急性时相蛋白在胃癌复发早期诊断中的价值

目的:探讨血清急性时相蛋白变化在评估胃癌患者预后及术后复发早期诊断中的价值。方法:全自动速率散射比浊法检测120名胃癌患者手术前、后血清急性时相蛋白的水平;胃癌根治术87名患者,术后每3个月随访一次,且检测血清急性时相蛋白水平,现察其复发情况,至少随防18个月或至死亡。结果:胃癌组血清C反应蛋白(CRP)、α1-抗胰蛋白酶(α1-AT)和α-酸性糖蛋白(α-AG)水平显著高于健康对照组及良性胃病组(P<0.001),铜蓝蛋白(CER)、转铁蛋白(TFR)和前白蛋白(PAB)水平差异无显著性(P>0.05);胃癌术后一定时期血清CRP、α1-AT和α-AG水平显著低于术前水平(P<0.01或P<0.05),其它指标差异无显著性(P>0.05)。复发组30例,其血清CRP、α1-AT和α-AG水平一定时期后逐渐升高;无复发组57例,其血清CRP/α1-AT和α-AG水平则维持在相对恒定的正常水平,手术前后差异有显著性(P<0.01)。联合检测CRP、α1-AT和α-AG,对复发肿瘤诊断的敏感性、特异性、准确性、阳性预测值和阴性预测值分别达到90.91％、83.33％、90.48％、90.48％和83.33％。结论:联合检测急性时相蛋白可评估胃癌患者的预后,能为胃癌术后复发的早期诊断提供可靠的临床信息。

The value of acute- phase proteins in early recurrence diagnosis after curative gastric cancer surgery

Objective To understand the value of acute - phase protein measurements on the assessing prognosis and the early diagnosis in recurrence after curative gastric cancer surgery. Methods Acute - phase serum protein levels were measured before and after curative gastric cancer surgery in 120 patients. The levels of C- reactive protein ( CRP ), α1 - antitrypsin ( α1 -AT) and α1 - acid glucoprotein ( α1 - AG) of 87 patients were measured every three months after thoroughly curative gastric cancer surgery, they were observed for minimum 18 months or until death. Results The levels of serum CRP α1 - AT and α1 - AG in patients with gastric cancer were significantly higher than that in control group and benign gastric lesions group ( P < 0.01); in a certain period, serum levels of acute - phase protein in patients after curative gastric cancer surgery were significantly lower than those in patients before surgery( P <0.05). There were 30 cases was found recurrence, the level of serum CRP α1 - At and α1 - AT increased gradually, after a certain period, Butthe level of serum CRP,α1 - AT and α1 -AG in the nan - recurrence group keeped invariablences relatively, they -were significant before and after operation ( P < 0. 01. Combine crp、α1 - AT and α1 - AG, the sensitivity , specificity , accuracy , positive forecast numerical value and negative forecast value was 90.91% 、83.33% 、90.48% 、90.48% and 83.33% respectively Conclusion Combine CRP α1 - AT and α1 - AG may assess the prognosis of gastric cancer, it may provide clinically useful information about tumor recurrence after curative gastric cancer surgery