目的：通过与CA125比较，探讨外周血KISS1 mRNA在上皮性卵巢癌（epithelial ovarian cancer，EOC）中的诊断价值。方法：采集2010年1月至2014年1月在南通大学第二附属医院住院拟手术的EOC患者40例手术前一天的外周静脉血和正常健康者静脉血，用RT-PCR法和电化学发光法分别检测外周血KISS1 mRNA和CA125的表达。结果：EOC早期组（Ⅰ~Ⅱ期）、晚期组（Ⅲ~Ⅳ期）KISS1 mRNA的表达量均显著高于正常健康者（均 P <0.01），而早期与晚期EOC组间比较无显著差异（ P >0.05）；EOC晚期组CA125的表达量明显高于早期组及正常健康者（均 P <0.01），而早期组与正常健康者比较无显著差异（ P >0.05）。KISS1 mRNA ROC(receptive operator character curve, ROC)曲线的切值（cutoff)设为0.51、0.72时，阳性预测值（positive predictive value，PPV）分别为0.58和1，阴性预测值（negative predictive value, NPV）分别为0.92和0.7；CA125的cutoff值设为20、100 U/ml时，PPV分别为0.72和1，NPV分别为0.87和0.81。KISS1 mRNA、CA125对EOC均具有中度诊断效能（ P =0.34）；两者比较， KISS1 mRNA对早期EOC具有较高诊断价值（ P =0.018），而CA125对晚期EOC的诊断价值较高（ P <0.01）。结论：患者外周血KISS1 mRNA与CA125对EOC具有同等的诊断价值，KISS1 mRNA可作为EOC的一个新的肿瘤标志物；两者的联合检测可提高EOC的诊断效能，特别是早期EOC的诊断率。

Objective: To assess the diagnostic value of KISS1 mRNA in peripheral blood from patients with epithelial ovarian cancer (EOC) through comparison with CA125 measurement. Methods: Peripheral bloods were collected from 20 healthy individuals and 40 EOC patients, admitted into the Second Affiliated Hospital of Nantong University between January 2010 and January 2014, the day before the planned operations. The level of KISS1 mRNA in these blood samples was quantitated by RT-PCR, and in comparison, CA125 level in the same group of samples was measured by a chemiluminescence-based immunoassay. Results: KISS1 mRNA level in the peripheral blood from EOC patients of all stages was significantly higher than that of the healthy group ( P <0.01). However, the mRNA level in blood from patients with early EOC (FIGO Ⅰ & Ⅱ) was not significantly different from that of the advanced EOC (FIGO Ⅲ & Ⅳ) patients ( P >0.05). In contrast, CA125 level of the advanced EOC group was significantly higher than that of the early EOC group and the healthy group ( P <0.01). However, no significant differences of CA125 levels were found between the early EOC patients and the healthy volunteers ( P >0.05). When the cutoff values of receptive operator character curve (ROC) for the KISS1 mRNA were set to be 0.51 and 0.72, the corresponding positive predictive values (PPV) were 0.58 and 1.0, and the negative predictive values (NPV) were 0.92 and 0.7 respectively. When the cutoff values were 20 U/ml and 100U/ml for CA125 levels, the PPV were 0.72 and 1.0, and the NPV were 0.87 and 0.81, indicating that both KISS1 mRNA and CA125 levels have a moderate diagnostic efficiency ( P =0.34) for EOC. While the KISS1 mRNA level has a higher diagnostic value than that of CA125 for early stages of EOC ( P =0.018), CA125 measurement is more valuable than the KISS1 mRNA level in diagnosing advanced EOC ( P <0.018). Conclusion: KISS1 mRNA in peripheral blood is a potential novel biomarker. When deployed together with CA125 assay, it would likely improve the diagnosis of EOC, especially for the early stage cancer.

南通市社会事业科技创新与示范计划资助项目（No. HS2013039）。