微RNA在卵巢上皮性癌发生发展中作用及其临床意义

研究表明,miRNA参与了胚胎发育、损伤修复、糖尿病、心脏病等许多重要生理病理过程,特别是在恶性肿瘤的发生发展中发挥了重要作用,并具有潜在的临床意义。本文比较详细地叙述了有关miRNA的重要基础研究成果,并就miRNA在卵巢癌组织及细胞中的表达、miRNA在卵巢癌发生发展中的作用、miRNA与卵巢癌早期诊断、化疗耐药及预后判断等方面的最新研究成果进行了综述。     

卵巢上皮性肿瘤中FKBP38 蛋白的表达研究

目的:探讨卵巢上皮性肿瘤中FK506结合蛋白38(FK506-binding protein 38,FKBP38)蛋白的表达及潜在的临床意义。方法:采用免疫组化的方法检测20例正常输卵管组织,30例卵巢上皮性良性肿瘤,27例卵巢交界性肿瘤组织,130例卵巢上皮性癌(epithelial ovarian carcinoma,EOC)组织中FKBP38蛋白的表达,并分析其表达水平与临床病理参数的关系。结果:FKBP38蛋白在卵巢上皮性癌中的表达明显低于正常输卵管组织、卵巢上皮性良性和交界性肿瘤组织,差异有统计学意义(P0.05)。FKBP38蛋白表达在根据国际妇产科联盟(International Federation of Gynecology and Obstetrics,FIGO)标准定义的不同分期的卵巢上皮性癌组织中具有统计学差异(P0.05)。FKBP38蛋白在卵巢高级别浆液性癌的表达比低级别浆液性癌中的表达显著性降低(P0.05)。但把卵巢上皮性癌按照不同年龄及不同组织学分型分层后,FKBP38蛋白表达差异无统计学意义(P0.05)。结论:FKBP38蛋白表达的下调可能与卵巢上皮性癌的发生和分化密切相关,提示FKBP38蛋白作为卵巢恶性肿瘤诊断和治疗的潜在性生物靶点需进一步探索和研究。     

ROMA在卵巢上皮性癌早期诊断中的研究进展

卵巢上皮性癌(Epithelial ovarian cancer,EOC)死亡率居妇科恶性肿瘤首位,早期诊断可明显改善患者预后。人附睾上皮分泌蛋白(human epididymis protein 4,HE4)对早期EOC的检测敏感性高,有助于对EOC高危患者的筛选,与CA125可互补,增加盆腔包块患者中EOC早期诊断力度。HE4与CA125联合检测及结合绝经状态预测盆腔包块患者中卵巢恶性肿瘤的发病风险模型(Risk of Ovarian Malignancy Algorithm,ROMA),能成功预测盆腔包块患者中EOC高风险个体,对卵巢良恶性肿瘤的鉴别预测更为准确且更易被接受,有较大的临床应用价值。     

ROMA在卵巢上皮性癌早期诊断中的研究进展

卵巢上皮性癌（Epithelial ovarian cancer,EOC）死亡率居妇科恶性肿瘤首位,早期诊断可明显改善患者预后。人附睾上皮分泌蛋白（human epididymis protein 4,HE4）对早期EOC的检测敏感性高,有助于对EOC高危患者的筛选,与CA125可互补,增加盆腔包块患者中EOC早期诊断力度。HE4与CA125联合检测及结合绝经状态预测盆腔包块患者中卵巢恶性肿瘤的发病风险模型（Risk of Ovarian Malignancy Algorithm,ROMA）,能成功预测盆腔包块患者中EOC高风险个体,对卵巢良恶性肿瘤的鉴别预测更为准确且更易被接受,有较大的临床应用价值。     

