胃癌患者血清巨噬细胞移动抑制因子水平的临床意义

目的：检测胃癌患者血清巨噬细胞移动抑制因子（MIF）的浓度水平，并评估其在胃癌诊断中的应用价值。方法用ELISA方法检测2007年2月至2010年4月在我院手术胃癌患者106例，其中男71例，女35例，平均年龄56.2岁（22～78岁）。所有病例均经病理学确认为原发性胃癌）、48例胃炎患者（接受胃镜检查诊断为慢性胃炎）及50例健康（健康体检者，排除一切肿瘤以及炎症性相关疾病）对照者血清MIF水平，同时测定癌胚抗原CEA。通过多因素Logistic回归分析，利用受试者工作特征（ROC）曲线分析MIF、CEA以及联合诊断对胃癌的诊断价值。结果胃癌患者血清中MIF平均浓度为4586 pg/ml，均高于单纯胃炎患者（1602.4 pg/ml）和健康对照（1105.6 pg/ml），差异均有显著统计学意义（P均＜0.05）。胃癌患者血清MIF的水平与患者性别、年龄、病理类型不相关。但胃癌患者血清MIF水平随着肿瘤分期的升高而升高，差异有显著统计学意义（P＜0.05）。伴有淋巴结转移胃癌患者MIF水平显著高于未转移者（P＜0.05）。根据ROC曲线分析，MIF检测胃癌的临界值为3018 pg/ml时诊断效能最大，敏感度为79.4%，特异度为85.1%。MIF与CEA联合检测诊断价值高于单独诊断（P＜0.05）。结论胃癌患者血清中存在高水平的MIF，MIF可能为胃癌潜在的肿瘤标志物，MIF联合CEA可提高胃癌的诊断率，值得临床应用。

Clinical significance of macrophage migration inhibitory factor as a new tumor marker for gastric cancer

Objective To detect the serum levels of macrophage migration inhibitory factor（ MIF） in patients with gastric cancer , and to evaluate its application value in the diagnosis of gastric cancer. Methods We used ELISA to detect the serum MIF in 106 patients with gastric cancer,48 patients with gastritis and 50 healthy controls, simultaneous determination of carcinoembryonic antigen CEA. The multivariate logistic regression analysis and univariate receiver operating characteristic （ROC） analyses were done for CEA and MIF. Results The average MIF concentration （4586 pg/ml） in gastric cancer patients was significantly higher than in gastritis patients （1602.4 pg/ml） and healthy donors （1105.6pg/ml）,the differences were statistically significant （P〈0.05）.The MIF levels were not related with sex, age and pathology types,but the level of serum MIF in patients with gastric cancer increased with stage of the tumor and the difference was statistically significant （P〈0.05）,significantly higher than that without metastasis metastatic gastric cancer MIF level in patients with lymph node （P〈0.05）. According to the analysis of ROC curve, the critical value of MIF detection in gastric cancer was 3018 pg/ml in the diagnosis of maximum efficiency, the sensitivity was 79.4%, specificity was 85.1%. The value of combined detection of MIF and CEA is higher than single diagnosis（P〈0.05）. Conclusion We conclude that MIF is a promising new biomarker for gastric cancer, and the combination of MIF and CEA increase the sensitivity and specificity of detection of gastric cancer.