结直肠癌患者手术前后血清IGF-1水平变化及临床价值分析

目的 用酶联免疫吸附测定法检测结直肠癌患者手术前后血清 IGF-1的含量，并探讨其手术前后血清水平变化及在结直肠癌发生发展中的作用。方法 选取在佳木斯大学附属第一医院首次确诊并行结直肠癌切除术患者共30例为观察组，于手术前清晨及术后30 d采集空腹静脉血。选取同时期体检健康者30例为对照组，采集体检当日空腹静脉血。用Elisa法检测两组患者血清IGF-1的含量，观察血清IGF-1含量在两组中的变化规律，分析IGF-1与结直肠癌临床各参数的关系。结果 观察组术前血清IGF-1水平为（200.48±42.25）ng/ml，高于观察组术后的（164.52±35.45）ng/ml和对照组的（146.26±43.14）ng/ml，差异有统计学意义（P＜0.05）；观察组术后血清IGF-1水平较对照组稍高，但差异无统计学意义（P＞0.05）；高分化、中分化者血清IGF-1水平低于低分化者，差异有统计学意义（P＜0.05）；Dukes分期中A+B和C+D期之间比较，差异有统计学意义（P＜0.05）。结论 结直肠癌患者血清IGF-1参与结直肠癌的病变过程，是一种有促进细胞增殖、分化等多种生物学活性的细胞因子，可能作为结直肠癌发生、发展的重要预测指标及手术切除后手术效果的评定指标之一。

Analysis of Changes and Clinical Value of Serum IGF-1 Levels in Patients with Colorectal Cancer before and after Operation

Objective To detect the serum levels of IGF-1 in patients with colorectal cancer before and after operation by enzyme-linked immunosorbent assay (ELISA), and to explore the changes of serum levels before and after operation and the development of colorectal cancer. Methods A total of 30 patients with primary colorectal cancer resection were enrolled in the First Affiliated Hospital of Jiamusi University. The fasting venous blood was collected in the early morning before surgery and 30 d after surgery. At the same time, 30 healthy subjects in the same period of physical examination were selected as the control group, and fasting venous blood was collected on the day of physical examination. Serum IGF-1 levels were measured by Elisa method. The changes of serum IGF-1 levels in the two groups were observed. The relationship between IGF-1 and clinical parameters of colorectal cancer was analyzed. Results The preoperative serum IGF-1 level in the observation group was (200.48±42.25) ng/ml, which was higher than that in the observation group (164.52±35.45) ng/ml and the control group (146.26±43.14) ng/ml,the difference was statistically significant (P<0.05). The level of serum IGF-1 in the observation group was slightly higher than that in the control group, but the difference was not statistically significant (P>0.05). The high-differentiation and moderately differentiated patients had low serum IGF-1 level. In the poorly differentiated, the difference was statistically significant (P<0.05); the difference between A+B and C+D in Dukes stage was statistically significant (P<0.05). Conclusion Serum IGF-1 in colorectal cancer patients is involved in the pathological process of colorectal cancer. It is a cytokine that promotes various biological activities such as cell proliferation and differentiation. It may be an important predictor and operation for colorectal cancer. One of the evaluation indicators of the surgical effect after resection.