34例乳腺癌细胞体外ATP-TCA法敏感性检测分析

乳腺癌在妇女疾病中是较为常见的恶性肿瘤之一。外科手术是治疗乳腺癌的首选方法,但局部切除者的复发率高。术后复发与手术方式、肿瘤病理类型及术后使用化疗药物种类有关。故选择针对乳腺癌患者个体有效的药物进行化疗是术后控制复发的重要手段,寻找与临床相关性好、敏感、标准化、快速、简易的方法是药敏试验的方向。三磷酸腺苷一肿瘤细胞药敏试验（ATP—TCA法）,是根据ATP为细胞的基本能量单位,当细胞的代谢受损时,ATP合成下降．细胞死亡时受酶的作用,ATP迅速水解消失。     

MMP-2和TIMP-2基因启动子区多态性与卵巢上皮性癌关系的研究

为探讨MMP-2和TIMP-2基因启动子区单核苷酸多态性(SNPs)与卵巢上皮性癌发病风险的关系, 采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)方法检测了246例卵巢上皮性癌患者和324例对照妇女的MMP-2 C-1306T、C-735T和TIMP-2 G-418C 3个SNPs的基因型。结果显示, MMP-2 C-1306T SNP的等位基因及基因型频率分布在卵巢癌与对照组间无显著差异(P=0.55和P=0.42); 但卵巢癌组MMP-2 C-735T SNP的C等位基因和C/C基因型频率(80.7%和66.7%)明显高于对照组(75.5%和55.9%), 与T/T+C/T基因型比较, 携带C/C基因型可以显著增加卵巢癌的发病风险(OR=1.58, 95% CI=1.12~2.23), 进一步分层分析显示, C/C基因型主要与宫内膜样癌和年龄≥50岁妇女的发病风险显著相关, OR值分别为1.69(95%CI=1.03~2.79)和1.71(95% CI=1.14~2.57); 对MMP-2 C-1306T、C-735T 2个SNPs的单体型分析显示, 4种单体型频率(T_-1306-T_-735、T_-1306-C_-735、C_-1306-T_-735和C_-1306-C_-735)在两组间分布无显著差异(P=0.24); 虽然TIMP-2 G-418C SNP的等位基因及基因型频率在卵巢癌组与对照组间分布无显著性差异(P=0.33和P=0.47), 但以病理类型分层分析显示, 携带TIMP-2 G-418G/G基因型有增加宫内膜样癌发病风险的趋势(OR=1.62, 95%CI=0.94~2.78)。以上结果提示, MMP-2基因启动子区C-735T SNP的C/C基因型可能是卵巢上皮性癌发病的潜在危险因素, 而C-1306T SNP可能与卵巢上皮性癌的发病风险无关; TIMP-2 G-418C SNP可能与不同病理类型的卵巢上皮性癌发病风险有关。     

动态监测上皮性卵巢癌患者血清CA125水平对疗效及预后的评估价值

目的:通过观察卵巢上皮性癌患者术前、术后及化疗后CA125水平变化,探讨其水平变化对患者预后的评价价值。方法:选取2012年3月至2013年2月间医院诊治的卵巢上皮性癌患者85例为研究对象,所有患者均接受规范的卵巢癌分期手术或卵巢癌细胞减灭术,术后常规进行系统化疗。比较手术及化疗后患者血清CA125水平的变化,分析患者血清CA125水平动态变化、转阴时间与患者预后关系。结果:治疗后,患者CA125水平呈明显下降趋势,差异具有统计学意义(P0.05)。T1/2≤20 d患者存活时间明显长于T1/220 d的患者,差异具有统计学意义(P0.05)。CA125转阴时间≤8周的患者存活时间长于CA125转阴时间8周的患者,差异具有统计学意义(P0.05)。其复发率明显低于CA125转阴时间8周的患者,复发时间长于CA125转阴时间8周的患者,差异具有统计学意义(P0.05)。结论:通过检测血清CA125水平变化可以对卵巢上皮性癌患者预后进行较为准确的评价。     

