早期上皮性卵巢癌的临床价值[J]. 天津医科大学学报, 2010, 16(3):502-505.
[18] Liu X W, Jia Y X, Stoopler M B, et al. Next-generation sequencing of pulmonary sarcomatoid carcinoma reveals high frequency of actionable MET gene mutations[J]. Journal of Clinical Oncology:Official Journal of the American Society of Clinical Oncology, 2016, 34(8):794-802.
[19] Shah K, Bradbury N A. Lemur tyrosine kinase 2, a novel target in prostate cancer therapy[J]. Oncotarget, 2015, 6(16):14233-14246.
[20] 张榕婧. LMTK2在结肠癌中的功能和机制研究[D].北京:中国科学院大学, 2020.