卵巢癌电镜扫描图（图）
美国拉什大学医学院的科学家最近发现了不孕妇女血液中的一种蛋白分子可用作早期卵巢癌诊断的生物标记。
该蛋白分子是一种人体自身免疫系统对间皮素（mesothelin）产生反应时产生的抗体。该蛋白通常广泛表达于卵巢癌细胞的表面，而在正常组织中只有极少量细胞表达
这项研究的论文发表在最新一期的《Cancer Epidemiology, Biomarkers & Prevention》杂志上。
论文的第一作者，拉什大学药理学、妇产科学和预防药物专家Judith Luborsky博士认为这项发现及其重要，因为目前临床上还没有能早期检测卵巢癌的方法，这也是为何该疾病死亡率高的主要原因。
Luborsky博士说道：“这项研究中发现的卵巢癌生物标记是独一无二的，我们不仅仅只研究那些患有卵巢癌的病人，还检测了那些很可能患上卵巢癌和正常的人。”
由于卵巢的胚胎发育，组织解剖及内分泌功能较复杂，它所患的肿瘤可能是良性或恶性。 因卵巢癌临床早期无症状，鉴别其组织类型及良恶性相当困难，卵巢癌在剖腹探查术中发现肿瘤局限于卵巢的仅占30%，大多数已扩散到子宫双侧附件，大网膜及盆腔各器官，所以卵巢癌在诊断和治疗上确是一大难题。多年来专家们对卵巢恶性肿瘤的病理形态，临床发生发展规律及治疗方案进行了许多的探讨，积累了大量的经验。到目前为止，就国内外临床资料统计，其五年生存率仅25%～30% 。卵巢癌是相对常见的病，大约有1.4%的女性会患上这种病。但是如果发现得早，90%的病人都能活下来；发现得迟，癌细胞扩散到卵巢，存活率就低于30%。
在拉什大学的这项研究中，科学家们测试了109位不孕妇女血液中的间皮素抗体，其中28位诊断有卵巢癌，24位有早期卵巢癌迹象，并与152位健康女性比较。其中不孕的原因有子宫内膜异位、排卵失常、卵巢功能早衰或不明原因。
结果显示，在卵巢功能早衰、排卵失常和未知原因导致不孕的妇女中，间皮素抗体的表达水平在卵巢癌患者和早期患者中均明显较高。而子宫内膜异位病人和正常妇女较低。科学家们解释子宫内膜异位主要和另一种不同的卵巢癌相关，所以间皮素抗体水平较低。
Luborsky说道：“之前就有假设推断自身免疫性反应或其它的一些因素会导致恶性肿瘤的发生。这些抗体会在卵巢组织发生癌变的早期就表达升高，因此它很有可能用于未来临床上卵巢癌的诊断分子。”（生物探索 Jun译）
生物探索推荐英文论文原文摘要：
Autoantibodies to Mesothelin in Infertility
Background: According to extensive epidemiologic data, infertility is associated with increased ovarian cancer risk. Previous studies showed that both women with infertility and those with ovarian cancer have autoantibodies to ovarian antigens. The objective was to determine if women with infertility have antibodies to mesothelin, a well-characterized ovarian cancer antigen.
Methods: Sera were obtained from women with infertility (n = 109), ovarian cancer (n = 28), benign ovarian tumors or cysts (n = 24), and from healthy women (n = 152). Infertility included those with a risk for ovarian cancer; endometriosis (n = 23), ovulatory dysfunction (n = 17), premature ovarian failure (POF; n = 25) and unexplained infertility (n = 44). Sera were assayed for mesothelin antibodies and for circulating mesothelin antigen by immunoassay and compared with assay control sera (n = 16) to determine a positive result.
Results: Mesothelin antibodies were significantly more frequent in women with prematurely reduced ovarian function including ovulatory dysfunction (59%), ovarian failure (44%) and unexplained infertility (25%) compared with controls. In contrast, women with endometriosis, who also have a high risk for ovarian cancer, did not have mesothelin antibodies. Serum levels of mesothelin were rarely elevated in women with infertility but were high in most patients with ovarian cancer.
Conclusions and Impact: We show for the first time that antibodies to mesothelin, a well-characterized ovarian cancer antigen, occur in some women with epidemiologic risk for ovarian cancer. The results suggest it may be possible to identify which women with infertility have ovarian cancer risk.