卵巢良性和恶性上皮性肿瘤中端粒酶蛋白表达及活性的研究

目的　研究卵巢良性和恶性上皮性肿瘤中端粒酶蛋白的表达水平及其活性 ,探讨其作为卵巢癌肿瘤标记物的可能性。方法　应用免疫组织化学方法检测了 30例卵巢癌和 10例卵巢腺瘤组织中端粒酶相关蛋白 1(TP1)和人端粒酶蛋白催化亚基 (hTRT)的表达水平 ,并采用TRAP -ELISA方法检测了 30例卵巢癌和 10例卵巢腺瘤组织中的端粒酶活性。结果　免疫组织化学结果显示 ,30例卵巢癌和 10例卵巢腺瘤组织中TP1和hTRT表达阳性率均为 10 0 %,其中卵巢癌的强阳性表达率高于卵巢囊腺瘤 (P <0 0 1) ,TP1和hTRT的表达强度无明显差别。TRAP ELISA方法检测发现 30例卵巢癌组织中 ,2 8例检测到端粒酶活性 ,阳性率为 93.3%;10例卵巢腺瘤中 ,仅 1例浆液性乳头状腺瘤检测到端粒酶活性 ,阳性率为 10 %(P <0 0 0 1)。结论　本研究的结果表明卵巢良性和恶性上皮性肿瘤中端粒酶蛋白TP1和hTRT的表达水平与端粒酶活性之间无明显相关性 ,端粒酶活性的检测与卵巢癌的发生发展密切相关 ,有望成为卵巢癌的一种肿瘤标记物。     

卵巢上皮性癌中MMP-7、VEGF—C的表达和微淋巴管密度变化的相关性及其意义

目的观察基质金属蛋白酶-7（matrix metalloproteinase-7,MMP-7）、血管内皮生长因子-C（vascular endothelial growth factor—C,VEGF—C）和D2—40在上皮性卵巢癌中的表达,探讨MMP-7、VEGF-C表达以及D2—40标记的微淋巴管密度（microlymphatic vessel density,MLVD）与卵巢癌临床病理生物学行为的关系。方法应用免疫组化对80例EOC及20例卵巢良性上皮性肿瘤组织进行MMP-7、VEGF-C和D2—40的检测,并进行MLVD测定。结果MMP-7、VEGF—C蛋白的表达阳性率及MLVD计数在EOC组分别为60．0％、57．5％以及13．06±6．16,均分别高于良性肿瘤组25．0％、25．0％及9．25±4．33（P〈0．05）。EOC中,MMP-7、VEGF-C蛋白的阳性表达率随肿瘤组织学分级的增加而升高,分别为29．4％、56．7％、78．8％和11．8％、60．0％、78．8％（P〈0．05）,腹腔脏器及淋巴结有转移者高于无转移者,分别为86．8％＆35．7％及86．8％＆27．1％（P〈0．05）,两个指标在PTNMⅢ-Ⅳ期阳性表达率分别为83．8％、83．8％,均显著高于PTNMⅠ-Ⅱ期的阳性表达率39．5％、34．9％（P〈o．05）;D2—40标记的MLVD计数在EOC中随组织学分级的增加而增高,分别为7．29±2．85、12．63±6．25、16．48±4．94,腹腔脏器及淋巴结有转移者高于无转移者16．50±4．31＆10．00±5．99（P〈0．05）,PTNMⅢ-Ⅳ期显著高于PTNMⅠ-Ⅱ期16．65±4．15＆10．02±5．99（P〈0．05）。EOC中,MMP-7、VEGF-C的表达分别与MLVD呈正相关性（r分别为0．510,0．455,均PG0．01）;MMP-7、VEGF-C的表达分别与EOC患者腹腔器官及淋巴结转移亦呈正相关（r分别为0．521,0．565,均P〈0．01）。结论MMP-7、VEGF-C的表达可以促进EOC中淋巴管的形成及淋巴道转移,联合检测MMP-7、VEGF-C及MLVD可能作为预测EOC患者侵袭、转移等生物学行为和评价预后的重要指标。     

