血清EpCAM、sE-Cad和FAM64A mRNA对卵巢癌患者腹腔镜根治术后复发转移的预测价值

doi:10.3969/j.issn.1673-8640.2026.05.005

摘要/Abstract

摘要：

目的探讨血清上皮细胞黏附分子（EpCAM）、可溶性上皮型钙黏蛋白（sE-Cad）和FAM64A mRNA基因对腹腔镜卵巢癌根治术后患者复发转移的预测价值。方法选取2022年1月—2023年1月青海红十字医院行腹腔镜根治术的卵巢癌患者100例。收集所有患者的临床资料，并检测术前血清EpCAM、sE-Cad水平和FAM64A mRNA相对表达量。对所有患者随访1年，根据复发和转移情况分为复发转移组（14例）、未复发转移组（86例）。采用受试者工作特征（ROC）曲线评价血清EpCAM、sE-Cad联合FAM64A mRNA判断卵巢癌患者术后复发转移的效能。结果复发转移组和未复发转移组国际妇产科联合会（FIGO）分期差异有统计学意义（P<0.05），其他临床资料差异均无统计学意义（P>0.05）。Ⅲ期卵巢癌患者血清EpCAM、sE-Cad水平和FAM64A mRNA相对表达量均显著高于Ⅱ期卵巢癌患者（P<0.05）。复发转移组血清EpCAM、sE-Cad水平和FAM64A mRNA相对表达量均显著高于未复发转移组（P<0.05）。血清EpCAM、sE-Cad、FAM64A mRNA单项检测和联合检测判断卵巢癌患者术后复发转移的曲线下面积（AUC）分别为0.802、0.793、0.736、0.947。结论腹腔镜根治术后出现复发转移的卵巢癌患者术前血清EpCAM、sE-Cad水平和FAM64A mRNA表达显著升高，3项指标联合检测对卵巢癌术后复发转移有较高的预测价值。

关键词: 上皮细胞黏附分子, 可溶性上皮型钙黏蛋白, FAM64A基因, 腹腔镜卵巢癌根治术, 复发转移

Abstract:

Objective To investigate the predictive roles of serum epithelial cell adhesion molecule（EpCAM），soluble epithelial cadherin（sE-Cad）and FAM64A mRNA for recurrence and metastasis in ovarian cancer patients after laparoscopic radical surgery. Methods A total of 100 patients with ovarian cancer who underwent laparoscopic radical surgery at Qinghai Red Cross Hospital from January 2022 to January 2023 were enrolled. The clinical data were collected，and the levels of serum EpCAM and sE-Cad before surgery and the relative expression level of FAM64A mRNA were determined. All the patients were followed up for 1 year，and they were classified into recurrence and metastasis group（14 cases）and non-recurrence and metastasis group（86 cases）. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of serum EpCAM，sE-Cad combined with FAM64A mRNA in predicting recurrence and metastasis in ovarian cancer patients after surgery. Results There was a statistical significance in the International Federation of Gynecology and Obstetrics（FIGO）stages between recurrence and metastasis group and non-recurrence and metastasis group（P<0.05），while there was no statistical significance in the other clinical data（P>0.05）. The levels of serum EpCAM，sE-Cad and FAM64A mRNA relative expression in stage Ⅲ ovarian cancer patients were higher than those in stage Ⅱ ovarian cancer patients（P<0.05）. The levels of serum EpCAM，sE-Cad and FAM64A mRNA relative expression in recurrence and metastasis group were higher than those in non-recurrence and metastasis group（P<0.05）. The areas under curves（AUC）of single and combined determinations of serum EpCAM，sE-Cad and FAM64A mRNA for predicting recurrence and metastasis in ovarian cancer patients after surgery were 0.802，0.793，0.736 and 0.947，respectively. Conclusions The levels of serum EpCAM，sE-Cad and FAM64A mRNA expression are increased in ovarian cancer patients with recurrence and metastasis after laparoscopic radical surgery. The combined determination has a high predictive value for recurrence and metastasis in ovarian cancer patients after surgery.

