胃癌患者血清可溶性E-选择素检测的临床意义

目的：探讨血清可溶性E-选择素（sE-selectin ）检测在胃癌诊治中的临床意义。方法：采用ELISA 法检测200 例胃癌患者、45例胃良性疾病患者和40例健康体检者血清中的可溶性E-选择素水平，比较其中140 例胃癌患者手术前后血清可溶性E-选择素水平的变化，并对胃癌患者血清可溶性E-选择素、CEA 、CA199 和CA724 的阳性率进行比较。结果：胃癌组血清可溶性E-选择素表达水平为69.12± 18.19ng/mL，与正常对照组（15.85± 5.27ng/mL）及良性疾病组（19.47±7.88ng/mL）比较，差异性具有统计学意义（P<0.01）。 血清可溶性E-选择素阳性表达与肿瘤部位及组织学分型无明显相关（P>0.05），但与病理分期及肝转移呈正相关（P<0.05，P<0.01）。胃癌患者手术后血清可溶性E-选择素水平明显下降。胃癌患者血清可溶性E-选择素阳性率远远高于其他消化道肿瘤标物（CEA 、CA199、CA724），P<0.01。结论：可溶性E-选择素有可能成为胃癌早期辅助诊断、预测复发转移及评估预后有价值的肿瘤标记物。

Clinical Significiance of Detection of Serum Soluble E-selectin in Patients with Gastric Cancer

Objective:To study the clinical significance of serum soluble E-selectin (sE-selectin) in diagnosis and treat-ment of gastric cancer.Methods:Serum E-selectin was detected with ELISA in 200 cases of gastric cancer,45 cases of be-nign gastric diseases and 40 healthy controls.The changes in serum sE-selectin level of 140 patients with gastric cancer were analyzed before and after surgery, and the positive ratio of sE-selectin was compared with that of CEA,CA199 and CA724 in patients with gastric cancer.Results:The level of serum sE-selectin in patients with gastric cancer was 69.12±18.19 ng/mL,higher than that in those with benign diseases[(19.47±7.88)ng/mL] and healthy controls [(15.85±5.27)ng/mL].The differences were significant(P<0.01).The level of serum sE-selectin was correlated with clinical stage and hepatic me-tastasis in gastric cancer patients,but was not correlated with focal location and histological grade (P>0.05).The positive rate of serum sE-selectin in cases with hepatic metastasis was higher than that in those without hepatic metastasis (P<0.01).The level of serum sE-selectin in patients with gastric cancer declined significantly at one month after surgery.The positive rate of serum sE-selectin in patients with gastric cancer was much higher than that of other digestive tumor mark-ers(CEA,CA199,and CA724,P<0.01).Conclusion:sE-selectin may be a valuable marker for early diagnosis and progno-sis of gastric cancer.