中国人卵巢上皮性肿瘤nm23H1基因遗传不稳定性的研究

采用石蜡包埋组织抽提DNA,PCR-单链构象多态性(PCR-SSCP),常规银染、Envision免疫组织化学染色和Leica-Qwin计算机图像分析等方法,研究人类17号染色体D17S396位点微卫星不稳定(microsatellite instablility,MSI)和杂合性缺失(loss of heterozygosity,LOH),对卵巢上皮性肿瘤nm23H1蛋白表达的影响,阐明nm23H1基因遗传不稳定性与卵巢肿瘤进展的关系,为揭示nm23H1基因作用机制和肿瘤转移机制提供实验依据。本实验中,卵巢上皮性癌D17S396位点遗传不稳定发生率为40%,明显高于交界性肿瘤的9.52%,而在良性肿瘤和正常卵巢组织中,未见该位点遗传不稳定的发生。其中,LOH的发生率,随肿瘤恶性程度的增高而增加(P<0.05)。在卵巢上皮性癌中,淋巴转移组的LOH发生率高于无淋巴转移组(P<0.01)。FIGO Ⅲ Ⅳ期的LOH发生率高于Ⅰ Ⅱ期(P<0.05)。MSI发生率与卵巢上皮癌组织类型、分化程度、淋巴转移及FIGO分期均无关。nm23H1 蛋白阳性率在卵巢上皮性癌和交界性肿瘤组织中分别为56.00%和57.14%,高于良性肿瘤的13.64%和正常卵巢组织的8.33%(P<0.01)。卵巢上皮性癌中,淋巴转移组nm23H1蛋白阳性率低于无淋巴转移组;FIGO Ⅲ Ⅳ期nm23H1蛋白阳性率低于Ⅰ Ⅱ期(P<0.05)。此外,计算机图像定量分析显示,在各临床病理参数影响下,nm23H1蛋白的表达强度没有差异。在卵巢上皮性癌中,LOH阳性组中nm23H1蛋白阳性率为0.00%,显著低于LOH阴性组的73.68%(P<0.01)。实验结果提示, nm23H1基因的遗传不稳定性可能是卵巢上皮性癌发生、发展的一个重要机制。LOH的发生可作为卵巢组织恶变的判断指标。nm23H1基因的MSI和LOH,通过相互独立的途径调控卵巢上皮癌的发生和转移,后者可抑制卵巢上皮癌局部nm23H1蛋白的表达,并赋予卵巢上皮癌高淋巴结转移、低预后的特性。提高卵巢上皮癌局部nm23H1蛋白的表达,可减缓肿瘤的淋巴转移并提高预后率。     

Out-Patient Peritoneal Lavage Cytology In the Detection of Residual Epithelial Ovarian Cancer

Peritoneal lavage fluid cytology was performed in 87 out-patients with histologically proven epithelial ovarian cancer undergoing primary management. A total of 246 peritoneal lavages were attempted, usually with temporary cannulae (n = 229). From these, 184 samples were obtained, of which 156 (85%) were suitable for cytological analysis. The sensitivity of peritoneal lavage fluid cytology in 67 patients with known residual disease was 57% whereas serum CA 125 levels were elevated in 58 (87%). Pre- and post-treatment peritoneal lavage fluid cytology had prognostic value, but this was less than that of serum CA 125 measurements.     

Heterotypic Three-dimensional In Vitro Modeling of Stromal-Epithelial Interactions During Ovarian Cancer Initiation and Progression