Key words: Epithelial cell adhesion molecule, Soluble epithelial cadherin, FAM64A gene, Laparoscopic ovarian cancer radical surgery, Recurrence and metastasis

中图分类号:

R446.62

万颜婕, 王乾印, 丁鑫. 血清EpCAM、sE-Cad和FAM64A mRNA对卵巢癌患者腹腔镜根治术后复发转移的预测价值[J]. 检验医学, 2026, 41(5): 446-451.

WAN Yanjie, WANG Qianyin, DING Xin. Predictive roles of serum EpCAM，sE-Cad and FAM64A mRNA for recurrence and metastasis in ovarian cancer patients after laparoscopic radical surgery[J]. Laboratory Medicine, 2026, 41(5): 446-451.

图/表 6

表1 引物序列

基因名称	上游引物（5'~3'）	下游引物（5'~3'）
FAM64A	GGTCGAAGAAGGGCAAGCAG	CACCATTCCAAGCACAACACC
GAPDH	GGGCCAAAAGGGTCATCATC	ATGACCTTGCCCACAGCCTT

表2 复发转移组和未复发转移组临床资料比较

图1 不同FIGO分期卵巢癌患者血清EpCAM、sE-Cad水平和FAM64A mRNA相对表达量比较注：（a）EpCAM；（b）sE-Cad；（c）FAM64A mRNA。

图2 未复发转移组和复发转移组血清EpCAM、sE-Cad水平和FAM64A mRNA相对表达量比较注：（a）EpCAM；（b）sE-Cad；（c）FAM64A mRNA。

表3 血清EpCAM、sE-Cad、FAM64A mRNA单项检测和联合检测判断卵巢癌患者术后复发转移的效能

项目	AUC（95%CI^①）	最佳临界值	敏感性/%	特异性/%	Youden指数
EpCAM	0.802（0.711~0.875）	31.791 pg·mL^-1	64.29	86.05	0.503
sE-Cad	0.793（0.701~0.868）	2 280.134 pg·mL^-1	57.14	94.19	0.513
FAM64A mRNA	0.736（0.638~0.819）	1.146	57.14	86.05	0.432
联合检测	0.947（0.883~0.982）	0.567	92.86	84.88	0.777

图3 血清EpCAM、sE-Cad、FAM64A mRNA单项和联合检测判断卵巢癌患者术后复发转移的ROC曲线注： EpCAM； sE-Cad； FAM64A mRNA；联合检测；参考线。

