赵俪梅　傅亚均　陈勇

[摘要] 目的 探讨卵巢癌患者血清胸苷激酶1（TK-1）水平及其临床意义。 方法 研究2010年3月～2014年6月重庆市北部新区第一人民医院及重庆市西南医院就诊的初治卵巢癌患者116例（卵巢癌组），选择同期卵巢良性肿瘤患者54例（卵巢良性肿瘤组）及健康体检者56例（健康对照组）。记录三组一般情况、临床特征等资料，采集血清检测TK-1及CA125水平。对接受治疗患者定期随访，观察无进展生存情况。对影响无进展生存时间的危险因素进行多因素Logistic回归分析。采用Pearson和Spearman系数进行各指标间的相关性分析。 结果 卵巢癌组患者TK-1[（4.89±1.85）pmol/L]及CA125[（647.08±208.83）pmol/L]水平显著高于卵巢良性肿瘤组[（0.59±0.23）、（22.71±9.62）pmol/L]及健康对照组[（0.61±0.20）、（22.11±9.94）pmol/L]，且临床分期越高TK-1水平越高，有远处转移患者TK-1较无转移更高（均P < 0.01）。血清TK-1与CA125水平及临床分期呈正相关（r = 0.657、0.567，均P < 0.01）。初始高TK-1水平（≥4.00 pmol/L）患者远期（30个月）无进展生存比率较低TK-1水平（<4.00 pmol/L）患者更低，差异有统计学意义（P = 0.011）。临床分期、初始CA125及TK-1水平是无进展生存时间的负性影响因素。 结论 卵巢癌患者血清TK-1显著升高，与临床分期及CA125水平相关。初始高TK-1水平预示预后较差，高临床分期、初始高CA125及TK-1水平影响治疗后无进展生存时间。

[关键词] 卵巢癌；胸苷激酶1；糖类抗原125；预后

[中图分类号] R737.31 [文献标识码] A [文章编号] 1673-7210（2015）02（b）-0039-05

[Abstract] Objective To investigate the serum thymidine kinase 1 （TK-1） level and its clinical significance of patients with primaryovarian cancer. Methods The research included 116 patients with ovarian cancer （ovarian cancer group）from March 2010 to June 2014 in the First People's Hospital of Chong Qing New North Zone and Southwest Hospital of Chongqing， while the 54 patients with ovarian benign tumor （ovarian benign tumor group） and 56 cases of healthy control （healthy controls group）were selected. The general situation， clinical manifestations of three groups were recorded and levels of serum TK-1 and CA125 were detected. Patients with treatment were followed up regularly， and the risk factors of progression-free survival time were analyzed with Logistic regression. The correlation between the indexes were analyzed by Pearson and Spearman coefficient. Results The levels of TK-1 [（4.89±1.85） pmol/L] and CA125 [（647.08±208.83） pmol/L] of patients in the ovarian cancer group were significantly higher than those in the ovarian benign tumor group [（0.59±0.23）， （22.71±9.62） pmol/L] and healthy control group [（0.61±0.20）， （22.11±9.94） pmol/L]. The TK-1 levels were higher in patients with advanced clinical stageor and distant metastasis than others （all P < 0.01）. The level of TK-1 was significant positive correlation with CA125 level and clinical stage （r = 0.657， 0.567， all P < 0.001）. The long-term （about 30 months）progression-free survival rate of patients with initial high level of TK-1 （≥4.00 pmol/L）was lower than that of the low level （<4.00 pmol/L）， the difference was statistically significant （P = 0.011）. Clinical stage， initial levels of CA125 and TK-1 were negative risk factors of progression-free survival time. Conclusion There is significant increase of serum TK-1 level in ovarian cancer patients， and it is related to the CA125 level and clinical stage. Initial high TK-1 level predicts poor prognosis. Advanced clinical stage， the initial high level of CA125 and TK-1 affect progression-free survival time after treatment.

[Key words] Ovarian cancer； Thymidine kinase 1； Carbohydrate antigen 125； Prognosis

卵巢癌是临床上常见的妇科生殖系统肿瘤，病理类型复杂多样，早期诊断困难，病死率高。每年全球约有超过22万女性发生卵巢癌，美国每年约新增22 500例，病死约14 600例，病死率高达67.7%[1]。卵巢癌早期与晚期预后差异巨大，且早期缺乏典型临床症状及特异性诊断方法，导致大部分患者发现时已是中晚期。同时，治疗后复发及远处转移也是导致临床上患者死亡的最重要原因。糖类抗原125（carbohydrateantigen，CA125）是目前临床应用最广，公认的用于卵巢癌患者诊断及预后评价的血清肿瘤学标志物[2]。然而CA125的准确性仍不够理想，假阳性率较高，临床上亟需寻找更为准确的指标或联合指标来改进对卵巢癌的诊断及预后判断。……