Epithelial ovarian cancers (EOCs) are the leading cause of death from gynecological malignancy in Western societies. Despite advances in surgical treatments and improved platinum-based chemotherapies, there has been little improvement in EOC survival rates for more than four decades ^1,2. Whilst stage I tumors have 5-year survival rates >85%, survival rates for stage III/IV disease are <40%. Thus, the high rates of mortality for EOC could be significantly decreased if tumors were detected at earlier, more treatable, stages ^3-5. At present, the molecular genetic and biological basis of early stage disease development is poorly understood. More specifically, little is known about the role of the microenvironment during tumor initiation; but known risk factors for EOCs (e.g. age and parity) suggest that the microenvironment plays a key role in the early genesis of EOCs. We therefore developed three-dimensional heterotypic models of both the normal ovary and of early stage ovarian cancers. For the normal ovary, we co-cultured normal ovarian surface epithelial (IOSE) and normal stromal fibroblast (INOF) cells, immortalized by retrovrial transduction of the catalytic subunit of human telomerase holoenzyme (hTERT) to extend the lifespan of these cells in culture. To model the earliest stages of ovarian epithelial cell transformation, overexpression of the CMYC oncogene in IOSE cells, again co-cultured with INOF cells. These heterotypic models were used to investigate the effects of aging and senescence on the transformation and invasion of epithelial cells. Here we describe the methodological steps in development of these three-dimensional model; these methodologies aren''t specific to the development of normal ovary and ovarian cancer tissues, and could be used to study other tissue types where stromal and epithelial cell interactions are a fundamental aspect of the tissue maintenance and disease development.     

PARP-1 抑制剂靶向治疗上皮性卵巢癌的研究进展

简介聚二磷酸腺苷核糖聚合酶-1（PARP-1）及其功能和在DNA 损伤修复中的作用,综述PARP-1 抑制剂的作用机制、发展现状以及在上皮性卵巢癌治疗中的应用,并探讨PARP-1 抑制剂靶向治疗上皮性卵巢癌的临床试验失败原因,展望PARP-1 抑制剂的应用前景,提出需对PARP-1 抑制剂在用于治疗上皮性卵巢癌中的耐药机制和选择性展开深入研究。     

Twist1调控FoxM1 在上皮性卵巢癌中的表达

目的:探讨Twist1调控转录因子Fox M1在上皮性卵巢癌中的表达。方法:采用免疫组织化学SP法检测Fox M1、Twist1在上皮性卵巢癌组织中表达情况,斯皮尔曼秩相关分析其在上皮性卵巢癌组织中的表达相关性;双荧光素酶报告系统检测Twist1对Fox M1的调控作用;Real-time quantitative RT-PCR和蛋白免疫印迹技术验证Twist1对Fox M1的调控作用。结果:Twist1、Fox M1在上皮性卵巢癌组织中的阳性表达率分别是71.4%(40/56)、78.6%(44/56),明显高于正常卵巢组织,差异有统计学意义(P<0.05);且其在上皮性卵巢癌中的表达显著相关(r=0.896,P<0.01);Twist1可以结合并激活Fox M1启动子(P<0.05);上调Twist1表达可以激活Fox M1在卵巢癌细胞中的表达(P<0.05),而干扰Twist1后可以下调Fox M1的表达(P<0.05)。结论:Twist1参与调控增殖相关转录因子Fox M1在卵巢癌中的表达,可能是一个潜在的治疗靶点。     

Circulating Exosomal miR-1290 for Diagnosis of Epithelial Ovarian Cancer

The aim of the study was to develop a new diagnostic biomarker for identifying serum exosomal miRNAs specific to epithelial ovarian cancer (EOC) and to find out target gene of the miRNA for exploring the molecular mechanisms in EOC. A total of 84 cases of ovarian masses and sera were enrolled, comprising EOC (n = 71), benign ovarian neoplasms (n = 13). We detected expression of candidate miRNAs in the serum and tissue of both benign ovarian neoplasm group and EOC group using real-time polymerase chain reaction. Immunohistochemistry were constructed using formalin fixed paraffin embedded (FFPE) tissue to detect expression level of suppressor of cytokine signaling 4 (SOCS4). In the EOC group, miRNA-1290 was significantly overexpressed in serum exosomes and tissues as compared to benign ovarian neoplasm group (fold change ≥ 2, p < 0.05). We observed area under the receiver operating characteristic curve (AUC) for miR-1290, using a cut-off of 0.73, the exosomal miR-1290 from serum had AUC, sensitivity, and specificity values of 0.794, 69.2 and 87.3, respectively. In immunohistochemical study, expression of SOCS4 in EOC was lower than that in benign ovarian neoplasm. Serum exosomal miR-1290 could be considered as a biomarker for differential diagnosis of EOC from benign ovarian neoplasm and SOCS4 might be potential target gene of miR-1290 in EOC.     