参考文献 24

[1]	蒋冬, 杨旭, 帅旭. 卵巢癌患者腹腔镜术后外周血IL-37、HK10、SMRP水平监测意义研究[J]. 中国性科学, 2024, 33(1):98-102.
[2]	董延华, 张彩丽, 樊荣, 等. 腹腔镜根治术对卵巢癌患者生活质量、并发症发生情况及预后的影响[J]. 癌症进展, 2023, 21(23):2621-2624.
[3]	VITO ANDREA C, UCCELLA S, SOZZI G, et al. Primary site disease and recurrence location in ovarian cancer patients undergoing primary debulking surgery vs. interval debulking surgery[J]. Eur J Surg Oncol, 2021, 47(5):1075-1082. DOI PMID
[4]	KAN T, ZHANG S, ZHOU S, et al. Single-cell RNA-seq recognized the initiator of epithelial ovarian cancer recurrence[J]. Oncogene, 2022, 41(6):895-906. DOI PMID
[5]	XIAO D, XIONG M, WANG X, et al. Regulation of the function and expression of EpCAM[J]. Biomedicines, 2024, 12(5):1129. DOI URL
[6]	SÜER H, ERUS S, CESUR E E, et al. Combination of CEACAM5,EpCAM and CK19 gene expressions in mediastinal lymph node micrometastasis is a prognostic factor for non-small cell lung cancer[J]. J Cardiothorac Surg, 2023, 18(1):189. DOI
[7]	AZNAB M, SHAHHOSSEINI R, SAFAEI M, et al. Salivary and serum levels of soluble E-cadherin in patients with gastrointestinal cancers:a comparative study[J]. J Cancer Res Ther, 2023, 19(7):1982-1987. DOI URL
[8]	FU M, ZHANG J, ZHANG L, et al. Cell cycle-related FAM64A could be activated by TGF-β signaling to promote glioma progression[J]. Cell Mol Neurobiol, 2023, 43(6):2975-2987. DOI PMID
[9]	卵巢癌诊疗规范(2018年版)[J]. 肿瘤综合治疗电子杂志, 2019, 5(2):87-96.
[10]	AKTER S, RAHMAN M A, HASAN M N, et al. Recent advances in ovarian cancer:therapeutic strategies,potential biomarkers,and technological improvements[J]. Cells, 2022, 11(4):650. DOI URL
[11]	LIU S, WU M, WANG F. Research progress in prognostic factors and biomarkers of ovarian cancer[J]. J Cancer, 2021, 12(13):3976-3996. DOI PMID
[12]	LI D, GUO X, YANG K, et al. EpCAM-targeting CAR-T cell immunotherapy is safe and efficacious for epithelial tumors[J]. Sci Adv, 2023, 9(48):eadg9721.
[13]	JIANG X, WANG S, LIANG Q, et al. Unraveling the multifaceted role of EpCAM in colorectal cancer:an integrated review of its function and interplay with non-coding RNAs[J]. Med Oncol, 2023, 41(1):35. DOI
[14]	IBRAHIM H M, ABDELRAHMAN A E, ELSEBAI E, et al. Clinicopathologic impact of NANOG,ZEB1,and EpCAM biomarkers on prognosis of serous ovarian carcinoma[J]. Asian Pac J Cancer Prev, 2023, 24(9):3247-3259. DOI URL
[15]	CHEN W, YE S, WANG X, et al. Soluble E-cadherin promotes invasiveness of neoplastic cells in salivary gland carcinoma ex pleomorphic adenoma[J]. J Oral Pathol Med, 2023, 52(1):63-71. DOI URL
[16]	PAWAR N R, BUZZA M S, DURU N, et al. Matriptase drives dissemination of ovarian cancer spheroids by a PAR-2/PI3K/Akt/MMP9 signaling axis[J]. J Cell Biol, 2023, 222(11):e202209114. DOI URL
[17]	HU Q P, KUANG J Y, YANG Q K, et al. Beyond a tumor suppressor:soluble E-cadherin promotes the progression of cancer[J]. Int J Cancer, 2016, 138(12):2804-2812. DOI URL
[18]	何旻, 巢琳, 华亦汇. 乳腺癌改良根治术后血清sE-Cad、s-CD105水平与复发转移的相关性分析[J]. 中国现代医学杂志, 2024, 34(5):95-100.
[19]	庞倩, 蒙绪君, 肖钦晓. 基于数据挖掘分析FAM64A在肺腺癌中的表达模式和作用机制[J]. 东南大学学报(医学版), 2022, 41(5):629-636.
[20]	ZHAO X, CHEN H, QIU Y, et al. FAM64A promotes HNSCC tumorigenesis by mediating transcriptional autoregulation of FOXM1[J]. Int J Oral Sci, 2022, 14(1):25. DOI
[21]	SHINDEN Y, HIRASHIMA T, NOHATA N, et al. Molecular pathogenesis of breast cancer:impact of miR-99a-5p and miR-99a-3p regulation on oncogenic genes[J]. J Hum Genet, 2021, 66(5):519-534. DOI
[22]	ZHENG H C, REN D H, ZHANG C Y, et al. A bioinformatics analysis of the clinicopathological and prognostic significance of FAM64A mRNA expression in gynecological cancers[J]. J Obstet Gynaecol, 2023, 43(1):2216280. DOI URL
[23]	姚卓城. FAM64A通过调节细胞增殖与迁移参与乳腺癌的发生发展[D]. 广州: 南方医科大学, 2019.
[24]	西尔艾力·吾门尔, 赵艳萍. 18F-FDG PET/CT显像联合CA125及HE4在上皮性卵巢癌患者术后复发/转移诊断中的价值[J]. 分子影像学杂志, 2020, 43(1):70-75.