COPS5 Conferred the Platinum Resistance in Epithelial Ovarian Cancer

Development of platinum resistance is one of the major causes of epithelial ovarian cancer (EOC) treatment failure. COP9 signalosome subunit 5 (COPS5) was found to take part in the progression of EOC in our previous study. Herein, we aim to uncover the potential utility of COPS5 in EOC chemoresistance. COPS5 levels were analyzed to define clinic pathologic correlates using a matched tissue microarray and online datasets. The effect of COPS5 inhibition by the lentivirus-mediated short hairpin RNA on cell viability, proliferation and migration was accessed in vitro and in vivo. Results showed that COPS5 was upregulated in patients after platinum resistance. Kaplan–Meier survival curves revealed that COPS5 overexpression was correlated with shorter PFS and OS. COPS5 downregulation inhibited the cell proliferation, migration, and reduced the sensitivity of EOC to platinum. Overall, our data indicated that COPS5 inhibition might represent a new therapeutic strategy for overcoming platinum resistance in patients with EOC.     

Expression of Serum Amyloid A in Human Ovarian Epithelial Tumors: Implication for a Role in Ovarian Tumorigenesis

Serum amyloid A (SAA) is an acute phase protein which is expressed primarily in the liver as a part of the systemic response to various injuries and inflammatory stimuli; its expression in ovarian tumors has not been described. Here, we investigated the expression of SAA in human benign and malignant ovarian epithelial tumors. Non-radioactive in situ hybridization applied on ovarian paraffin tissue sections revealed mostly negative SAA mRNA expression in normal surface epithelium. Expression was increased gradually as epithelial cells progressed through benign and borderline adenomas to primary and metastatic adenocarcinomas. Similar expression pattern of the SAA protein was observed by immunohistochemical staining. RT-PCR analysis confirmed the overexpression of the SAA1 and SAA4 genes in ovarian carcinomas compared with normal ovarian tissues. In addition, strong expression of SAA mRNA and protein was found in the ovarian carcinoma cell line OVCAR-3. Finally, patients with ovarian carcinoma had high SAA serum levels, which strongly correlated with high levels of CA-125 and C-reactive protein. Enhanced expression of SAA in ovarian carcinomas may play a role in ovarian tumorigenesis and may have therapeutic application. (J Histochem Cytochem 58:1015–1023, 2010)     

Lipocalin2 Expressions Correlate Significantly With Tumor Differentiation in Epithelial Ovarian Cancer

We recently identified lipocalin2 (LCN2) as being upregulated in ovarian cancer cell lines. The purpose of this study was to validate LCN2 upregulation in ovarian cancers and to investigate its potential as a serum biomarker. We assayed LCN2 expression in ovarian cancers using real-time PCR and IHC. To evaluate the potential of LCN2 as a biomarker, we measured serum LCN2 levels in 54 ovarian cancers, 15 borderline and 53 benign ovarian tumors, and 90 healthy controls. SYBR green PCR and IHC showed LCN2 overexpression in ovarian cancers. LCN2 immunoreactivity was significantly associated with tumor differentiation (p=0.009), as well-differentiated tumors showed the highest LCN2 expression. Serum LCN2 level in ovarian cancer was significantly higher than in the other study groups (p<0.001), and in accordance with IHC results, it also correlated with tumor differentiation, with well-differentiated tumors having the highest value. The sensitivity and specificity of LCN2 in detecting ovarian cancer was 72.2% and 50.4%, respectively. By Cox univariate analysis, LCN2 positivity was an independent prognostic factor for overall survival (hazard ratio = 1.47, p=0.012). In conclusion, LCN2 expressions are upregulated and related to tumor differentiation in ovarian cancers and should be included in future research assessing potential biomarkers for ovarian cancer. (J Histochem Cytochem 57:513–521, 2009)     

Effect of Ovarian Cancer Ascites on Cell Migration and Gene Expression in an Epithelial Ovarian Cancer In Vitro Model

A third of patients with epithelial ovarian cancer (EOC) present ascites. The cellular fraction of ascites often consists of EOC cells, lymphocytes, and mesothelial cells, whereas the acellular fraction contains cytokines and angiogenic factors. Clinically, the presence of ascites correlates with intraperitoneal and retroperitoneal tumor spread. We have used OV-90, a tumorigenic EOC cell line derived from the malignant ascites of a chemonaive ovarian cancer patient, as a model to assess the effect of ascites on migration potential using an in vitro wound-healing assay. A recent report of an invasion assay described the effect of ascites on the invasion potential of the OV-90 cell line. Ascites sampled from 31 ovarian cancer patients were tested and compared with either 5% fetal bovine serum or no serum for their nonstimulatory or stimulatory effect on the migration potential of the OV-90 cell line. A supervised analysis of data generated by the Affymetrix HG-U133A GeneChip identified differentially expressed genes from OV-90 cells exposed to ascites that had either a nonstimulatory or a stimulatory effect on migration. Ten genes (IRS2, CTSD, NRAS, MLXIP, HMGCR, LAMP1, ETS2, NID1, SMARCD1, and CD44) were upregulated in OV-90 cells exposed to ascites, allowing a nonstimulatory effect on cell migration. These findings were validated by quantitative polymerase chain reaction. In addition, the gene expression of IRS2 and MLXIP each correlated with prognosis when their expression was assessed in an independent set of primary cultures established from ovarian ascites. This study revealed novel candidates that may play a role in ovarian cancer cell migration.     

卵巢上皮癌中ING4 基因启动子的甲基化状态及其临床意义

目的：探讨卵巢上皮癌中ING4 基因启动子的甲基化状态及其临床意义。方法：收集2005 年7 月至2012 年6 月哈尔滨医科 大学附属第一医院行全面分期手术并经病理检查确诊的150 例卵巢上皮癌组织标本,并以同期因子宫肌瘤或子宫腺肌症行子宫 全切除术或次全切除术并经病理检查确诊为正常卵巢组织的150 例标本作为对照组。采用甲基化特异性PCR（MSP）技术检测卵 巢上皮癌组织与正常卵巢组织中ING4 基因启动子的甲基化状态,蛋白印迹法检测ING4 蛋白的表达,并分析ING4 基因启动子 的甲基化状态与卵巢上皮癌临床病例特征的关系。结果：卵巢上皮癌组织中ING4 基因启动子的甲基化阳性率为42.7%（64/150）, 明显高于正常卵巢组织（4%,6/150）,差异有统计学意义（P<0.05）。ING4 基因启动子甲基化阳性的卵巢上皮癌组织中ING4蛋白 表达阴性或弱阳性;ING4 基因启动子甲基化阴性的卵巢上皮癌和正常卵巢组织中ING4 蛋白表达阳性;在64 例ING4 基因启动 子甲基化的卵巢上皮癌组织中,ING4 蛋白表达强度与ING4 基因启动子的甲基化程度呈负相关（r=-0.435,P<0.05）。卵巢上皮癌 组织中,ING4 基因甲基化的阳性率随着手术病理分期和组织学分级的增加而增加（P<0.05）;卵巢透明细胞癌（55.6%,10/18）和卵 巢子宫内膜样癌（59.3%,16/27）中ING4 基因甲基化的阳性率显著高于浆液性囊腺癌（33.9%,20/59）和粘液性囊腺癌（39.1%, 18/46）（P<0.05）;ING4基因启动子的甲基化状态与患者的年龄、有无腹水及淋巴结转移均无显著相关性（P>0.05）。结论：ING4 基 因启动子的甲基化可能促进了其在卵巢上皮癌组织中的表达失活,进而促进了卵巢上皮癌的生长和分化。